cloprostenol and Alopecia

Prostaglandin F2α analogs, commonly prescribed for glaucoma treatment, have been shown to induce side effects such as cutaneous hypertrichosis and hyperpigmentation. Therefore, these medications have theoretic applications in the treatment of alopecia and disorders of hypopigmentation. We reviewed the literature to find original studies assessing the use of prostaglandin F2α analogs in these settings. Studies and reports were analyzed in regards to androgenic alopecia, alopecia areata, chemotherapy-induced alopecia, vitiligo, and hypopigmented scarring. Based on the results of these studies, and consideration of pathophysiologic mechanism, the most promising applications for prostaglandin F2α analogs include androgenic alopecia, chemotherapy-induced alopecia, and alopecia areata concurrently treated with corticosteroids.

Topics: Adrenal Cortex Hormones; Alopecia; Amides; Animals; Bimatoprost; Cloprostenol; Dinoprost; Disease Models, Animal; Double-Blind Method; Drug Evaluation, Preclinical; Eyelashes; Glaucoma; Hair Follicle; Humans; Hyperpigmentation; Hypertrichosis; Hypopigmentation; Melanins; Mice; Prostaglandins F, Synthetic; Randomized Controlled Trials as Topic; Retrospective Studies; Single-Blind Method

Balding causes widespread psychological distress but is poorly controlled. The commonest treatment, minoxidil, was originally an antihypertensive drug that promoted unwanted hair. We hypothesized that another serendipitous discovery, increased eyelash growth side-effects of prostamide F(2α)-related eyedrops for glaucoma, may be relevant for scalp alopecias. Eyelash hairs and follicles are highly specialized and remain unaffected by androgens that inhibit scalp follicles and stimulate many others. Therefore, we investigated whether non-eyelash follicles could respond to bimatoprost, a prostamide F(2α) analog recently licensed for eyelash hypotrichosis. Bimatoprost, at pharmacologically selective concentrations, increased hair synthesis in scalp follicle organ culture and advanced mouse pelage hair regrowth in vivo compared to vehicle alone. A prostamide receptor antagonist blocked isolated follicle growth, confirming a direct, receptor-mediated mechanism within follicles; RT-PCR analysis identified 3 relevant receptor genes in scalp follicles in vivo. Receptors were located in the key follicle regulator, the dermal papilla, by analyzing individual follicular structures and immunohistochemistry. Thus, bimatoprost stimulates human scalp follicles in culture and rodent pelage follicles in vivo, mirroring eyelash behavior, and scalp follicles contain bimatoprost-sensitive prostamide receptors in vivo. This highlights a new follicular signaling system and confirms that bimatoprost offers a novel, low-risk therapeutic approach for scalp alopecias.

Topics: Administration, Topical; Adult; Alopecia; Amides; Animals; Antihypertensive Agents; Base Sequence; Bimatoprost; Cloprostenol; Female; Glaucoma; Hair Follicle; Humans; Immunohistochemistry; Male; Mice; Middle Aged; Organ Culture Techniques; Receptors, Prostaglandin; RNA, Messenger; Scalp; Young Adult

Female-pattern androgenetic alopecia is a very common disorder that has been associated with extreme psychological morbidity. Few treatments have documented utility and many physicians are often overwhelmed with how little is pharmacologically available to treat this condition. Novel treatments that are effective, safe, less costly and simple are in high demand. We report a case of female-pattern androgenetic alopecia that failed to respond to a novel treatment with injected bimatoprost solution. Hypothetically, the treatment should have been effective and although we did not have success, this report suggests critical points to consider in the future of prostaglandin analogs, as well as other therapies being considered for the treatment of female-pattern hair loss.

Topics: Alopecia; Amides; Bimatoprost; Cloprostenol; Female; Humans; Injections, Intradermal; Middle Aged; Prostaglandins, Synthetic; Scalp; Treatment Failure

Topics: Acne Vulgaris; Alopecia; Amides; Bimatoprost; Cloprostenol; Dermatologic Agents; Drug Interactions; Humans