Hair Regrowth with Novel Hemp Extract: A Case Series.

Q2 Medicine International Journal of Trichology Pub Date : 2023-01-01 Epub Date: 2023-04-19 DOI:10.4103/ijt.ijt_34_22
Gregory Luke Smith
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A hair count of the greatest area of alopecia was carried out before treatment was started and again after 6 months of treatment. To facilitate consistent hair count analysis, a permanent tattoo was placed at the point for maximum hair loss on the scalp. The subjects were also asked to qualitatively rate their psychosocial perception of \"scalp coverage\" improvement after the study was completed. The qualitative scale included \"very unhappy,\" \"unhappy,\" \"neutral,\" \"happy,\" and \"very happy.\" The subjects were photographed in a standard manner before and after the study. The photographs were compared for improvements in \"scalp coverage\" by an independent physician. The qualitative scale included \"none,\" \"mild,\" \"moderate,\" and \"extensive\" improvement of scalp coverage.</p><p><strong>Results: </strong>The results revealed that all subjects had some regrowth. This ranged from 31.25% (from 16 to 21 hairs) to 2000% (from 1 to 21 hairs). 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Abstract

Introduction: The endocannabinoid system (ECS), discovered in the 1990s, is a system involved with maintaining cellular homeostasis by down-regulating the damaging inflammatory responses and upregulating regenerative processes. Cannabidiol (CBD), tetrahydrocannabivarin (THCV), and cannabidivarin (CBDV) are all phytocannabinoids found in varying quantities in hemp extract. These three cannabinoids have novel therapeutic effects on hair regrowth through the ECS. The method of action is different from and synergistic with current hair regrowth therapies. The three cannabinoids are fat-soluble and poorly absorbed past the epidermis, but topical application easily reaches hair follicles where they act as partial or full CB1 antagonist and agonist of transient receptor potential vanilloid-1 (TRPV1) and vanilloid receptor-4 (TRPV4). All these ECS receptors relate to hair follicle function. Blocking the CB1 receptor on the hair follicle has been shown to result in hair shaft elongation; in addition, the hair follicle cycle (anagen, catagen, and telogen phases) is controlled by TRPV1. The effects of CBD on hair growth are dose dependent and higher doses may result in premature entry into the catagen phase through a different receptor known as TRPV4. CBD has also been shown to increase Wnt signaling, which causes dermal progenitor cells to differentiate into new hair follicles and maintains anagen phase of the hair cycle.

Objective: This study was conducted on subjects with androgenetic alopecia (AGA), as follow-up to a prior published study using hemp extract high in CBD without CBDV or THCV. That study showed an average 93.5% increase in hair numbers after 6 months of use. This subsequent study is being done to determine if daily topical application of a hemp-oil high in CBD, THCV, and CBDV concentrations would result in improved hair regrowth in the area of the scalp most affected by AGA.

Materials and methods: A case series study was done of 31 (15 men and 16 women, 27 Caucasian, 2 Asian, and 1 mixed race) subjects with AGA. They used a once-daily topical hemp extract formulation, averaging about 33 mg/day for 6 months. A hair count of the greatest area of alopecia was carried out before treatment was started and again after 6 months of treatment. To facilitate consistent hair count analysis, a permanent tattoo was placed at the point for maximum hair loss on the scalp. The subjects were also asked to qualitatively rate their psychosocial perception of "scalp coverage" improvement after the study was completed. The qualitative scale included "very unhappy," "unhappy," "neutral," "happy," and "very happy." The subjects were photographed in a standard manner before and after the study. The photographs were compared for improvements in "scalp coverage" by an independent physician. The qualitative scale included "none," "mild," "moderate," and "extensive" improvement of scalp coverage.

Results: The results revealed that all subjects had some regrowth. This ranged from 31.25% (from 16 to 21 hairs) to 2000% (from 1 to 21 hairs). The average increase was statistically significant 246% (15.07 hairs/cm2 increase) in men and 127% (16.06 hairs/cm2) in women. There were no reported adverse effects. All subjects rated their psychosocial perception of the effects of the hair loss, as "happy" or "very happy." Independent review of the photographs revealed evidence of "mild" to "extensive" scalp coverage improvements for all of the subjects.

Conclusion: Although the exact mechanism of therapeutic effects is not known, THCV and CBDV are most likely functioning as full CB1 receptor neutral antagonists and CBD is most likely functioning as a partial CB1 receptor antagonist and potentially through Wnt messaging. All three cannabinoids were functioning as TRPV1 agonists. The addition of menthol through the peppermint extract is probably acting through promoting a rapid onset of anagen phase. This topical hemp formulation was superior to oral finasteride, 5% minoxidil once daily foam and CBD topical extract alone. Since this hemp extract works through novel mechanisms entirely different from both finasteride and minoxidil, it can be used in conjunction with these current drugs and would be expected to have synergistic effects. However, safety and efficacy of this combination would be to be evaluated.

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新型大麻提取物头发再生:案例系列。
引言:内源性大麻素系统(ECS)于20世纪90年代被发现,是一个通过下调破坏性炎症反应和上调再生过程来维持细胞稳态的系统。大麻二酚(CBD)、四氢大麻酚(THCV)和大麻素(CBDV)都是大麻提取物中含量不同的植物大麻素。这三种大麻素通过ECS对头发再生具有新的治疗作用。该作用方法与目前的头发再生疗法不同,并具有协同作用。这三种大麻素是脂溶性的,通过表皮吸收很差,但局部应用很容易到达毛囊,在毛囊中它们作为瞬时受体电位香草素-1(TRPV1)和香草素受体-4(TRPV4)的部分或全部CB1拮抗剂和激动剂。所有这些ECS受体都与毛囊功能有关。阻断毛囊上的CB1受体已被证明会导致发干伸长;此外,毛囊周期(生长期、衰退期和休止期)由TRPV1控制。CBD对头发生长的影响是剂量依赖性的,更高的剂量可能导致通过一种称为TRPV4的不同受体过早进入紧张期。CBD还被证明可以增加Wnt信号传导,使真皮祖细胞分化为新的毛囊,并维持头发周期的生长期。目的:本研究针对雄激素性脱发(AGA)受试者,作为先前发表的一项研究的后续研究,该研究使用CBD含量高的大麻提取物,不含CBDV或THCV。该研究显示,使用6个月后,头发数量平均增加93.5%。这项后续研究旨在确定每天局部施用CBD、THCV和CBDV浓度高的大麻油是否会改善受AGA影响最严重的头皮区域的头发再生。材料和方法:对31名AGA受试者(15名男性和16名女性、27名高加索人、2名亚洲人和1名混血)进行了一项病例系列研究。他们使用了一种每天一次的局部大麻提取物配方,6个月内平均约33毫克/天。在治疗开始前和治疗6个月后,对脱发最大区域进行毛发计数。为了便于进行一致的头发数量分析,在头皮上最大程度脱发的部位放置了一个永久性纹身。研究完成后,受试者还被要求对他们对“头皮覆盖”改善的心理社会感知进行定性评价。定性量表包括“非常不快乐”、“不快乐”,“中性”、“快乐”和“非常快乐”。受试者在研究前后以标准的方式拍照。一位独立医生对这些照片的“头皮覆盖率”进行了比较。定性量表包括头皮覆盖率的“无”、“轻度”、“中度”和“广泛”改善。结果:结果显示,所有受试者都有一些再生。这一比例从31.25%(16至21根头发)到2000%(1至21根毛发)不等。男性的平均增长率为246%(15.07根毛发/cm2),女性为127%(16.06根毛发/cm3),具有统计学意义。无不良反应报告。所有受试者对脱发影响的心理社会感知评分为“快乐”或“非常快乐”。对照片的独立审查显示,所有受试对象的头皮覆盖率都有“轻度”到“广泛”的改善。结论:尽管治疗效果的确切机制尚不清楚,但THCV和CBDV最有可能作为完全CB1受体中性拮抗剂发挥作用,CBD最有可能是部分CB1受体拮抗剂,并可能通过Wnt信息传递发挥作用。所有三种大麻素都作为TRPV1激动剂发挥作用。通过薄荷提取物添加薄荷醇可能是通过促进生长期的快速开始起作用的。这种局部大麻制剂优于口服非那雄胺、5%米诺地尔每日一次泡沫和单独的CBD局部提取物。由于这种大麻提取物的作用机制与非那雄胺和米诺地尔完全不同,因此可以与这些现有药物联合使用,并有望产生协同作用。然而,这种组合的安全性和有效性有待评估。
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A Cross-sectional Observational Study to Correlate the Trichoscopic Findings of Female Pattern Hair Loss with the Disease Severity and Underlying Histopathological Changes. A Study of Serum Ferritin and Thyroid-Stimulating Hormone Levels in Male Patients with Androgenetic Alopecia. Alopecia Areata with Renal Dysgenesis. Graham-Little-Piccardi-Lassueur Syndrome with Mucosal Involvement: A Rare Case. Mucinous Lupus Alopecia with Papulonodular Mucinosis as a Sole Cutaneous Manifestation of Systemic Lupus Erythematosus.
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