Follicular proteoglycans are key players with structural, functional, and regulatory roles in the growth and cycling behaviour of the hair follicles. The expression pattern of specific proteoglycans is strongly correlated with follicular phase transitions, which further affirms their functional involvement. Research shows that bioactive proteoglycans, e.g., versican and decorin, can actively trigger follicular phase shift by their anagen-inducing, anagen-maintaining, and immunoregulatory properties. This emerging insight has led to the recognition of “dysregulated proteoglycan metabolism” as a plausible causal or mediating pathology in hair growth disorders in both men and women. In support of this, declined expression of proteoglycans has been reported in cases of anagen shortening and follicular miniaturisation. To facilitate scientific communication, we propose designating this pathology “follicular hypoglycania (FHG),” which results from an impaired ability of follicular cells to replenish and maintain a minimum relative concentration of key proteoglycans during anagen. Lasting FHG may advance to structural decay, called proteoglycan follicular atrophy (PFA). This process is suggested to be an integral pathogenetic factor in pattern hair loss (PHL) and telogen effluvium (TE). To address FHG and PFA, a proteoglycan replacement therapy (PRT) program using oral administration of a marine-derived extract (Nourkrin® with Marilex®, produced by Pharma Medico Aps, Aarhus, Denmark) containing specific proteoglycans has been developed. In clinical studies, this treatment significantly reduced hair fall, promoted hair growth, and improved quality of life in patients with male- and female-pattern hair loss. Accordingly, PRT (using Nourkrin® with Marilex®) can be recommended as an add-on treatment or monotherapy in patients with PHL and TE.

IMPORTANCEA recent expert consensus exercise emphasized the importance of developing a global network of patient registries for alopecia areata to redress the paucity of comparable, real-world data regarding the effectiveness and safety of existing and emerging therapies for alopecia areata.OBJECTIVE To generate core domains and domain items for a global network of alopecia areata patient registries.EVIDENCE REVIEW Sixty-six participants, representing physicians, patient organizations, scientists, the pharmaceutical industry, and pharmacoeconomic experts, participated in a 3-round eDelphi process, culminating in a face-to-face meeting at the World Congress of Dermatology,

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ооо «Институт Красивых волос», Москва, Россия, 105082Миноксидил является базовым препаратом для наружной терапии андрогенетической алопеции у мужчин и женщин. Между тем отношение к миноксидилу неоднозначно как среди пациентов, так и среди врачей. недостаточное понимание этиологии разных форм потери волос, отсутствие ясности в механизмах интеракции миноксидила с клетками-мишенями, в особенности с клетками волосяного фолликула, а также специфичность реакции самих волос на ранних этапах лечения компрометирует действие препарата на волосы и организм человека в целом, ограничивая терапевтические возможности при лечении облысения, снижает комплаентность лечению у пациента. в статье приводится обзор научных исследований о стимулирующих механизмах миноксидила на рост волос, о клинической эффективности и преимуществе использования лекарственной формы препарата в виде пены при андрогенетической алопеции.Ключевые слова: миноксидил, пена миноксидил, андрогенетическая алопеция, лечение. Minoxidil: a final judgment or a hope?A.g. gADzHIgoRoEvA «Institute of nice Hair», Moscow, Russia, 105082Minoxidil is a basic drug for the topical treatment of androgenetic alopecia in males and females. Meanwhile, the attitude of both patients and medical professionals to minoxidil is controversial. Insufficient understanding of the etiology of various forms of hair loss, lack of clear understanding of the mechanisms of interaction between minoxidil and target cells, particularly the hair follicle cells, as well as specific reactions of the hair itself at the early stages of treatment, compromise drug effect on the hair and the entire human body, which results in limited therapeutic potential in treatment of hair loss and reduces patients' compliance. This article provides an overview of the research of stimulatory mechanisms of minoxidil on hair growth, clinical efficacy and benefits of the use of foam-like dosage form of the drug in patients with androgenetic alopecia.

Evidence-based medicine (EBM) aims for the ideal that healthcare professionals make conscientious, explicit, and judicious use of the best available evidence gained from the scientific method to clinical decision-making. It seeks to assess the strength of the evidence for benefits of diagnostic tests and treatments, using techniques from science, engineering, and statistics, such as the systematic review of medical literature, meta-analysis, risk-benefit analysis, and randomized controlled trials. The limited success rate of EBM therapies suggests that the complex nature of hair loss may be inadequately served by the present levels of evidence, and that physicians treating hair loss may have fallen short of adequately researching a robust evidence to underpin their practices. Against this backdrop, the concept of precision medicine (PM) is evolving. PM refers to the customization of medical care to the patient’s individual characteristics based on the patient’s genetic background and other molecular or cellular analysis, while classifying patients into subpopulations that differ in their susceptibility to a particular medical condition, in the biology or prognosis of those medical conditions, or in their response to a specific treatment. With the advances in hair research, the powerful tools of molecular biology and genetics, and innovative technologies, we have the robust scientific data and tools to adapt the concept of PM to the practice of trichiatry. Finally, databases pertaining to the development and efficacy of PM must be analyzed and be used to form the basis of evidence-based personalized trichiatry.