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Clinical Study on Viviscal Formulas
Treatment of Hereditary
Androgenic Alopecia in Middle-Aged Males by Combined Oral and Topical
Administration of Special Marine Extract-Compound
A.
Lassus*, J. Santalahti*, M. Sellmann**
*Helsinki Research Center -
Stora Roberts-Gatan 8 A 1, FIN-00120 Helsinki, Finland
** Dermatological clinic -
Friedrich-Ebert-Platz 17, 51373 Leverkusen, Germany
SUMMARY
30
middle-aged males with hereditary androgenic alopecia were treated for eight
months with compound of marine extract Viviscal®. The preparation was
administered orally in tablet form (2-3 tablets daily), and topically applied in
form of hair lotion and shampoo. The results were evaluated by measurement of
the bald areas, photography, ultrasound measurements, elasticity index and the
erythemal index of the skin. The study showed that Viviscal® had a substantial
effect on hair loss and in most patients on regrowth of permanent hair in the
bald areas. No adverse effects were observed except some drying of the skin of
the scalp in all patients. The results are impressive, considering the rather
high average age of the test group.
INTRODUCTION
Throughout
history men have concocted various potions from animal, vegetable and mineral
substances in an attempt to improve hair growth and at the present time hair
transplants and scalp reductions are used to minimise visible alopecia. The
results of surgical procedures are, however, not always cosmetically acceptable.
An alternative approach is the use of pharmaceutical preparations. Minoxidil, a
piperidinopyrimidine derivative, is a potent peripheral vasodilator.
Recent trials using topical
minoxidil have shown that it has a stimulatory effect on hair regrowth in some
individuals with either androgenic alopecia or alopecia areata(1,2).
Recently it was shown in
double-blind study that a new compound derived from marine fish had a good
effect in early male pattern baldness in young males when given orally(3).
In the present study on older population with male pattern baldness received
both oral and topical treatment with the same active substance.
MATERIAL AND METHODS
Patients
A total of 30 males with hereditary
androgenic alopecia classified on the Hamilton scale(4) as II - IV
took part in the study. The clinical data of the patients are presented in Table
1. The mean age was 40 years (range 34 - 48) and the mean duration of hair loss
11 years (range 3 - 20). Twenty-five of them had earlier been treated with
topical Minoxidil and/or photochemotherapy with no or minimal response. Seven
were heavy smokers (20 cigarettes or more per day) and four smoked only
occasionally. All 30 subjects were in good health and did not use concomitant
medication. Before treatment oral informed consent was obtained from all
patients.
Treatment design
All patients were treated for eight
months. The oral dose of Viviscal® depended on the body weight (2 tablets daily
if <80kg and 3 tablets daily if>80kg). In addition, Viviscal® lotion was rubbed
onto the bald areas every evening and the hair was washed with Viviscal® shampoo
2-3 times/week (both lotion and shampoo contain 1% of the same active
ingredients as the tablets). Clinical evaluations were carried out at baseline
and thereafter bi-monthly for eight months. At each visit the patients were
asked for severity of hair loss and possible adverse reactions. Before start of
treatment and at each later visit the total cumulative areas of baldness were
measured as square centimetres and expressed as a percentage of the total scalp
area. In addition, a photography of the scalp was taken at each visit. At
baseline and each later visit, the epidermal and dermal thickness was measured
with a Dermascan-C equipment and an elasticity index was determined using a
Dermaflex-A equipment (Cortex Ltd., Denmark) (5,6). An erythermal
index was measured using an erythemal meter (Diastron Ltd., UK) (7).
All measurements were carried out in the same site of the scalp.
For statistical analysis, the
student's T-test was used.
RESULTS
The
clinical results of the treatment are shown in Table 2. At baseline 12 patients
estimated the hair loss as severe, 5 as moderate and 13 as mild. After two
months of treatment the hair loss had stopped in all subjects. Prior to the
study, the mean area of baldness of the total scalp was 39% (11 - 52%) and after
end of treatment 9% (4 - 25%). Thirteen patients showed total regrowth (43%),
seven >75% regrowth (23%), four 50 - 75% regrowth (13%), another four 30 - 50%
regrowth and two (7%) patients no regrowth. Five of the six patients with poor
results were heavy smokers. Eighteen patients (60%) developed an increased
growth of their beard and two increase of chest hair during the treatment
period. These were all good responders to the treatment.
The increase of epidermal and
dermal thickness is shown in Table 3. Both layers of the skin became
significantly thicker. Also the elasticity index as well as the erythemal index
increased significantly. At baseline the heavy smokers had a mean lower
erythemal index (0.139) as compared with the whole group (0.209) and the
increase was less (mean 0.187) after treatment as compared with that of the
whole series (0.306).
All patients experienced a mild
to moderate dying of the scalp during treatment. No further adverse reactions
were reported or observed.
DISCUSSION
The
results of the present study confirm the results presented earlier(3),
that Viviscal® is effective in the treatment of hereditary androgenic alopecia.
However, in the present trial the study population was significantly older with
a much longer duration of baldness. The study design was also different, as the
oral dose given was higher in heavier subjects and topical treatment was used
simultaneously and the treatment period was longer. It was also of interest that
the treatment seemed to effect hair growth in the face and on the chest in some
individuals.
The mechanism by which Viviscal®
stimulates regrowth of hair is still unclear. Nutritional factors are probably
of importance, but there are still other effects which remain unknown.
Theoretically one may speculate that the active substances can have a blocking
effect on the androgenic receptors in the papilla. Simultaneous topical
treatment seems to be of importance, both as a nutritional factor and by
increase in capillary circulation as shown by the increase of the erythemal
index. This is further stressed by the observation that heavy smokers responded
less well. Oral treatment alone does not cause vasodilation(3).
In conclusion, Viviscal®
seems to be effective in the treatment of androgenic alopecia in both young and
middle-aged males. The weight-dependent dosing of the oral treatment and the
combination with topical treatment may be the most efficient mode of using
Viviscal®.
REFERENCES
1)
Olsen EA., Weiner MS, Delong ER., Pinnel SR. et al. Topical minoxidil in early
male pattern baldness. J. Am. Acad. Dermatol. 1985; 13: 185-192.
2) Weiss VC., West FP.,
Fu TS., Robinson LA. Et al. Alopecia areata treated with topical minoxidil.
Arch. Dermatol. 1984; 120:457-463.
3) Lassus A., Eskelinen
E. A comparative study of a new food supplement, Viviscal(r), with fish extract
for the treatment of hereditary androgenic alopecia in young males. J. Int. Med.
Res 1992; 20: 445-453.
4) Hamilton JB.
Patterned loss of hair in man: types and incidences. Ann. NY. Acad. Sci 1951;
53:708-711.
5) Serup J., Holm P.,
Stender IM. Et al. Skin atrophy and telangiectasia after topical corticosteroids
as measured non-invasively with high frequency ultrasound, evaporimetry and
laser flowmetry: methological aspects including evaluations of regional
differences. Bioeng. Skin 1987; 3: 43-58.
6) Serup J., Northeved
A. Skin elasticity in psoriasis. In vivo measurement of tensile distensibility,
hysteresis and resilient distension with a new method. Comparison with skin
thickness as measured with high-frequency ultrasound. J. Dermatol. 198; 12:
318-324.
7) Diffey BL., Oliver
RJ., Farr Pm. A portable instrument for quantifying erythema induced by
ultraviolet radiation. Br. J. Dermatol. 198; 111: 663-672.
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