Androgenetic alopecia (AGA) is the most common cause of hair loss among males [1]. It is characterized by progressive thinning of the scalp hairs, defined by various patterns [2], which can start at any age after puberty and is potentially reversible. Even if from a medical point of view, AGA is considered a relatively mild condition; however, people suffering from this condition consider AGA a serious condition that impacts their self-esteem, well-being, social relationships, and confidence.
The main factors underling hair loss in AGA are genetic predisposition and increased sensitivity of the hair follicles to androgens [3]. AGA is often precipitated and exacerbated by conditions that can induce telogen effluvium, including drugs, acute stressors, and weight loss [4]. However, in recent years it has been shown that other factors, such as microinflammation [5], decreased microcirculation [6], and aging [7], can cause hair loss in AGA. These changes contribute to shifting the normal balance of the hair cycle leading to a shortening of the anagen phase. The major components of balding in AGA are frontotemporal recession and loss of hair over the vertex. Hairs become shorter and finer, and finally complete hair loss occurs except at the lateral and posterior margins of scalp, where hair is retained.
Histologically, in AGA large terminal follicles diminish in size during hair cycles, and the resulting miniaturized follicle eventually produces a microscopic hair. Testosterone is necessary for miniaturization, and 5-alpha-reductase inhibitors, which block the conversion of testosterone to its more active form dihydrotestosterone (DHT), delay the progression of AGA [8]. Recently, Garza and coworkers [9] reported the preservation of stem cell population and a decreased conversion of hair follicle stem cells to progenitor cells in bald scalp biopsies from AGA individuals. This finding is consistent with the current clinical concept that AGA is a nonscarring type of alopecia and suggests potential reversibility of the condition.
Currently, only two medications, based on finasteride and minoxidil as active pharmacological ingredients, are approved by the US Food and Drug Administration (FDA) for AGA treatment. However, they are costly, require lifelong treatment, and may have side effects. Furthermore, people are frequently reluctant/intimidated by the pharmacological approach to treat a disease that is not life threatening. Thus, a topical, nonpharmacological, effective cosmetic treatment could be more acceptable to patients.
The aim of the present study was to assess the efficacy of the use of a patented (US 6,479,059 B2 and CH 703 390), topical cosmetic product, Crescina® HFSC (human follicle stem cell; Labo Cosprophar AG, Basel, Switzerland), claimed to be effective for the treatment of male AGA [10]. The active ingredients contained in the product were chosen to obtain three main effects: proliferation of the stem cells of both the bulge and the dermal papilla, keratinization, and stimulation of microcirculation. Stem cell and dermal papilla stem cell proliferation was achieved by hydrolyzed rice protein and corosolic acid, respectively. Keratinization was stimulated by cysteine, lysine, and a glycoprotein (lectin). Microcirculation was stimulated by benzyl nicotinate. The mentioned results were obtained from studies commissioned by the company Labo Cosprophar AG, which has filed a patent (CH 703 390 B1) [10].