Submitted:
25 June 2026
Posted:
29 June 2026
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Abstract
Keywords:
1. Introduction
2. Methods
2.1. Study Design and Setting
2.2. Participants
2.3. Ethics and Consent
2.4. Interventions
2.5. Outcomes and Assessments
2.6. Statistical Analysis
3. Results
3.1. Participant Disposition and Baseline Values
3.2. Hair-Cycle and Hair-Density Outcomes
| Endpoint | Group | T0 | T28 | T56 | T84 | T84 vs T0 |
|---|---|---|---|---|---|---|
| Anagen/telogen ratio | Serum A | 8.4 | 9.6 | 9.7 | 9.8 | +17.0% |
| Anagen/telogen ratio | Serum B placebo | 8.3 | 8.7 | 8.6 | 8.1 | -2.6% |
| Hair density, hairs/cm2 | Serum A | 127.1 | 169.8 | 168.6 | 169.6 | +33.5% |
| Hair density, hairs/cm2 | Serum B placebo | 135.2 | 144.7 | 144.0 | 145.0 | +7.2% |
| Hair shaft thickness, micrometers | Serum A | 80.5 | 84.5 | 87.0 | 89.0 | +10.6% |
| Hair shaft thickness, micrometers | Serum B placebo | 83.5 | 82.8 | 82.1 | 82.2 | -1.6% |
| Endpoint | Group | T0 vs T28 | T0 vs T56 | T0 vs T84 |
|---|---|---|---|---|
| Anagen/telogen ratio | Serum A | <0.0001 | 0.0013 | 0.0004 |
| Anagen/telogen ratio | Serum B placebo | 0.0198 | 0.8717 | 0.8012 |
| Hair density | Serum A | <0.0001 | <0.0001 | <0.0001 |
| Hair density | Serum B placebo | 0.1123 | 0.1151 | 0.1539 |
| Hair shaft thickness | Serum A | 0.0203 | 0.0101 | 0.0027 |
| Hair shaft thickness | Serum B placebo | 0.6989 | 0.2104 | 0.1835 |
| Endpoint | T0 | T28 | T56 | T84 |
|---|---|---|---|---|
| Anagen/telogen ratio | 0.8774 | 0.0972 | 0.0212 | 0.0005 |
| Hair density | 0.5086 | 0.0439 | 0.0484 | 0.0488 |
| Hair shaft thickness | 0.3270 | 0.5856 | 0.1170 | 0.0291 |
3.3. Scalp Hydration, TEWL, and Sebum Outcomes
| Endpoint | Group | T0 | T28 | T56 | T84 | T84 vs T0 |
|---|---|---|---|---|---|---|
| Scalp hydration, arbitrary units | Serum A | 25.4 | 29.8 | 30.2 | 31.0 | +22.2% |
| Scalp hydration, arbitrary units | Serum B placebo | 18.7 | 20.1 | 18.4 | 18.2 | -2.9% |
| Nano TEWL, g/h/m2 | Serum A | 9.8 | 8.4 | 7.2 | 7.1 | -27.2% |
| Nano TEWL, g/h/m2 | Serum B placebo | 11.9 | 10.7 | 11.6 | 10.8 | -9.2% |
| Sebum level, micrograms/cm2 | Serum A | 23.3 | 19.7 | 16.5 | 16.3 | -30.2% |
| Sebum level, micrograms/cm2 | Serum B placebo | 26.5 | 26.9 | 27.3 | 27.3 | +2.7% |
| Endpoint | Group | T0 vs T28 | T0 vs T56 | T0 vs T84 |
|---|---|---|---|---|
| Scalp hydration | Serum A | 0.0045 | 0.0003 | 0.0001 |
| Scalp hydration | Serum B placebo | 0.4481 | 0.8908 | 0.7808 |
| Nano TEWL | Serum A | 0.1933 | 0.0081 | 0.0124 |
| Nano TEWL | Serum B placebo | 0.0845 | 0.7657 | 0.2019 |
| Sebum level | Serum A | 0.1973 | 0.0041 | 0.0171 |
| Sebum level | Serum B placebo | 0.9188 | 0.6485 | 0.7929 |
| Endpoint | T0 | T28 | T56 | T84 |
|---|---|---|---|---|
| Scalp hydration | 0.0165 | 0.0005 | <0.0001 | <0.0001 |
| Nano TEWL | 0.1200 | 0.0947 | 0.0015 | 0.0073 |
| Sebum level | 0.5543 | 0.1871 | 0.0484 | 0.0449 |
3.4. Clinical Hair-Density Evaluation
| Endpoint / analysis | Serum A | Serum B placebo |
|---|---|---|
| Median T0 | 2.0 | 2.0 |
| Median T84 | 3.5 | 2.0 |
| Mean T0 | 1.9 | 2.1 |
| Mean T84 | 3.3 | 2.3 |
| SD T0 | 0.5 | 0.6 |
| SD T84 | 0.7 | 0.6 |
| Within-group p value | <0.0001 | 0.0781 |
| Participants improved at T84 | 90% | 35% |
| Participants not improved at T84 | 10% | 65% |
| Between-group comparison at T84 | p<0.0001 | p<0.0001 |
3.5. Participant Questionnaire
| Question | Strongly agree | Agree | Neutral | Disagree | Strongly disagree |
|---|---|---|---|---|---|
| Has the product reduced scalp itching? | 10% | 40% | 35% | 10% | 5% |
| Has the product reduced scalp dryness? | 25% | 45% | 20% | 5% | 5% |
| Has the product reduced discomfort or sensitivity on the scalp? | 20% | 50% | 30% | 0% | 0% |
| Has the product reduced redness or visible irritation of the scalp? | 15% | 45% | 40% | 0% | 0% |
| Has the product improved overall scalp comfort? | 30% | 55% | 10% | 5% | 0% |
| Has the product helped reduce hair loss? | 40% | 55% | - | 5% | 0% |
| Has the product made your hair feel stronger and healthier? | 30% | 65% | - | 5% | 0% |
| Has the product made your scalp feel fresher and cleaner? | 20% | 50% | - | 30% | 0% |
| Is the product easy to apply? | 35% | 65% | - | 0% | 0% |
| Does the product have a pleasant texture? | 25% | 65% | - | 10% | 0% |
| Is the product fragrance pleasant? | 15% | 70% | - | 15% | 0% |
| Does the product absorb easily without leaving residue or greasiness? | 15% | 50% | - | 20% | 15% |
| Does the product leave a pleasant feeling on the scalp after application? | 20% | 60% | - | 20% | 0% |
| Question | Strongly agree | Agree | Neutral | Disagree | Strongly disagree |
|---|---|---|---|---|---|
| Has the product reduced scalp itching? | 5% | 5% | 60% | 30% | 0% |
| Has the product reduced scalp dryness? | 0% | 20% | 40% | 40% | 0% |
| Has the product reduced discomfort or sensitivity on the scalp? | 0% | 35% | 55% | 10% | 0% |
| Has the product reduced redness or visible irritation of the scalp? | 5% | 25% | 45% | 10% | 15% |
| Has the product improved overall scalp comfort? | 0% | 45% | 15% | 25% | 15% |
| Has the product helped reduce hair loss? | 15% | 30% | - | 35% | 20% |
| Has the product made your hair feel stronger and healthier? | 10% | 30% | - | 35% | 25% |
| Has the product made your scalp feel fresher and cleaner? | 0% | 35% | - | 50% | 15% |
| Is the product easy to apply? | 20% | 75% | - | 0% | 5% |
| Does the product have a pleasant texture? | 10% | 40% | - | 40% | 10% |
| Is the product fragrance pleasant? | 15% | 40% | - | 35% | 10% |
| Does the product absorb easily without leaving residue or greasiness? | 5% | 20% | - | 50% | 25% |
| Does the product leave a pleasant feeling on the scalp after application? | 5% | 25% | - | 45% | 25% |
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Kligman, A.M. Pathologic dynamics of human hair loss: I. Telogen effluvium. Arch. Dermatol. 1961, 83, 175–198. [Google Scholar] [CrossRef] [PubMed]
- Headington, J.T. Telogen effluvium: New concepts and review. Arch. Dermatol. 1993, 129, 356–363. [Google Scholar] [CrossRef]
- Harrison, S.; Sinclair, R. Telogen effluvium. Clin. Exp. Dermatol. 2002, 27, 389–395. [Google Scholar] [CrossRef] [PubMed]
- Malkud, S. Telogen effluvium: A review. J. Clin. Diagn. Res. 2015, 9, WE01–WE03. [Google Scholar] [CrossRef] [PubMed]
- Ramos, P.M.; Miot, H.A. Female pattern hair loss: A clinical and pathophysiological review. An. Bras. Dermatol. 2015, 90, 529–543. [Google Scholar] [CrossRef] [PubMed]
- Ludwig, E. Classification of the types of androgenetic alopecia (common baldness) occurring in the female sex. Br. J. Dermatol. 1977, 97, 247–254. [Google Scholar] [CrossRef] [PubMed]
- Cash, T.F. The psychosocial consequences of androgenetic alopecia: A review of the research literature. Br. J. Dermatol. 1999, 141, 398–405. [Google Scholar] [CrossRef] [PubMed]
- Davis, D.S.; Callender, V.D. Review of quality of life studies in women with alopecia. Int. J. Womens Dermatol. 2018, 4, 18–22. [Google Scholar] [CrossRef] [PubMed]
- Stenn, K.S.; Paus, R. Controls of hair follicle cycling. Physiol. Rev. 2001, 81, 449–494. [Google Scholar] [CrossRef] [PubMed]
- Paus, R.; Cotsarelis, G. The biology of hair follicles. N. Engl. J. Med. 1999, 341, 491–497. [Google Scholar] [CrossRef] [PubMed]
- Schneider, M.R.; Schmidt-Ullrich, R.; Paus, R. The hair follicle as a dynamic miniorgan. Curr. Biol. 2009, 19, R132–R142. [Google Scholar] [CrossRef] [PubMed]
- Driskell, R.R.; Clavel, C.; Rendl, M.; Watt, F.M. Hair follicle dermal papilla cells at a glance. J. Cell Sci. 2011, 124, 1179–1182. [Google Scholar] [CrossRef] [PubMed]
- Rishikaysh, P.; Dev, K.; Diaz, D.; Qureshi, W.M.; Filip, S.; Mokry, J. Signaling involved in hair follicle morphogenesis and development. Int. J. Mol. Sci. 2014, 15, 1647–1670. [Google Scholar] [CrossRef] [PubMed]
- Jahoda, C.A.; Horne, K.A.; Oliver, R.F. Induction of hair growth by implantation of cultured dermal papilla cells. Nature 1984, 311, 560–562. [Google Scholar] [CrossRef] [PubMed]
- du Cros, D.L. Fibroblast growth factor and epidermal growth factor in hair development. J. Invest. Dermatol. 1993, 101, 106S–113S. [Google Scholar] [CrossRef] [PubMed]
- Ozeki, M.; Tabata, Y. Promoted growth of murine hair follicles through controlled release of basic fibroblast growth factor. Tissue Eng. 2002, 8, 359–366. [Google Scholar] [CrossRef] [PubMed]
- Lin, W.H.; Xiang, L.J.; Shi, H.X.; Zhang, J.; Jiang, L.P.; Cai, P.T.; Lin, Z.L.; Lin, B.B.; Huang, Y.; Zhang, H.L.; et al. Fibroblast growth factors stimulate hair growth through beta-catenin and Shh expression in C57BL/6 mice. BioMed Res. Int. 2015, 2015, 730139. [Google Scholar] [CrossRef] [PubMed]
- Hwang, K.A.; Hwang, Y.L.; Lee, M.H.; Kim, N.R.; Roh, S.S.; Lee, Y.; Kim, C.D.; Lee, J.H.; Choi, K.C. Adenosine stimulates growth of dermal papilla and lengthens the anagen phase by increasing cysteine level via fibroblast growth factors 2 and 7 in an organ culture of mouse vibrissae hair follicles. Int. J. Mol. Med. 2012, 29, 195–201. [Google Scholar] [CrossRef] [PubMed]
- Hoffmann, R. TrichoScan: Combining epiluminescence microscopy with digital image analysis for the measurement of hair growth in vivo. Eur. J. Dermatol. 2001, 11, 362–368. [Google Scholar] [PubMed]
- Hoffmann, R. TrichoScan: A novel tool for the analysis of hair growth in vivo. J. Investig. Dermatol. Symp. Proc. 2003, 8, 109–115. [Google Scholar] [CrossRef] [PubMed]
- Van Neste, D.; Trueb, R.M. Critical study of hair growth analysis with computer-assisted methods. J. Eur. Acad. Dermatol. Venereol. 2006, 20, 578–583. [Google Scholar] [PubMed]
- Dhurat, R.; Saraogi, P. Hair evaluation methods: Merits and demerits. Int. J. Trichology 2009, 1, 108–119. [Google Scholar] [CrossRef] [PubMed]
- Berardesca, E.; EEMCO Group. EEMCO guidance for the assessment of stratum corneum hydration: Electrical methods. Skin. Res. Technol. 1997, 3, 126–132. [Google Scholar] [CrossRef] [PubMed]
- Rogiers, V.; Balls, M.; Basketter, D.; Berardesca, E.; Edwards, C.; Elsner, P.; Leveque, J.L.; Masson, P.; Loden, M.; Parra, J.; et al. EEMCO guidance for the assessment of transepidermal water loss (TEWL) in cosmetic sciences. Skin. Pharmacol. Appl. Skin. Physiol. 2001, 14, 117–129. [Google Scholar] [CrossRef] [PubMed]
- Berardesca, E.; Loden, M.; Serup, J.; Masson, P.; Rodrigues, L.M. The revised EEMCO guidance for the in vivo measurement of water in the skin. Skin. Res. Technol. 2018, 24, 351–358. [Google Scholar] [CrossRef] [PubMed]
- Suchonwanit, P.; Triyangkulsri, K.; Ploydaeng, M.; Leerunyakul, K. Assessing biophysical and physiological profiles of scalp seborrheic dermatitis in the Thai population. BioMed Res. Int. 2019, 2019, 5128376. [Google Scholar] [CrossRef] [PubMed]
- Firooz, A.; Sadr, B.; Babakoohi, S.; Sarraf-Yazdy, M.; Fanian, F.; Kazerouni-Timsar, A.; Nassiri-Kashani, M.; Naghizadeh, M.M.; Dowlati, Y. Variation of biophysical parameters of the skin with age, gender, and body region. Sci. World J. 2012, 2012, 386936. [Google Scholar] [CrossRef] [PubMed]
- Green, M.; Kashetsky, N.; Feschuk, A.; Maibach, H.I. Transepidermal water loss (TEWL): Environment and pollution - A systematic review. Skin. Health Dis. 2022, 2, e104. [Google Scholar] [CrossRef] [PubMed]
- Lee, Y.I.; Kim, J.; Park, S.R.; Ham, S.; Lee, H.J.; Park, C.R.; Kim, H.N.; Kang, B.H.; Jung, I.; Suk, J.M.; et al. Age-related changes in scalp biophysical parameters: A comparative analysis of the 20s and 50s age groups. Skin. Res. Technol. 2023, 29, e13433. [Google Scholar] [CrossRef] [PubMed]
- van Rooijen, G.J.H.; Moloney, M.M. Plant seed oil-bodies as carriers for foreign proteins. Bio/Technology 1995, 13, 72–77. [Google Scholar] [CrossRef] [PubMed]
- Ling, H. Oleosin fusion expression systems for the production of recombinant proteins. Biologia 2007, 62, 119–123. [Google Scholar] [CrossRef]
- Bhatla, S.C.; Kaushik, V.; Yadav, M.K. Use of oil bodies and oleosins in recombinant protein production and other biotechnological applications. Biotechnol. Adv. 2010, 28, 293–300. [Google Scholar] [CrossRef] [PubMed]
- Wosicka, H.; Cal, K. Targeting to the hair follicles: Current status and potential. J. Dermatol. Sci. 2010, 57, 83–89. [Google Scholar] [CrossRef] [PubMed]
- World Medical Association. World Medical Association Declaration of Helsinki: Ethical principles for medical research involving human subjects. JAMA 2013, 310, 2191–2194. [Google Scholar] [CrossRef] [PubMed]
- Hopewell, S.; Chan, A.W.; Collins, G.S.; Hrobjartsson, A.; Moher, D.; Schulz, K.F.; Tunn, R.; Aggarwal, R.; Berkwits, M.; Berlin, J.A.; et al. CONSORT 2025 statement: Updated guideline for reporting randomised trials. BMJ 2025, 388, e081123. [Google Scholar] [CrossRef] [PubMed]
| Endpoint | Serum A baseline | Serum B baseline |
|---|---|---|
| Anagen/telogen ratio | 8.4 | 8.3 |
| Hair density, hairs/cm2 | 127.1 | 135.2 |
| Hair shaft thickness, micrometers | 80.5 | 83.5 |
| Scalp hydration, arbitrary units | 25.4 | 18.7 |
| Nano TEWL, g/h/m2 | 9.8 | 11.9 |
| Sebum level, micrograms/cm2 | 23.3 | 26.5 |
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