Search Results (58)

Background: Chemotherapy-induced alopecia (CIA) significantly impacts patient quality of life (QoL). Scalp cooling therapy (SCT) is effective, but its success in clinical settings remains variable. Objective: To evaluate the association between a refined multidisciplinary team-based approach, integrating appearance care professionals, and SCT efficacy in breast cancer patients. Methods: This retrospective before–after single-institution study compared SCT outcomes before (Group A, n = 66) and after (Group B, n = 79) implementing a refined care model among patients who completed their full planned chemotherapy courses. The baseline characteristics were comparable except for a significantly higher proportion of patients starting a weekly regimen in Group B (54.4% vs. 30.3%, p = 0.004). The model featured enhanced staff training, a specialized hair/scalp charting system, and task-sharing between nurses and integrated certified hairdressers. The primary endpoint was the number of cycles with Grade 2 or higher alopecia (CTCAE v5.0). Results: The refined approach was associated with improved scalp cooling outcomes. The percentage of patients with Grade 2+ alopecia at treatment completion decreased from 53.0% in Group A to 32.9% in Group B (p = 0.015). The overall proportion of time spent with Grade 2+ alopecia fell from 17.3% to 6.5% (p < 0.001). In the ddAC f/b wPTX regimen, the median number of Grade 2+ cycles reduced from 10.0 to 4.0 (p = 0.033). While the wPTX f/b ddAC regimen showed a numerical reduction (1.0 vs. 0.0 cycles), it did not reach statistical significance (p = 0.326). Conclusions: The refined multidisciplinary approach, including the integration of appearance care professionals, was associated with improved scalp cooling outcomes and lower median cycle numbers across regimens. Although these findings may be partly influenced by the baseline imbalance in chemotherapy regimens, this comprehensive team-based care model offers a feasible strategy for enhancing patient support in oncology settings. Full article

Background: Major depressive disorder, particularly in its treatment-resistant form, remains a leading cause of global disability. When pharmacotherapy and psychotherapy fail, neuromodulation techniques such as electroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS) are increasingly utilized. However, variability in protocols and outcome reporting continues to generate uncertainty regarding their comparative benefits and safety profiles. Objective: To comprehensively map and synthesize the available evidence on the clinical benefits and adverse effects of ECT and rTMS in adults with major depressive disorder and treatment-resistant depression. Methods: A scoping review was conducted following PRISMA-Sc guidelines and registered in PROSPERO; PubMed–MEDLINE, Scopus, and the Virtual Health Library were searched from inception to October 2022. Observational and experimental studies evaluating ECT and or rTMS in adults with depressive disorders were included. Data were extracted on study design, population characteristics, stimulation parameters, clinical outcomes, and adverse effects. Methodological quality was assessed using National Heart, Lung, and Blood Institute tools. Results: A total of 165 studies comprising 10,701 participants were included. ECT and rTMS were consistently associated with clinically meaningful reductions in depressive symptom severity across heterogeneous protocols. ECT demonstrated the most robust response rates, particularly in treatment-resistant and severe depression, while rTMS showed substantial efficacy with a more favorable safety profile. Adverse effects were more frequent and severe with ECT, including transient cognitive disturbances and cardiovascular complications, whereas rTMS was predominantly associated with mild, self-limited side effects such as headache and scalp discomfort. Considerable heterogeneity in stimulation parameters and diagnostic subgroups was observed across studies. Conclusions: Both ECT and rTMS represent effective neuromodulation strategies for major depressive disorder and treatment-resistant depression. ECT remains the most potent intervention in highly refractory cases, whereas rTMS offers a less invasive alternative with strong tolerability. Standardization of stimulation protocols, biomarker-informed stratification, coadjuvancy analysis, and long-term controlled studies are necessary to refine clinical positioning and advance precision neuromodulation in depression care. Full article

Background: Deep burns in pediatric population often require split-thickness skin grafts (STSGs) and the identification of an optimal donor site is crucial to minimize morbidity, accelerate healing and reduce short- and long-term complications. The scalp appears to be increasingly used in clinical practice, but evidence remains limited, despite the promise of novel bioengineering and regenerative approaches. Methods: A systematic review about the use of scalp for STSG in pediatrics was conducted across PubMed, Scopus, and Cochrane (2005–2025). Clinical outcomes considered were donor-site healing time, early and late complications, perioperative practices, and quality of scars. Results: Four studies met the inclusion criteria (n = 417, mean age 2.9–7.3 years) with follow-up periods up to 27 years. Epithelialization occurred between 7 and 25 days. Early complications included folliculitis (up to 44% in certain hair types) and delayed healing (n = 13; 52%). A rigorous harvesting technique is needed to avoid preventable complications. Late sequelae included alopecia (1.6% to 33%—the latter largely unperceived by patients) and hypertrophic scarring (1.6–4%). Scar quality was rated good in >80% of cases. Conclusions: Evidence supports the scalp as a safe, efficient, and cosmetically favorable donor site for pediatric STSG. Based on evidence and clinical experience, we propose the first structured scalp-donor management algorithm to optimize safety, reduce complications, and standardize perioperative care in the management of pediatric burns. Full article

This study explores Serbia’s rich ethnopharmacological heritage by systematically documenting the traditional use of medicinal plants for treating skin diseases during the 19th and 20th centuries. Drawing on key ethnographic sources—including monographs, scholarly articles, and field reports—the review analyzes historical records of folk medicine practices and their cultural contexts. A total of 164 plant species from 63 botanical families, as well as one mushroom species, were identified as being used in the treatment of skin-related conditions classified according to the International Classification of Primary Care. Reported ailments were grouped into three main categories: hair and scalp disorders, bites, and various inflammatory skin conditions such as eczema and psoriasis. Remedies for wound healing were the most frequently documented, both in terms of application and diversity of plant species employed. By preserving and systematizing this historical knowledge, the study provides a valuable foundation for future pharmacological and dermatological research, highlighting the continued relevance of traditional remedies in modern clinical practice. Full article

Dry electroencephalography (EEG) electrodes enable rapid, gel-free setups, which are crucial for point-of-care diagnostics, but often face challenges with comfort and signal quality—especially in a clinical context. Novel “flower” dry electrodes are a special type of reusable scalp electrodes for dry EEG, featuring a distinct flower-like shape with angled pins in three intertwined layers. While the new electrode design has been validated in an in vivo study on healthy volunteers, we tested its clinical applicability in a proof-of-concept study involving three patients diagnosed with epilepsy and delirium. The recordings were of high diagnostic quality, enabling the reliable identification of pathological patterns, such as generalized spike–wave complexes and intermittent delta activity, with a signal-to-noise ratio comparable to prior reports for sponge-based EEG systems (limited case series). The signal-to-noise ratio (SNR) proved to be sufficiently high for clinical diagnostic purposes, resulting in visually clear and interpretable EEG data that enabled effective assessment of patients’ neurophysiological signals. Consequently, our findings demonstrate that the comfortable flower-electrode design is a viable and effective tool for epilepsy diagnostics, extended recording, and clinical neurophysiology. It represents a significant step towards patient-centered and gel-free EEG technology, specifically in point-of-care and emergency applications, without compromising the diagnostic quality of the recordings. Full article

Background: Cerliponase alfa is currently the only approved disease-modifying therapy for neuronal ceroid lipofuscinosis type 2 (CLN2) disease and requires lifelong intracerebroventricular (ICV) infusion, traditionally via a scalp-sited ventricular access device (VAD). Chest-sited port (chest port) for intracerebroventricular access using a tunneled central venous access device is described as an alternative, though data remain limited. Methods: We present an anonymized caregiver narrative perspective describing two pediatric patients with CLN2 disease receiving cerliponase alfa infusions via different ICV access strategies: one patient who transitioned from a scalp-based ventricular access device to a chest port and one patient who initiated therapy with a chest port. A semi-structured caregiver interview was used to capture experiential insights related to decision-making, procedural burden, safety considerations, and psychosocial adaptation. Results: The caregiver identified key advantages of chest ports for ICV infusion, including durability of the device, enhanced securement, and smooth long-term routine integration. The transition from a scalp VAD to a chest port was described as proactive, well-coordinated, and associated with high caregiver satisfaction. Noted considerations included increased visibility of the access needle to the child, proximity to oral secretions, and potential misidentification of the port by emergency medical services. Families implemented mitigation strategies through labeling, education, and coordination with the care team. Conclusions: This caregiver-centered case report highlights how access device choice meaningfully shapes treatment burden, safety planning, and daily life for families managing CLN2 disease. As chest-port methodologies become adopted, incorporating caregiver and patient perspectives is essential to developing patient-centered treatment options for long-term intracerebroventricular therapy. Full article

Hair loss, or alopecia, constitutes a significant and prevalent concern affecting individuals worldwide. Despite the availability of numerous commercial solutions, many individuals continue to experience substantial psychological distress, leading to adverse impact on personal relationships, social interactions, and occupational performance. The limitations of conventional treatments, such as oral medication with potential systemic side effects and topical applications with localized adverse events, have driven the exploration of alternative therapies. Emerging localized injectable treatments for hair regrowth (PRP, stem cells, exosomes) offer a promising avenue for addressing this persistent issue. These injectable therapies hold the potential to minimize the systemic side effects often associated with oral medications, while also mitigating the localized adverse events that can arise from topical applications. This narrative review provides a comprehensive overview of the medical state-of-the-art in off-label injectable hair regrowth treatments, delving into the diverse range of available options. A critical component of this narrative review involves a thorough evaluation of relevant clinical studies, assessing the efficacy and safety profiles of these emerging therapies. Furthermore, detailed attention is given to injection techniques and administration protocols, crucial factors in optimizing treatment outcomes. These evolving therapies represent a significant advancement in the field of scalp regenerative medicine. By stimulating hair follicle reactivation, these treatments aim to promote sustained and natural hair growth, providing individuals with more effective and durable solutions. The enhanced safety profiles of these injectable therapies, compared to conventional systemic pharmacological treatments (minoxidil, finasteride), offer a substantial improvement in patient care, addressing a widespread clinical need. Full article

Background: Brain temperature is an important determinant of neurological outcomes in ill infants, yet contributions of environmental temperature and cerebral blood flow remain uncovered because of the lack of non-invasive probes. Methods: Using non-invasive cot-side probes, we examined how cerebral blood flow influences brain temperature during mild cold stress induced by incubator-to-cot transfer. We studied 43 clinically stable infants in a tertiary neonatal intensive care unit. After cot transfer, infants were routinely fitted with knit caps and wrapped in cotton blankets. Scalp and superficial and deep brain temperatures were measured using infrared and zero-heat-flux thermometers, and superior vena cava (SVC) flow—a proxy for cerebral blood flow—was assessed using Doppler velocimetry before, immediately after, and 2 h after transfer, adjusting for rectal temperature. Results: Ambient temperature decreased from 29.7 (SD 0.8) °C to 26.8 (SD 0.9) °C, while rectal temperature remained stable. Scalp and brain temperatures declined after transfer but superficial and deep brain temperatures returned to baseline after 2 h of cap use. The regression coefficient between SVC flow and superficial brain temperature shifted from −0.176 (95% CI, −0.386 to 0.035) to 0.239 (−0.280 to 0.759) after transfer (difference: 0.415 [0.106 to 0.724]; p = 0.009), and then returned to baseline after 2 h (−0.079 [−0.528 to 0.372]). Conclusions: Relationships between brain temperature and perfusion were successfully monitored using non-invasive cot-side biosensors; cerebral blood flow appears to shift from facilitating heat dissipation in warm conditions to supporting heat delivery during cold stress. These findings underscore the physiological role of cerebral blood flow in maintaining brain temperature. Full article

The cosmetic and personal care industry is increasingly shifting toward plant-derived ingredients that combine multifunctional biological activity with favorable safety and sustainability profiles. Trigonella foenum-graecum L. (fenugreek), a leguminous plant traditionally used in food and medicine, has recently attracted growing attention as a potential cosmetic and cosmeceutical ingredient. This review provides a comprehensive and critical synthesis of current knowledge on fenugreek in the context of skin and hair care applications. First, the phytochemical profile of fenugreek relevant to cosmetics is examined, with emphasis on polyphenols and flavonoids, steroidal saponins, alkaloids (notably trigonelline), and mucilage-rich galactomannans. The biological activities of these constituents are then discussed in relation to key cutaneous and scalp mechanisms, including antioxidant defense, anti-inflammatory and antimicrobial effects, anti-glycation and dermal matrix protection, skin hydration and barrier support, as well as hair growth promotion and scalp health. Particular attention is given to recent in vitro, ex vivo, and emerging clinical evidence supporting anti-aging, moisturizing, and hair-care claims. Current formulation strategies and green extraction technologies enabling the incorporation of fenugreek-derived ingredients into topical products are reviewed, alongside considerations of safety, toxicity, and regulatory status under EU cosmetic legislation. Finally, existing research gaps are identified, highlighting the need for standardized extracts, robust clinical validation, and advanced omics-based approaches. This review highlights fenugreek’s strong potential as a versatile plant-based ingredient in cosmetics, despite remaining understudied in topical applications. Full article

Alopecia profoundly impacts psychological well-being and quality of life, yet current therapeutic options such as minoxidil and finasteride exhibit limited efficacy. Fibroblast growth factor 7 (FGF-7), also known as keratinocyte growth factor (KGF), is a paracrine growth factor secreted by dermal papilla cells that specifically activates the epithelial receptor FGFR2b. Receptor engagement triggers multiple downstream signaling cascades, including the MAPK/ERK, PI3K/Akt, and Wnt/β-catenin pathways, promoting keratinocyte proliferation, stem cell activation, and the transition of hair follicles into the anagen phase. Both in vitro and in vivo animal studies consistently demonstrate that FGF-7 accelerates telogen-to-anagen transition and enhances follicular regeneration. FGF-7 acts synergistically with insulin-like growth factor 1 (IGF-1) and vascular endothelial growth factor (VEGF) to sustain nutrient delivery and cell proliferation. Human scalp studies further reveal a strong association between the FGF-7/FGFR2b signaling and follicular activity; however, clinical trials remain scarce. Topical application of FGF-7 has demonstrated an excellent safety profile, whereas systemic administration necessitates careful monitoring. Future directions include the development of engineering to extend the systemic half-life, advanced delivery systems, and gene or mRNA-based therapeutic approaches. Thus, the FGF-7/FGFR2b axis is a highly compelling molecular target for next-generation hair regeneration therapies. Full article

Background/Objectives: Trichoscopy is an important diagnostic tool for hair and scalp disorders, but it requires significant expertise. Publicly available large language models (LLMs) are becoming more popular among both physicians and patients, yet their usefulness in trichology is unknown. We aimed to evaluate the diagnostic accuracy of four publicly available LLMs when interpreting trichoscopic images, as well as to compare their performance with that of dermatology residents, board-certified dermatologists, and trichology experts. Method: In this prospective comparative study, a preprocessed set of trichoscopic images was assessed in an online image-based survey. To reduced recognition bias from public image repositories, all images were structurally transformed while preserving diagnostic features. Fifteen dermatologists (five residents, four board-certified dermatologists, six trichology experts) provided a suspected diagnosis (SD), and up to three the differential diagnoses (DD). Four LLMs (ChatGPT-4o, Claude Sonnet 4, Gemini 2.5 Flash, and Grok-3) evaluated the images under the same conditions. Results: The overall diagnostic accuracy among 15 dermatologists was 58.1% (95% CI, 53.0–63.0) for SD and 68.3% (95% CI, 63.4–72.8) for SD + DD. Experts significantly outperformed residents and board-certified dermatologists. AI models achieved an accuracy of 18.2% (95% CI, 11.8–26.9) for SD and 44.4% (95% CI, 35.0–54.3) for SD + DD. Gemini 2.5 Flash performed best, with an accuracy of 62.5% for SD + DD. Agreement among dermatologists increased with experience (AC1 up to 0.65 for experts), while agreement among AI models was moderate to good (AC1 up to 0.70). Agreement between AI models and dermatologists was only slight to fair (AC1 = 0.06 for SD and 0.21 for SD + DD). All human-AI differences were statistically significant (p < 0.001). Conclusions: In trichology, publicly available LLMs currently underperform compared to human experts, especially in providing a single correct diagnosis. These models require further development and specialized training before they can reliably assist with trichological diagnoses in routine care. Full article

Like with skin, both men and women—regardless of ethnicity—gradually lose satisfaction with changes in hair brought about by ageing. Especially when such transition is apparent by others, and that the hair condition has a significant role in an individual’s overall physical appearance and self-perception. Beyond the familiar age-related signs such as hair greying, hair loss, and hair fragility, this review includes current knowledge of biological processes underlying hair pigmentation and hair growth, highlights variations in gender and ethnicity, as well as delineates hair fibre diameter, ellipticity, and elasticity properties that collectively contribute to the characteristics of aged hair. Additionally, in view of the rising importance of enhancing scalp skin health to promote healthy hair growth, the latter part of the review focuses on age-associated alterations to the scalp skin and its microbiome. Consideration of the morphological changes in the hair fibre, biological processes occurring within the hair follicle and its enveloping scalp environment provide a unique, holistic overview of hair and scalp changes during ageing. Finally, after acknowledging the impact caused by chronological ageing and environmental stresses, it is important to recognise that healthy tresses are largely influenced by scalp skin care, and this stimulates the advancement of appropriate cosmetic solutions that help delay or improve the appearance of aged hair. Full article

Androgenetic alopecia (AGA) is a prevalent, multifactorial hair disorder affecting a substantial portion of both males and females, with significant psychosocial consequences. Over the past decade, regenerative medicine has reshaped AGA treatment, offering biologically driven alternatives to conventional pharmacological and surgical therapies. Among these, Autologous Micrografting Technology (AMT) (Regenera Activa^® by Rigenera^® Technology, Barcelona, Spain) emerged 10 years ago as a notable innovation leveraging the body’s intrinsic regenerative potential through micrografts derived from a healthy scalp tissue. This review provides a comprehensive overview of the pathophysiology of AGA—including genetic, hormonal, and inflammatory contributors—and evaluates the clinical efficacy, safety, and mechanistic basis of AMT in comparison with other regenerative strategies such as platelet-rich plasma, adipose-derived mesenchymal stem cells, and exosome-based treatments. Clinical studies demonstrate that AMT yields significant short-term improvements in hair density and thickness with favorable safety outcomes. Moreover, advancements in device technology and treatment protocols have enhanced consistency and reproducibility. As multimodal and personalized approaches gain traction in hair restoration, AMT is a minimally invasive point-of-care procedure within the evolving regenerative landscape. Future studies are warranted to optimize treatment algorithms, extend follow-up data, better define patient selection criteria for maximizing outcomes with AMT, and expand the indication of autologous micrografting technology. Full article

Hair loss and scalp dysfunction are prevalent concerns with limited non-medicinal long-term solutions. Growth factors and plant-derived extracellular vesicle (EV) represent promising regenerative approaches. In this exploratory randomized controlled trial, 60 healthy adults (18–60 years) were randomly assigned into five groups: (A) placebo; (B) base formula with 0.1% caffeine and panthenol; (C) base + recombinant Fc-fusion long-acting insulin-like growth factor-1 (rIGF-1) and fibroblast growth factor-7 (rFGF-7); (D) base + Centella asiatica (C. asiatica) EV; and (E) base + rIGF-1, rFGF-7, and C. asiatica EV. Participants applied their assigned product once daily for 56 days. Scalp and hair parameters, including sebum content, hair length, thickness, density, and hair loss, were assessed at baseline and Days 14, 28, 42, and 56. The combination of C. asiatica EV with rIGF-1 and rFGF-7 (Group E) showed the greatest improvements across all endpoints, including significant increases in hair thickness, density, and length, and a reduction in sebum content and hair loss by Day 56 compared with placebo. The results support further study of topical use of C. asiatica-derived EV with recombinant long-acting growth factors as a novel, naturally derived, cosmetic intervention for scalp and hair care. Full article

Sensitive scalp (SSC) is a common but often overlooked dermatological state, characterized by subjective symptoms such as pruritus, tingling, tightness, pain, or burning sensations. Primary SSC typically occurs in the absence of visible clinical inflammation. Numerous studies have suggested that the onset of SSC may be influenced by a variety of intrinsic and extrinsic factors, including physical (ultraviolet radiation, changes in temperature and humidity), chemical (cosmetic ingredients, environmental pollutants), and psychological factors (emotional stress). This article provides a narrative review of the current research on SSC, drawing on literature published between 1963 and 2024 in PubMed, Elsevier, and Web of Science databases. We summarize its hallmark symptoms, available evaluation methods, potential mechanisms, and contributing factors and propose corresponding scalp care recommendations. This review aims to offer theoretical insights into the pathogenesis of SSC and to support the development of effective protective strategies. Full article