الفهرس 
Title pageOnly 14 pages are availabe for public view
 |  | from | 153 |  |  |
| | | from | 153 | | |
Abstract
Androgenetic alopecia (AGA), or male-pattern hair loss (MPHL), is a common hair loss disorder mediated by dihydrotestosterone, the potent form of testosterone. Its prevalence shows similar trends with some variation across different populations. Approximately 73٪ of men and 57٪ of women over the age of 80 are affected by androgenetic alopecia, and 58٪ of men over the age of 50 are affected. Androgenetic alopecia can lead to negative psychological effects in both men and women. These include self-conscious preoccupation, worries about aging, helplessness, and feelings of diminished attractiveness; these effects are more pronounced in women. The pathogenesis of AGA is characterized by a stepwise miniaturization of the hair follicle, resulting in the vellus transformation of terminal hair. The duration of the anagen phase (growing stage of hair cycle) in successive hairs becomes progressively shorter, resulting in the miniaturization of the hair follicle and ultimately a bald appearance. This gradual miniaturization is thought to be due to the enzymatic conversion of testosterone into dihydrotestosterone (DHT) by 5a reductase, which then acts on receptors present on the hair follicle, resulting in early termination of anagen phase. These changes in the hair cycle dynamics are mediated by the decreased expression of anagen-maintaining factors and increased expression of apoptosis-promoting cytokines. Several therapies have been proposed for the treatment of AGA, such as oral finasteride, topical minoxidil (2٪ and 5٪ solutions or foams), Minoxidil 5٪ foam is also approved by the FDA for female pattern hair loss FPHL which is characterized by diffuse thinning that rarely results in complete baldness. Minoxidil hypothesized to arrest follicular miniaturization and increase anagen duration, both of which counteract the AGA hair loss process.Low level laser therapy (LLLT) has been used for treatment. This thought to activate anagen re-entry in telogen hair follicles (resting stage of hair cycle), prolong the duration, and increase the rate of growth during the anagen phase and prevent entry into the catagen phase (regression stage of hair cycle). The mechanism by which LLLT induces these changes may be explained by observations of increased ATP production, increased production of reactive oxygen species (ROS), increased nitric oxide (NO) release, and vasodilation following LLLT. Due to the varying efficacy and safety profiles of the present treatment modalities for AGA, there remains the need for additional treatments promoting hair regrowth. Platelet-rich plasma (PRP), a new biotechnology, is the product of a heightened interest in cell-based therapy and tissue engineering. This therapy is defined as an autologous preparation of plasma with concentrated platelets. PRP contains various growth factors and cytokines that enhance the body‟s inherent capacity to repair and regenerate. More recently, it has captured attention in the field of dermatology, particularly for its role in treating acne scars, fat grafting, wound healing, and hair regrowth. PRP is an effective therapeutic modality for AGA. This current study aimed to compare between the efficacy of low level laser therapy alone or in combination with minoxidil or platelet rich plasma in the management of androgetic alopecia. The present randomized medical study was accomplished in the dermatologic outpatient treatment center in the National Institute of Laser Enhanced Sciences (NILES), Cairo University, Egypt. Approval of the dermatologic Researching Ethical Board from NILES, Cairo University. Moreover, we obtained informed written signed consent explaining the benefits and side effects from every patient. All included patients were subdivided randomly into 3 equal groups (A,B,C) 15/each by using the envelope concealment manner; group A: Patients were treated by 4 sessions of PRP injections combined with sessions of LLLT. group B: Patients were notified to rub the affected area with 1ml of 5٪ minoxidil solution topically (6 puffs) twice daily for 3 months combined with sessions of LLLT. group C: Patients had only received sessions of LLLT. In this present study, PRP had been prepared. All AGA patients were evaluated upon their initial visit, at 3 and 6 months from the start of the treatment through global photography. Patient satisfaction degree was described as: very satisfied, satisfied, neutral and dissatisfied. The occurrences of unwanted reactions if any were stated. Folliscope assessed the hair measures (hair density, terminal/vellus ratio and hair diameter). The three modalities showed variable degree of clinical improvement based on objective evaluation using the folliscope together with patients‟ satisfaction. The combined PRP and LLLT showed significant better outcomes when compared to pre-treatment, postwards, and follow-up period and also when compared with those of the combined Minoxidil and LLLT or with LLLT alone. The improvement of group B (LLLT plus minoxidil 5٪ topical solution) was better than that of group C (LLLT only).