Alopecia androgenética: uma revisão sobre a resolutividade do tratamento cirúrgico e sua implicação no contexto biopsicossocial do paciente

Authors

  • Alexandre Souza Deliborio
  • Vomer Silva

DOI:

https://doi.org/10.34119/bjhrv6n3-264

Keywords:

Alopecia, Androgenetic, Androgenic, hair loss, hair transplantation, quality of life

Abstract

Contextualização: O cabelo desempenha um papel fundamental na percepção de si e está associado à vitalidade juvenil. A perda de cabelo afeta uma vasta parcela da população masculina, incluindo os jovens. Embora as causas do enfraquecimento do cabelo sejam multifatoriais, a alopecia androgenética (AAG) é a etiologia mais comum, culminando em efeitos estéticos que podem causar impacto na saúde mental e qualidade de vida dos pacientes. Justificativa: Ressalta-se a importância da investigação científica dos benefícios psíquicos e de qualidade de vida associados ao transplante capilar em pacientes acometidos pela alopecia androgenética, no contexto do aspecto biopsicossocial envolvido. Objetivo: Elucidar os desfechos psíquicos e de qualidade de vida do transplante capilar em pacientes masculinos acometidos pela alopecia androgenética. Metodologia: A revisão integrativa foi conduzida conforme parâmetros metodológicos previamente estabelecidos, obedecendo etapas rigorosas de confecção. Estas fases são essenciais na identificação do tema de pesquisa, formulação dos critérios de inclusão, extração de dados oriundos dos estudos inclusos, análise metodológica destes, além da interpretação de resultados e síntese descritiva. Resultados: Após a busca e seleção de estudos nas bases de dados eletrônicas: Pubmed/Medline, Embase e psycINFO, avaliamos 1.375 estudos, delimitando 5 destes como pertinentes exclusivamente aos critérios de inclusão. O conjunto avaliado indica impacto psicossocial significativo da condição de alopecia androgenética em pacientes masculinos, com desfechos positivos decorrentes da intervenção cirúrgica de restauração capilar, influindo sobre a qualidade de vida destes indivíduos. Conclusão: O transplante capilar, quando assertivamente indicado, é o método mais eficaz na contenção dos sinais de calvície, repercutindo positivamente na aparência, autoestima, desempenho social, qualidade de vida e no contexto psíquico do paciente acometido pela AAG. Investigações científicas futuras são necessárias para consolidarmos as discussões pertinentes ao tema. Com maior abrangência populacional e parametrização metodológica pode-se recomendar a melhor terapêutica baseada em evidências, respeitando o contexto biopsicossocial associado.

References

Schneider, M.R.; Schmidt-Ullrich, R.; Paus, R. The Hair Follicle as a Dynamic Miniorgan. Curr. Biol. 2009, 19, R132–R142. [CrossRef] [PubMed]

Terry RL. Further evidence on components of facial attractiveness. Percept Mot Skills. 1977; 45:130.

Severi G, Sinclair R, Hopper JL, et al. Androgenetic alopecia in men aged 40-69 years: prevalence and risk factors. Br J Dermatol 2003; 149:1207–13.

Hamilton JB. Patterned loss of hair in man; types and incidence. Ann N Y Acad Sci 1951; 53:708–28.

Lolli F, Pallotti F, Rossi A, et al. Androgenetic alopecia: a review. Endocrine 2017; 57:9–17.

Kelly Y, Blanco A, Tosti A. Androgenetic alopecia: an update of treatment options. Drugs 2016; 76:1349–64.

Hadshiew, I.M.; Foitzik, K.; Arck, P.C.; Paus, R. Burden of hair loss: Stress and the underestimated psychosocial impact of telogen effluvium and androgenetic alopecia. J. Investig. Dermatol. 2004, 123, 455–457. [CrossRef] [PubMed]

Cash TF. The psychosocial consequences of androgenetic alopecia: a review of the research literature. Br J Dermatol. 1999; 141(3):398-405. doi:10.1046/j.1365-2133.1999.03030.x

Hunt N, McHale S. The psychological impact of alopecia. BMJ. 2005; 331(7522):951-953. doi:10.1136/bmj.331.7522.951

Kivanç-Altunay I, Savaş C, Gökdemir G, Köşlü A, Ayaydin EB. The presence of trichodynia in patients with telogen effluvium and androgenetic alopecia. Int J Dermatol. 2003; 42(9):691-693. doi:10.1046/j.1365-4362.2003.01847.x

Collins K, Avram MR. Hair Transplantation and Follicular Unit Extraction. Dermatol Clin. 2021 Jul; 39(3):463-478. doi: 10.1016/j.det.2021.04.003. PMID: 34053598.

Singh M, Acharya A. Overview and Algorithmic Approach to Management of Male and Female Pattern Hair Loss. Indian J Plast Surg. 2021 Dec 14; 54(4):416-421. doi: 10.1055/s-0041-1739256. PMID: 34984079; PMCID: PMC8719953.

Tavares NV, Couto BAC, Rodrigues LC, et al. Kérion Celsi: importante diagnóstico diferencial para as dermatofitoses / Kérion Celsi: important differential diagnosis for dermatophytosis. Braz. J. Hea. Rev. [Internet]. 2021 Jun. 11;4(3):12721-3.

Dhami L. Psychology of Hair Loss Patients and Importance of Counseling. Indian J Plast Surg. 2021 Dec 31; 54(4):411-415. doi: 10.1055/s-0041-1741037. PMID: 34984078; PMCID: PMC8719979.

Llamas-Molina JM, Carrero-Castaño A, Ruiz-Villaverde R, Campos A. Tissue Engineering and Regeneration of the Human Hair Follicle in Androgenetic Alopecia: Literature Review. Life (Basel). 2022 Jan 14; 12(1):117. doi: 10.3390/life12010117. PMID: 35054510; PMCID: PMC8779163.

Lamana FA, Malveira MMH, Speranza MH, et al. Atualizações sobre o tratamento da alopécia androgenética em homens : Updates on the treatment of androgenetic alapécia in men. Braz. J. Hea. Rev. [Internet]. 2022 Nov. 9;5(6):22376-92.

Jimenez JJ, Wikramanayake TC, Bergfeld W, et al. Efficacy and safety of a low level laser device in the treatment of Male and Female Pattern Hair loss: a multicenter randomized Sham Devicecontrolled Double Blind study. Am J Clin Dermatol 2014;15(2):115–27.

Hamblin MR. Photobiomodulation for the management of alopecia, mechanisms of action, patient selection and perspectives. J Clin and Cosmetic and Investigational Dermatology 2006 ;( 12):669–78. [CrossRef] [PubMed]

Bernstein HF. Hair growth induced by diode laser treatment. Dermatol Surg 2005; 31(5):584. [CrossRef] [PubMed]

Keene S. The science of light bio-stimulation and low level laser therapy. Hair Transpl Forum Int 2014; 24(6):208–9. [CrossRef] [PubMed]

Hamblin MR, Demidova TN. Mechanism of low level light therapy. Proc SPIE 2006; 6140:1–12. [CrossRef] [PubMed]

Rose PT. Combination Approaches for Combatting Hair Loss. Dermatol Clin. 2021 Jul; 39(3):479-485. doi: 10.1016/j.det.2021.04.004. Epub 2021 May 15. PMID: 34053599.

Uebel CO, Da Silva JB, Cantarelli D, et al. The role of platelet rich plasma in women with female androgenetic alopecia. Plast Reconstr Surg 2006; 118(6): 1458–66. [CrossRef] [PubMed]

Greco J, Brandt R. Preliminary experience and extended applications for the use of autologous platelet rich plasma in hair transplantation surgery. Hair Transpl Forum Int’l 2007; 17(4):131–2. [CrossRef] [PubMed]

Heseler MJ, Shyam N. Platelet rich plasma and its utilities in alopecia, a systematic review. Dermatol Surg 2020; 46(1):93–102. [CrossRef] [PubMed]

Hausauer AK, Humphrey S. The physician guide to platelet rich plasma in Dermatologic Surgery part II, Clinical Evidence. Dermatol Surg 2020; 46(4):447–56. [CrossRef] [PubMed]

Rose, P.T. Hair restoration surgery: Challenges and solutions. Clin. Cosmet. Investig. Dermatol. 2015, 8, 361–370. [CrossRef] [PubMed]

Langer, R.; Vacanti, J.P. Tissue engineering. Science 1993, 260, 920–926. [CrossRef] [PubMed]

Finlay AY, Khan GK. Dermatology Life Quality Index (DLQI)—a simple practical measure for routine clinical use. Clin Exp Dermatol. 1994; 19(3):210–216. doi:10.1111/j.1365-2230.1994.tb01167.x

Chren MM, Lasek RJ, Quinn LM, Mostow EN, Zyzanski SJ. Skindex, a quality-of-life measure for patients with skin disease: reliability, validity, and responsiveness. J Invest Dermatol. 1996; 107(5):707–713. doi:10.1111/1523-1747.ep12365600.

Chren MM, Lasek RJ, Sahay AP, Sands LP. Measurement properties of Skindex-16: a brief quality-of-life measure for patients with skin diseases. J Cutan Med Surg. 2001; 5(2):105–110. doi: 10.1177/120347540100500202.

Nijsten TE, Sampogna F, Chren MM, Abeni DD. Testing and reducing skindex-29 using Rasch analysis: skindex-17. J Invest Dermatol. 2006; 126(6):1244–1250. doi:10.1038/sj.jid.5700212.

Morgan M, McCreedy R, Simpson J, Hay RJ. Dermatology quality of life scales--a measure of the impact of skin diseases. Br J Dermatol. 1997; 136(2):202–206.

Kini SP, DeLong LK. Overview of health status quality-of-life measures. Dermatol Clin. 2012; 30(2):209–221, xiii. doi:10.1016/j.det.2011.11.007.

Both H, Essink-Bot ML, Busschbach J, Nijsten T. Critical review of generic and dermatology-specific health-related quality of life instruments. J Invest Dermatol. 2007; 127(12):2726–2739. doi:10.1038/sj.jid.5701142.

Lewis VJ, Finlay AY. A critical review of quality-of-life scales for psoriasis. Dermatol Clin. 2005; 23(4):707–716. doi:10.1016/j.det.2005.05.016.

Thadanipon K, Suchonwanit P. Measuring Patient Quality of Life Following Treatment for Alopecia. Patient Prefer Adherence. 2021 Jul 16; 15:1601-1610. doi: 10.2147/PPA.S282399. PMID: 34295154; PMCID: PMC8292623.

Stough D, Stenn K, Haber R, et al. Psychological effect, pathophysiology, and management of androgenetic alopecia in men. Mayo Clin Proc. 2005; 80(10):1316–1322.

Bater KL, Ishii M, Joseph A, Su P, Nellis J, Ishii LE. Perception of Hair Transplant for Androgenetic Alopecia. JAMA Facial Plast Surg. 2016 Dec 1;18(6):413-418. doi: 10.1001/jamafacial.2016.0546. PMID: 27560098; PMCID: PMC5469375.

Huang CH, Fu Y, Chi CC. Health-Related Quality of Life, Depression, and Self-esteem in Patients With Androgenetic Alopecia: A Systematic Review and Meta-analysis. JAMA Dermatol. 2021 Aug 1;157(8):963-970. doi:10.1001/jamadermatol.2021.2196. PMID: 34232264; PMCID: PMC8264758.

Razum J, Vukasović Hlupić T. Quality of life in young men with androgenetic alopecia: A mixed methods study. J Cosmet Dermatol. 2022 Feb;21(2):794-801. doi: 10.1111/jocd.14132. Epub 2021 Apr 16. PMID: 33817940.

Hafi B, Uvais NA, Afra TP, Razmi T M, Jafferany M, Abdul Latheef EN. Hair transplantation, body dysmorphic disorder, and patients' attitude: A survey-based study from south India. Dermatol Ther. 2020 Nov;33(6):e13945. doi: 10.1111/dth.13945. Epub 2020 Jul 14. PMID: 32618069.

Rosati P, Barone M, Alessandri Bonetti M, Giorgino R, Panasiti V, Coppola R, Tambone V, Persichetti P. A Systematic Review of Outcomes and Patient Satisfaction Following Surgical and Non-surgical Treatments for Hair Loss. Aesthetic Plast Surg. 2019 Dec;43(6):1523-1535. doi: 10.1007/s00266-019-01480-9. Epub 2019 Aug 26. PMID: 31451851.

Ghimire RB. Impact on Quality of Life in Patients who came with Androgenetic Alopecia for Hair Transplantion Surgery in a Clinic. JNMA J Nepal Med Assoc. 2018 Jul-Aug;56(212):763-765. doi: 10.31729/jnma.3500. PMID: 30387465; PMCID: PMC8827546.

Sinikumpu S-P, Jokelainen J, Auvinen J, et al. Association between psychosocial distress, sexual disorders, self-esteem and quality of life with male androgenetic alopecia: a population-based study with men at age 46. BMJ Open 2021;11: e049855. doi: 10.1136/bmjopen-2021-049855.

Elsaie LT, Elshahid AR, Hasan HM, Soultan FAZM, Jafferany M, Elsaie ML. Cross sectional quality of life assessment in patients with androgenetic alopecia. Dermatol Ther. 2020 Jul;33(4):e13799. doi: 10.1111/dth.13799. Epub 2020 Jul 9. PMID: 32520416.

Gonul M, Cemil BC, Ayvaz HH, Cankurtaran E, Ergin C, Gurel MS. Comparison of quality of life in patients with androgenetic alopecia and alopecia areata. An Bras Dermatol. 2018 Sep-Oct;93(5):651-658. doi: 10.1590/abd1806-4841.20186131. PMID: 30156613; PMCID: PMC6106669.

Liu F, Miao Y, Li X, et al. The relationship between selfesteem and hair transplantation satisfaction in male androgenetic alopecia patients. J Cosmet Dermatol. 2019; 18(5):1441-1447.

Liu Y, Liu F, Qu Q, Fan ZX, Miao Y, Hu ZQ. Evaluating the satisfaction of patients undergoing hair transplantation surgery using FACE-Q Scales. Aesthet Plast Surg. 2019;43(2): 375-382.

Published

2023-06-05

How to Cite

Deliborio, A. S., & Silva, V. (2023). Alopecia androgenética: uma revisão sobre a resolutividade do tratamento cirúrgico e sua implicação no contexto biopsicossocial do paciente. Brazilian Journal of Health Review, 6(3), 11742–11757. https://doi.org/10.34119/bjhrv6n3-264

Issue

Section

Original Papers