A Multimodal Hair-Loss Treatment Strategy Using a New Topical Phytoactive Formulation: A Report of Five Cases

Abstract

Introduction. Current approved medications for hair loss, such as topical minoxidil and oral finasteride, may have suboptimal efficacy or side effects precluding continued use in some patients. Thus, we report an evaluation of the efficacy, safety, and tolerability of a new topical botanical formulation -GASHEE containing over 12 phytoactive ingredients that affect multiple targets in the cascade of pathophysiologic events that cause hair loss. Five patients with various hair-loss conditions, including cases of previous treatment failures, are presented. Case Presentation. This is a case series of four women and one man with hair loss due to various causes, four of whom had failed minoxidil treatment for over a year. All patients used the topical treatment as a sole therapy for at least 3 months before the documentation of outcomes, which involved interval changes noted through each patient's account, direct observation, and photography. Discussion. In all patients, we observed significant improvements in hair regrowth in the nape, crown, vertex, and temple areas after 3-15 months of treatment. All patients were highly satisfied with their results and reported no adverse events. Although the use of botanicals in the treatment of hair loss is in an infant stage, the new formulation used in this study demonstrated a good efficacy related to hair growth, warranting further evaluation.

Figure 1

The hair follicle cycle showing the effects of various cytokines, growth promoters, and growth inhibitors regarding different stage transitions. BDNF, brain-derived neurotrophic factor; BMP-2/4, bone morphogenetic protein-2/4; col 17 A1, collagen-type XVII α 1 chain; DKK, Dickkopf-related protein; FGF5/7/18, fibroblast growth factor 5/7; GDNF, glial cell line-derived neurotrophic factor; HGF, hepatocyte growth factor; IGF-1, insulin-like growth factor-1; IL-1/6, interleukin-6; KGF, keratinocyte growth factor; PG D2/E2/F2a, prostaglandin D2/E2/F2a; SCF, stem cell factor; SHH, sonic hedgehog; TGF, transforming growth factor; TNF-α, tumor necrosis factor α; VDR = vitamin D receptor; WNT, wingless-type integration site.

Figure 2

Patient 1: a 68-year-old Caucasian woman. Top of the head before (a) and after (b) 3 months of treatment.

Figure 3

Patient 1: back of the head before (a) and after (b) 3 months of treatment.

Figure 4

Trichograms of a tattooed spot in the hair path line area of the midscale from patient 1, performed at 2, 3, and 15 months ((a), (b), and (c), respectively). A progressive interval improvement in hair density and caliber was noted.

Figure 5

Patient 2: a 48-year-old Chinese woman. Top of the head before (a) and after 3 months of treatment (b).

Figure 6

Patient 3: a 35-year-old African American man. Crown before (a) and after 3 months of treatment (b).

Figure 7

Patient 4: a 50-year-old African American woman diagnosed with central centrifugal cicatricial alopecia in the vertex and midscalp and traction alopecia in the temple, hairline, and nape areas. Right temple before (a) and after (b) 3 months of lotion use.

Figure 8

Patient 4: back of the head before (a) and after (b) 3 months of lotion use.

Figure 9

Patient 4: top of the head before (a) and after (b) 3 months of lotion use.

Figure 10

Patient 5: a 56-year-old, postmenopausal, Hispanic woman with marked thinning in the crown area, global loss of volume, and inability to grow hair long. Crown and back of head before (a) and after (b) 9 months of treatment.