In addition to effectively treating a persistent case of atopic dermatitis, dupilumab caused hair growth in a young patient with years of total alopecia.
The dual efficacy of the interleukin-4 (IL-4) receptor alpha antagonist, which was approved by the US Food and Drug Administration in March 2017 for the treatment of moderate to severe atopic dermatitis, can be explained by common links in the pathogenesis of atopic dermatitis and total alopecia.
In the article estet-portal.com you can read the results of the study in detail.
- Similarities in the pathogenesis of alopecia and atopic dermatitis
- Winter Dry Hair Tips
- Disorders that can cause dry hair
- Winter hair care: the secrets of professionals
- An unexpected effect of dupilumab
- Alopecia due to atopic dermatitis
- Treatment of atopic dermatitis and alopecia – suppression of autoimmune activity
Similarities in the pathogenesis of alopecia and atopic dermatitis
Atopic dermatitis is a disease with elevated IL-4, IL-5, IL-13 and IL-31. Dupilumab combats eczema by blocking the signaling of the cytokines IL-4 and IL-13, which play a role in maintaining the T-helper-2 (TH2) immune response that activates B cells.
Alopecia totalis (alopecia totalis) is a generalized form of alopecia areata, leading to complete baldness on the entire head, sometimes on other areas of the skin.
Atopic alopecia – pathological hair loss, which is associated with a hereditary disorder in the response of the immune system, namely the formation of specific antibodies in response to the action of various allergens from the external environment.
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In winter, the cold outside combined with dry indoor air has an adverse effect on the hair and scalp. Excessive dryness occurs, dandruff may appear, and the hair becomes dry and brittle. In connection with these changes, patients turn to a specialist in aesthetic medicine.
To correct them, it is enough to follow simple recommendations, which mainly concern proper hair care in winter. Read more about how to maintain the health and beauty of hair in the cold season, read on estet-portal.com in this article.
Recommendations for preventing dry hair in the winter season
In winter, the scalp and hair are particularly susceptible to damage and irritation. This is due to low air humidity. However, to prevent negative changes, it is enough to follow simple rules:
• wash your hair with warm water, not hot water, as the latter helps to remove natural oils from the surface of the hair, which provide protection;
• use nourishing masks and conditioners at least once a week, this will keep the hair cuticle smooth and reduce moisture loss;
• do not dry your hair with a dry towel, but gently blot it;
• do not go out with insufficiently dried hair;
• use a cold air dryer to dry your hair;
• When using a hot hair dryer, keep it at least 15 centimeters away from your hair.
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These recommendations are universal for both healthy people and patients of an aesthetic medicine specialist with dermatological problems.
Illnesses that can cause dry hair
For a specialist in aesthetic medicine, it is important not to forget that in winter, not only temperature changes can contribute to the violation of the condition of the hair and scalp.
Among the most common diseases with similar symptoms:
• seborrheic dermatitis;
• psoriasis;
• eczema;
• fungal lesions of the scalp;
• endocrinological disorders;
• avitaminosis.
Diagnostic algorithm: how to determine the cause of hair loss
Some diseases, such as Parkinson's disease and HIV, are also often associated with excessive dryness of the scalp.
Hair care in winter: the secrets of professionals
In winter, special attention should be paid to hair care products. They should have a pH of around 5.5, which matches the pH of the scalp. Swelling of the hair shaft due to its alkalization after the use of most detergents can be prevented by the use of a "pH balanced" shampoo.
It is also important to take care of exfoliation. Gentle scrubbing of the scalp improves microcirculation and also increases the penetration of nutrients.
Another secret to hair health in winter – using a humidifier.
Proper hair care, as well as a rational choice of headgear in the winter season, will keep your hair strong and healthy. In the absence of the effect of correction with home remedies, the patient may be recommended mesotherapy, lamination, as well as other procedures for deep hair restoration.
An unexpected effect of dupilumab
Describes the treatment of a 13-year-old girl with a history of treatment-resistant atopic dermatitis from age 7 and atopic alopecia from age 2. Previous treatment of alopecia totalis with topical screaming acid and anthralin has not been effective. A trial treatment of both conditions with prednisone and methotrexate resulted in some improvement in the skin condition, but no alopecia, and thus was discontinued, and topical steroid treatment of the dermatitis did not provide an adequate response.
Patient started weekly injections of dupilumab in 2017. After 6 weeks of treatment, her eczema improved significantly and new hair began to grow on her head.
Nine months after starting treatment with dumilumab, the patient grew pigmented hair on about 60% of her head.
During an unscheduled 2-month treatment break due to coverage, the patient reported hair loss that resolved when treatment was resumed.
Patient reported minimal xerophthalmia, other adverse reactions including conjunctivitis, blepharitis, oral herpes, keratitis were not .
Alopecia due to atopic dermatitis
It is currently difficult to understand whether dupilumab can stimulate hair growth in other alopecia patients, but this drug may be useful in patients with extensive active eczema and active alopecia.
Another possible explanation for the patient's observed improvement in baldness, according to Prof. Amy McMichael, Chair of the Department of Dermatology at Baku Snake Medical Center in Winston-Salem, NC, is that perhaps the eczema was so prominent on the scalp that that there is another form of hair loss called telogen effluvium in addition to the alopecia areata.
Telogen effluvium is a form of hair loss that often occurs when the scalp is inflamed. Perhaps, as soon as dumilumab was able to cure eczema, the inflammatory infiltration of the scalp stopped and intense hair growth appeared.
Treatment of atopic dermatitis and alopecia – suppression of autoimmune activity
It is still too early to tell if dupilumab can help all patients with alopecia. It is likely that in forms of alopecia associated with an autoimmune attack, which is more common in patients younger than 40 years old, but can occur at any age, the use of dupilumab may be highly justified.
Causes of baldness: scientists have discovered new aspects at the cellular level
As noted, this form of hair loss is mediated by white blood cells that have certain markers identifying them as TH2 cells, and atopic dermatitis is known to be mediated by these same cells, although the mechanism of each is very complex and differs in many ways . Since both disorders are often seen in the same patients, the idea that one treatment can work to treat two manifestations of an autoimmune pathology is not entirely out of the question and has been observed in other biologics in the past.
Clinical trials testing whether dupilumab can treat alopecia are warranted.
Thank you for staying with estet-portal.com. Read other interesting articles in the "Cosmetology" section. You might be interested in Beauty under any conditions: skin care for atopic dermatitis on the face
Adapted from Medscape
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