Compounding products for hair care goes beyond cosmetics. It is of extreme value for both patients & physicians. Several scalp & hair conditions cannot be treated with general or prescription products available in the market. These conditions may include hair loss, parasitic infestations, secondary bacterial infections, fungal infections, dandruff, seborrheic dermatitis& eczema.
At PFR We try to fill in this gap.

Hair loss
Hair loss is a common problem that can affect both men and women.

During a person’s lifetime, each hair follicle goes through many cycles of growth phase, transition phase and shedding phase. Different types of hair loss are due to the hair growth cycle being interrupted at different stages.

Common types include: Androgenic Alopecia also known as male-pattern hair loss, female-pattern hair loss, alopecia areata,thinning of hair known as telogen effluviumwhich can occur 3 months after a trigger such as childbirth ,sudden weight loss, crash dieting, starting a new drug , changing or stopping an an oral contraceptive, stress, major surgery, other causes might be some medications ,metabolic disorders, malnutrition (eg. severe iron deficiency, severe zinc deficiency) & severe infections.

Less common types of hair loss include Trichotillomania (compulsivehair pulling) & Scarring Alopecia caused by some conditions that affect the scalp aslupus erythematosus, lichen planopilaris & frontal fibrosing alopecia. Anagen effluvium is caused by cancer chemotherapy.

Androgenetic Alopecia or pattern baldness is a common type of hair loss affecting both men and women. Terminal hairs are replaced by shorter and finer hairs, due to the effect of androgens on the scalp hair follicle.

In men, it usually starts as a gradual receding of the hairline on both temples and then it advances to baldness. While in women, it starts by hair thinning that leads to a widened part line and a smaller ponytail volume.

 For many years, there has been a misconception about the cause of Androgenetic Alopecia relating it to the predominance of the male sex hormone, testosterone, which women also have in trace amounts under normal conditions. But while testosterone is at the core of the balding process, dihydrotestosterone (DHT) a derivative of the male hormone testosterone is now thought to be responsible for this type of alopecia .

Testosterone is converted to DHT by the enzyme 5-alpha reductase. So it’s not about the amount of circulating testosterone anymore but the level of DHT binding to receptors in scalp follicles. DHT shrinks hair follicles, making it impossible for healthy hair to survive.

Since hormones operate best when they are in a delicate balance, the androgens, as male hormones are called, do not need to be raised to trigger a problem. Their counterpart female hormones, when lowered, give an edge tothese androgens, such as DHT. Such an imbalance can also cause problems, including hair loss.

The main aim of treatment is to slow down further hair loss,and the secondary aim is to stimulate regrowth. Most treatments for androgenetic alopecia take 6-12 months to show an effect & need to continue for sustained benefit.

For Men , the use of topical Minoxidil or oral Finasteride (an inhibitor of Type II 5a-reductase ) or a combination of both are good treatment options.

For women the use of topical Minoxidil, oral spironolactone
(an antiandrogen) or combination therapy is an option.

PFR 5 WAY HAIR LOTION is a combination of Minoxidil Arginine , Azelaic acid, Pyridoxine &Vitamin E acetate .

Minoxidil when applied topicallyis known to increase blood flow which stimulates hair follicles, promoting hair regrowth by Reversing miniaturisation of follicles,Increasing blood flow around follicles,Stimulating follicle movement from resting to hair growth phase & Extending each follicle’s growth phase.

Due to its limited effectiveness (less than 10% cosmetically acceptable hair growth in patients with male-pattern baldness), it is often combined with other agents to increase its effectiveness. In those patients in whom it is effective, treatment must be continued or else the hair will be lost again.

 Arginine is an amino acid which boosts hair growth. As a precursor to nitric oxide, it is of vital importance for hair growth. Itimproves capillary blood circulation through the vasodilation attributed to its product, nitric oxide, it is believed that the improved perfusion of the cells of hair follicles contributes to hair regrowth by stimulating the production of new hairfollicles. Stimulating follicle movement from resting to hair growth phase & Extending each follicle’s growth phase.
Azelic acid, a potent 5-alpha-reductase inhibitor, has been included to prevent the formation of DHT, which prevents further hair loss by addressing the cause of the problem. Pyridoxine(vitamin B6) activates the enzymes and chemical reactions that start the metabolism of the hair proteins, keratin and melanin, in the hair follicles. This makes the hair follicles get enough keratin and melanin, which promotes hair growth and hair renewal.

Vitamin Eis an antioxidant that helps repair and build tissue. When you apply vitamin Eto your scalp, it helps reduce inflammation and repair damage to the follicles, and healthy follicles encourage hairgrowth.

 Saw palmetto:

Its androgenic effect is achieved by prostate selective inhibition of 5-α-reductase without influencing the plasma concentrations of testosterone.Saw palmetto has been shown to be involved in the conversion of testosterone to dihydrotestosterone (DHT), as well as in inhibition of DHT from binding to cellular and nuclear receptor sites, thereby increasing the metabolism and excretion of DHT. Improvement may depend on the amount of saw palmetto you use and attention to nutrition e.g reducing sugars and fats.

 Telogen Effluvium

It is a reactive hair condition that causes excessive hair shedding. The growth phase of hair is prematurely terminated by a triggering event such as childbirth, sudden weight loss, crash dieting, starting a new drug, changing or stopping an oral contraceptive, stress, major surgery causing hairs to enter the rest phase. Telogen Effluvium can either be acute; resolving within 6-9 months or Chronic lasting longer.

Identifiable causes of chronic effluvium include:

    Metabolic disorder such as Thyroid disease, Renal & Liver diseases.

    Vitamin and minerals deficiency

    Medications as some blood pressure medications, antidepressants, anti-epileptics, oral contraceptive pills, acne medication, warfarin.

    Severe infections or cancer.

Alopecia Areata :

Alopecia Areata is an autoimmune disorder, and unknown environmental triggers cause its expression. These unknown triggers signal the hairs in the growth phase of the affected area to convert to the shedding phase. Hairs prematurely stop growing and sheds rapidly,causing patches of Alopecia.

This type of Alopecia is characterised by unpredictable remission and relapse. Hair loss that involves the entire scalp is called Alopecia Totalis. Hair loss that involves the entire scalp and whole body is called Alopecia Universalis.

Treatment goals are to prevent the patch of loss from expanding and stimulate regrowth within it. Treatment choice depends on the extent and duration of hair loss.

For limited recent hair loss, potent topical corticosteroids such as Clobetasol 0.2 % lotion for at least 3-4 months can be used to stimulate hair regrowth.

Some conditions can affect the scalp such as lupus erythematosus, lichen planopilaris causing scarring alopecia. It often starts with scalp inflammation that leads to permanent scarring alopecia without treatment. Prescribing a potent topical corticosteroid eg. Clobetasol 0.2 % can help reduce inflammation before starting more systemic treatments.