The hair in childhood and old age

More than 20 syndromes, most congenital, have hypertrichosis as a feature. An excessive growth of non-androgen-dependent hair has been reported in association with many acquired diseases and medications, some of which, as cyclosporine, can be administered also in children. Even though primary hypertrichosis is benign in most cases, it may result in cosmetic disfigurement and psychosocial trauma; a pediatric assessment is necessary to rule out associated diseases. Lanugo hair can occur in otherwise healthy individuals but can be associated with polymyositis and neoplasms. Hirsutism can be idiopathic, but often can be associated with an adrenal or ovarian cause. Thus all women with hirsutism require careful evaluation. More, growing evidence has linked hyperandrogenism to increased risk of cardiovascular disease, genital tract neoplasms, and non-insulin-dependent diabetes mellitus. An application from the study of hairs comes from oligoelements. A recent study investigating the zinc status of eighty newborn babies with neural tube defects and their mothers compared with controls found a positive association between this defects and decreased hair zinc levels. As far it concerns the color of hairs our group has demonstrated that heterochromia of the scalp hair can be a sign of pigmentary mosaicism even without underlying malformations. The present elucidation of pathogenesis of androgenetic alopecia has lead to second generation steroidal 5α reductase inhibitors, such as G-198745 (a combined type 1 and type 2, 5α reductase blocker), W09704002, Turosteride, Mk-963, MK-434, Episteride, and MK-386. A variety of non-steroidal inhibitors such as zinc and saw palmetto are also under investigation. The possibility of gene therapy for androgenetic alopecia has been advanced in animal by the development of a cream capable to deliver DNA to hair follicles. Finally, the study of the stem cells of the hair follicle will give us new possibilities of treatment.