Senile trichiasis is primarily manifested by eyelid laxity, decreased horizontal elasticity and tension of the eyelids, leading to friction between the eyelashes and the cornea, which subsequently causes corneal damage and vision decline. Surgical intervention remains the most effective therapeutic approach for senile trichiasis. This article elaborates on the epidemiological characteristics, pathological mechanisms, and clinical manifestations of senile trichiasis and systematically reviews the surgical treatment method for upper and lower eyelid trichiasis, including traditional surgical techniques and emerging minimally invasive procedures combined with personalized therapies. Through a literature review, the effectiveness and recurrence rates of surgical treatment are summarized, emphasizing the importance of preoperative assessment and individualized treatment. Additionally, strategies and recommendations for preventing senile trichiasis are proposed.

Objective:To investigate the consistency of trichoscopic fields in androgenetic alopecia (AGA) patients by using scalp medical pigmentation (SMP) ink as visual marker, as well as the safety and durability.Methods:A retrospective analysis was conducted on patients with AGA who visited the Medical Cosmetology Center, Hangzhou First People’s Hospital, Westlake University School of Medicine from April to August 2024. Trichoscopic images were captured immediately and three months after using SMP ink for visual marker. Each patient’s two trichoscopic images were imported into Photoshop CC 2019 software for processing to obtain the location information of the marker, the distance between the marker center and the image center, and pigments areas. Consistency of markers during repeated trichoscopy was evaluated by comparing distances between pigment center and image center. The difference in distance between the two time points (3-month distance minus immediate-post-marking distance) was defined as "distance difference". Patients were divided into the same-operator group and different-operator group based on whether the two trichoscopy examinations were performed by the same operator. The impact of operator changes on the consistency of markers during repeated trichoscopy was assessed by comparing the "distance difference" between the two groups. Additionally, patients were categorized into single-point, double-point, and triple-point groups according to the number of markers. The influence of marker quantity on consistency of the markers was evaluated by comparing the "distance difference" among these three groups. Pigment spread was assessed by comparing pigment actural area in repeated trichoscopic images. Adverse reactions and ink fading within three months were recorded. Statistical analysis was performed using SPSS 27.0 software.The normal distribution measurement data was expressed as Mean ± SD, and the non-normal distribution measurement data was expressed as M ( Q1, Q3). The Wilcoxon signed-rank test was applied for comparison of the distance between the marker center and the image center in the preceding and subsequent trichoscopic images. Mann-Whitney U test was applied for comparison between the same-operator group and the different-operator group, and the Kruskal-Wallis rank sum test was used for comparison among the single-point, double-point, and triple-point groups. The paired sample t-test was used for comparison of the pigment actural area during repeated measurements. P<0.05 indicated statistically significant differences. Results:A total of 22 male AGA patients (aged 24-43 years) were included, with 46 pigment points marked (8 single-point, 4 double-point, 10 triple-point). Same-operator and different-operator groups comprised of 13 and 9 patients, respectively. No significant difference was found in distances between marker center and image center immediately vs. 3 months post-marking [0.91 (0.62, 1.53) mm vs. 0.83 (0.62, 1.22) mm, Z=-0.83, P=0.408]. Comparisons of the "distance difference" between the same-operator and different-operator groups, and among the single-point, double-point, and triple-point groups, showed no statistically significant differences (all P> 0.05). Pigment areas increased by (0.11±0.12) mm 2 at 3 months ( t=-6.47, P<0.001). All pigments exhibited fading within 3 months but remained identifiable without touch-up. Adverse reactions were minimal: mild puncture-site bleeding was observed, with no pigment-related allergies, foreign-body reactions, or significant scarring. Conclusion:Single-point SMP pigment enables reliable and consistent visualization of trichoscopic measurement points in AGA patients, unaffected by operator changes. The method demonstrates clinical convenience, flexibility, high safety, and long-term durability.

Objective:To investigate the efficacy of microneedling combined with topical 5% minoxidil tincture in the treatment of male androgenetic alopecia (AGA).Methods:This study was a prospective study. Male patients with newly diagnosed androgenetic alopecia at the Medical Cosmetic Center, Affiliated Hangzhou First People’s Hospital Westlake University School of Medicine, from April 2022 to April 2024 were selected. Age and BASP score were used as matching variables, and every 3 cases were matched as a group. In the study group, 1.0 mm microneedle combined with topical 5% minoxidil tincture was used for 2-3 times of acupuncture operation in the hair loss area, and then about 1 ml of 5% minoxidil tincture was applied to the scalp to promote absorption. From the second day, about 1 ml of 5% minoxidil tincture was evenly sprayed on the hair roots of the scalp in the hair loss area and massaged until absorption, once in the morning and evening every day. Control group 1 was evenly sprayed with 5% minoxidil tincture on the hair roots of the alopecia area, once a day in the morning and evening, about 1 ml each time. Patients in control group 2 received oral finasteride 1 mg once daily. The three groups were treated for 13 weeks, and adverse reactions were recorded during the treatment. Before and immediately after 13 weeks of treatment, the final hair density, velus hair density, hair follicle density, hair shaft average diameter, single hair follicle density and double hair follicle density of the three groups were measured by dermoscopy. Paired sample t-test was used for statistical analysis. After 13 weeks of treatment, the above measurement indexes of study group, control group 1 and control group 2 were analyzed by LSD multiple comparison method. Results:A total of 99 male patients were enrolled, with 33 in the study group [mean age: (31.6 ± 5.8) years, range: 18-45], 33 in control group 1[mean age: (31.7 ± 5.6) years, range: 20-44], and 33 in control group 2 [mean age: (32.2 ± 5.4 )years, range: 19-45].In the study group, three patients experienced transient pain in the treated areas during and after microneedling, which resolved spontaneously within two hours. Two patients developed scalp flaking three days post-treatment, which improved with increased washing frequency and targeted shampoo selection. No significant adverse reactions were observed in control groups 1 and 2.After 13 weeks of treatment, significant increases were observed in the study group compared to baseline for terminal hair density [(104.5 ± 29.6) hairs/cm 2 vs. (72.5 ± 27.9) hairs/cm 2], mean hair shaft diameter [(53.6 ± 11.4) μm vs. (45.7 ± 12.9) μm], follicular unit density [(71.4 ± 18.5) units/cm 2 vs. (57.8 ± 17.4) units/cm 2], and single-hair follicular unit density [(46.7 ± 11.1) units/cm 2 vs. (31.4 ± 12.3) units/cm 2], all with statistically significant differences ( P < 0.05). Control group 1 also showed significant increases in terminal hair density [(87.3 ± 24.5) hairs/cm 2 vs. (70.7 ± 26.0) hairs/cm 2], vellus hair density [(55.3 ± 13.9) hairs/cm 2 vs. (30.2 ± 8.8) hairs/cm 2], follicular unit density [(58.9 ± 17.1) units/cm 2 vs. (52.6 ± 15.5) units/cm 2], mean hair shaft diameter [(52.8 ± 15.7) μm vs. (50.1 ± 16.0) μm], and single-hair follicular unit density [(40.1 ± 11.1) units/cm 2 vs. (34.2 ± 12.0) units/cm 2], all with statistically significant differences ( P < 0.05).Control group 2 showed significant improvements in terminal hair density [(106.3 ± 22.5) hairs/cm 2 vs. (73.7 ± 26.9) hairs/cm 2], follicular unit density [(68.4 ± 18.1) units/cm 2 vs. (53.7 ± 15.4) units/cm 2], mean hair shaft diameter [(57.9 ± 16.2) μm vs. (50.6 ± 15.7) μm], single-hair follicular unit density [(48.1 ± 11.5) units/cm 2 vs. (34.2 ± 12.6) units/cm 2], and double-hair follicular unit density [(23.5 ± 6.4) units/cm 2 vs. (17.2 ± 6.8) units/cm 2], all with statistically significant differences ( P < 0.05). When comparing post-treatment outcomes, the study group exhibited significantly higher terminal hair density, vellus hair density, mean hair shaft diameter, follicular unit density, and single-hair follicular unit density than control group 1, while vellus hair density was significantly lower ( P < 0.05). The study group and control group 2 showed no statistically significant differences in most parameters except for double-hair follicular unit density, which was significantly lower in the study group ( P< 0.05). Conclusion:Microneedling combined with topical 5% minoxidil tincture is an effective treatment for male androgenetic alopecia, demonstrating significant improvements in hair density, follicular unit density, and hair shaft thickness.

Senile trichiasis is primarily manifested by eyelid laxity, decreased horizontal elasticity and tension of the eyelids, leading to friction between the eyelashes and the cornea, which subsequently causes corneal damage and vision decline. Surgical intervention remains the most effective therapeutic approach for senile trichiasis. This article elaborates on the epidemiological characteristics, pathological mechanisms, and clinical manifestations of senile trichiasis and systematically reviews the surgical treatment method for upper and lower eyelid trichiasis, including traditional surgical techniques and emerging minimally invasive procedures combined with personalized therapies. Through a literature review, the effectiveness and recurrence rates of surgical treatment are summarized, emphasizing the importance of preoperative assessment and individualized treatment. Additionally, strategies and recommendations for preventing senile trichiasis are proposed.

Objective:To investigate the consistency of trichoscopic fields in androgenetic alopecia (AGA) patients by using scalp medical pigmentation (SMP) ink as visual marker, as well as the safety and durability.Methods:A retrospective analysis was conducted on patients with AGA who visited the Medical Cosmetology Center, Hangzhou First People’s Hospital, Westlake University School of Medicine from April to August 2024. Trichoscopic images were captured immediately and three months after using SMP ink for visual marker. Each patient’s two trichoscopic images were imported into Photoshop CC 2019 software for processing to obtain the location information of the marker, the distance between the marker center and the image center, and pigments areas. Consistency of markers during repeated trichoscopy was evaluated by comparing distances between pigment center and image center. The difference in distance between the two time points (3-month distance minus immediate-post-marking distance) was defined as "distance difference". Patients were divided into the same-operator group and different-operator group based on whether the two trichoscopy examinations were performed by the same operator. The impact of operator changes on the consistency of markers during repeated trichoscopy was assessed by comparing the "distance difference" between the two groups. Additionally, patients were categorized into single-point, double-point, and triple-point groups according to the number of markers. The influence of marker quantity on consistency of the markers was evaluated by comparing the "distance difference" among these three groups. Pigment spread was assessed by comparing pigment actural area in repeated trichoscopic images. Adverse reactions and ink fading within three months were recorded. Statistical analysis was performed using SPSS 27.0 software.The normal distribution measurement data was expressed as Mean ± SD, and the non-normal distribution measurement data was expressed as M ( Q1, Q3). The Wilcoxon signed-rank test was applied for comparison of the distance between the marker center and the image center in the preceding and subsequent trichoscopic images. Mann-Whitney U test was applied for comparison between the same-operator group and the different-operator group, and the Kruskal-Wallis rank sum test was used for comparison among the single-point, double-point, and triple-point groups. The paired sample t-test was used for comparison of the pigment actural area during repeated measurements. P<0.05 indicated statistically significant differences. Results:A total of 22 male AGA patients (aged 24-43 years) were included, with 46 pigment points marked (8 single-point, 4 double-point, 10 triple-point). Same-operator and different-operator groups comprised of 13 and 9 patients, respectively. No significant difference was found in distances between marker center and image center immediately vs. 3 months post-marking [0.91 (0.62, 1.53) mm vs. 0.83 (0.62, 1.22) mm, Z=-0.83, P=0.408]. Comparisons of the "distance difference" between the same-operator and different-operator groups, and among the single-point, double-point, and triple-point groups, showed no statistically significant differences (all P> 0.05). Pigment areas increased by (0.11±0.12) mm 2 at 3 months ( t=-6.47, P<0.001). All pigments exhibited fading within 3 months but remained identifiable without touch-up. Adverse reactions were minimal: mild puncture-site bleeding was observed, with no pigment-related allergies, foreign-body reactions, or significant scarring. Conclusion:Single-point SMP pigment enables reliable and consistent visualization of trichoscopic measurement points in AGA patients, unaffected by operator changes. The method demonstrates clinical convenience, flexibility, high safety, and long-term durability.

Objective:To investigate the efficacy of microneedling combined with topical 5% minoxidil tincture in the treatment of male androgenetic alopecia (AGA).Methods:This study was a prospective study. Male patients with newly diagnosed androgenetic alopecia at the Medical Cosmetic Center, Affiliated Hangzhou First People’s Hospital Westlake University School of Medicine, from April 2022 to April 2024 were selected. Age and BASP score were used as matching variables, and every 3 cases were matched as a group. In the study group, 1.0 mm microneedle combined with topical 5% minoxidil tincture was used for 2-3 times of acupuncture operation in the hair loss area, and then about 1 ml of 5% minoxidil tincture was applied to the scalp to promote absorption. From the second day, about 1 ml of 5% minoxidil tincture was evenly sprayed on the hair roots of the scalp in the hair loss area and massaged until absorption, once in the morning and evening every day. Control group 1 was evenly sprayed with 5% minoxidil tincture on the hair roots of the alopecia area, once a day in the morning and evening, about 1 ml each time. Patients in control group 2 received oral finasteride 1 mg once daily. The three groups were treated for 13 weeks, and adverse reactions were recorded during the treatment. Before and immediately after 13 weeks of treatment, the final hair density, velus hair density, hair follicle density, hair shaft average diameter, single hair follicle density and double hair follicle density of the three groups were measured by dermoscopy. Paired sample t-test was used for statistical analysis. After 13 weeks of treatment, the above measurement indexes of study group, control group 1 and control group 2 were analyzed by LSD multiple comparison method. Results:A total of 99 male patients were enrolled, with 33 in the study group [mean age: (31.6 ± 5.8) years, range: 18-45], 33 in control group 1[mean age: (31.7 ± 5.6) years, range: 20-44], and 33 in control group 2 [mean age: (32.2 ± 5.4 )years, range: 19-45].In the study group, three patients experienced transient pain in the treated areas during and after microneedling, which resolved spontaneously within two hours. Two patients developed scalp flaking three days post-treatment, which improved with increased washing frequency and targeted shampoo selection. No significant adverse reactions were observed in control groups 1 and 2.After 13 weeks of treatment, significant increases were observed in the study group compared to baseline for terminal hair density [(104.5 ± 29.6) hairs/cm 2 vs. (72.5 ± 27.9) hairs/cm 2], mean hair shaft diameter [(53.6 ± 11.4) μm vs. (45.7 ± 12.9) μm], follicular unit density [(71.4 ± 18.5) units/cm 2 vs. (57.8 ± 17.4) units/cm 2], and single-hair follicular unit density [(46.7 ± 11.1) units/cm 2 vs. (31.4 ± 12.3) units/cm 2], all with statistically significant differences ( P < 0.05). Control group 1 also showed significant increases in terminal hair density [(87.3 ± 24.5) hairs/cm 2 vs. (70.7 ± 26.0) hairs/cm 2], vellus hair density [(55.3 ± 13.9) hairs/cm 2 vs. (30.2 ± 8.8) hairs/cm 2], follicular unit density [(58.9 ± 17.1) units/cm 2 vs. (52.6 ± 15.5) units/cm 2], mean hair shaft diameter [(52.8 ± 15.7) μm vs. (50.1 ± 16.0) μm], and single-hair follicular unit density [(40.1 ± 11.1) units/cm 2 vs. (34.2 ± 12.0) units/cm 2], all with statistically significant differences ( P < 0.05).Control group 2 showed significant improvements in terminal hair density [(106.3 ± 22.5) hairs/cm 2 vs. (73.7 ± 26.9) hairs/cm 2], follicular unit density [(68.4 ± 18.1) units/cm 2 vs. (53.7 ± 15.4) units/cm 2], mean hair shaft diameter [(57.9 ± 16.2) μm vs. (50.6 ± 15.7) μm], single-hair follicular unit density [(48.1 ± 11.5) units/cm 2 vs. (34.2 ± 12.6) units/cm 2], and double-hair follicular unit density [(23.5 ± 6.4) units/cm 2 vs. (17.2 ± 6.8) units/cm 2], all with statistically significant differences ( P < 0.05). When comparing post-treatment outcomes, the study group exhibited significantly higher terminal hair density, vellus hair density, mean hair shaft diameter, follicular unit density, and single-hair follicular unit density than control group 1, while vellus hair density was significantly lower ( P < 0.05). The study group and control group 2 showed no statistically significant differences in most parameters except for double-hair follicular unit density, which was significantly lower in the study group ( P< 0.05). Conclusion:Microneedling combined with topical 5% minoxidil tincture is an effective treatment for male androgenetic alopecia, demonstrating significant improvements in hair density, follicular unit density, and hair shaft thickness.

Objective:To investigate the effect of laboratory indicators on hair loss in patients with female pattern hair loss (FPHL).Methods:Patients with FPHL who visited the Outpatient Clinic of the Department of Medical Aesthetics in Hangzhou First People’s Hospital from November 2022 to November 2023 were selected as the study group, and healthy women who matched the age of the study group in the physical examination center during the same period were selected as the control group. The general information of the patient was recorded, and was also tested by trichoscopy to rule out other patterns of alopecia. Representative indicators including testosterone, dehydroepiandrosterone sulfate(DHEA-S), thyroid-stimulating hormone, 25-hydroxyvitamin D, and serum ferritin were selected from laboratory tests for further analysis. Otherwise, the proportion of deficiency in vitamin D(<20 ng/ml) was calculated based on 25-hydroxyvitamin D levels (number of deficiency cases/total number of cases in each group×100%). Count data were presented as samples (percentages), and chi-square test was used for comparison between groups. Normally distributed continuous data were presented with Mean±SD, independent samples t-test was used for comparison between groups, M( Q1, Q3) was used for non-normally distributed continuous data, and Wilcoxon rank-sum test was used for comparison between groups. Multivariate logistic regression was used to analyze the influencing factors of FPHL. P<0.05 was statistically significant. Results:A total of 37 patients were selected in both groups. The mean age was (28.8±1.3) years in the study group and (29.6±0.9) years in the control group ( t=0.49, P=0.625). The body mass index was (22.8±0.4) kg/m 2 in the study group, and (23.5±0.3) kg/m 2 in the control group ( t=1.26, P=0.211). The testosterone level was 0.58 (0.49, 0.79) nmol/L in the study group, and 0.54 (0.50, 0.78) nmol/L in the control group( Z=1.42, P=0.157). The level of DHEA-S was 6.21 (5.18, 9.60) μmol/L in the study group, and 6.20 (5.20, 9.34) μmol/L in the control group ( Z=2.75, P=0.006). The level of thyroid-stimulating hormone was 2.56 (1.55, 3.66) mU/L in the study group and 1.49 (1.05, 2.65) mU/L in the control group ( Z=2.51, P=0.012). The level of 25-hydroxyvitamin D was 15.44 (11.80, 21.20) ng/ml in the study group, and the level of 25-hydroxyvitamin D was 20.32 (12.07, 21.20) ng/ml in the control group ( Z=2.30, P=0.021), and the proportion of 25-hydroxyvitamin D deficiency in the study group was 64.9% (24/37), which was higher than that in the control group [40.5% (15/37)] ( χ2=4.39, P=0.036). The serum ferritin level was 64.44 (39.47, 133.45) μg/L in the study group and 67.75 (52.63, 143.83) μg/L in the control group ( Z=0.70, P=0.484). The results of multivariate logistic regression analysis showed that the risk of FPHL was increased by the high level of DHEA-S and thyroid-stimulating hormone, and the low level of 25-hydroxyvitamin D (all P<0.05). Conclusion:Abnormal level of DHEA-S, thyroid-stimulating hormone, and 25-hydroxyvitamin D may be risk factors for FPHL.

Objective:To investigate the effect of laboratory indicators on hair loss in patients with female pattern hair loss (FPHL).Methods:Patients with FPHL who visited the Outpatient Clinic of the Department of Medical Aesthetics in Hangzhou First People’s Hospital from November 2022 to November 2023 were selected as the study group, and healthy women who matched the age of the study group in the physical examination center during the same period were selected as the control group. The general information of the patient was recorded, and was also tested by trichoscopy to rule out other patterns of alopecia. Representative indicators including testosterone, dehydroepiandrosterone sulfate(DHEA-S), thyroid-stimulating hormone, 25-hydroxyvitamin D, and serum ferritin were selected from laboratory tests for further analysis. Otherwise, the proportion of deficiency in vitamin D(<20 ng/ml) was calculated based on 25-hydroxyvitamin D levels (number of deficiency cases/total number of cases in each group×100%). Count data were presented as samples (percentages), and chi-square test was used for comparison between groups. Normally distributed continuous data were presented with Mean±SD, independent samples t-test was used for comparison between groups, M( Q1, Q3) was used for non-normally distributed continuous data, and Wilcoxon rank-sum test was used for comparison between groups. Multivariate logistic regression was used to analyze the influencing factors of FPHL. P<0.05 was statistically significant. Results:A total of 37 patients were selected in both groups. The mean age was (28.8±1.3) years in the study group and (29.6±0.9) years in the control group ( t=0.49, P=0.625). The body mass index was (22.8±0.4) kg/m 2 in the study group, and (23.5±0.3) kg/m 2 in the control group ( t=1.26, P=0.211). The testosterone level was 0.58 (0.49, 0.79) nmol/L in the study group, and 0.54 (0.50, 0.78) nmol/L in the control group( Z=1.42, P=0.157). The level of DHEA-S was 6.21 (5.18, 9.60) μmol/L in the study group, and 6.20 (5.20, 9.34) μmol/L in the control group ( Z=2.75, P=0.006). The level of thyroid-stimulating hormone was 2.56 (1.55, 3.66) mU/L in the study group and 1.49 (1.05, 2.65) mU/L in the control group ( Z=2.51, P=0.012). The level of 25-hydroxyvitamin D was 15.44 (11.80, 21.20) ng/ml in the study group, and the level of 25-hydroxyvitamin D was 20.32 (12.07, 21.20) ng/ml in the control group ( Z=2.30, P=0.021), and the proportion of 25-hydroxyvitamin D deficiency in the study group was 64.9% (24/37), which was higher than that in the control group [40.5% (15/37)] ( χ2=4.39, P=0.036). The serum ferritin level was 64.44 (39.47, 133.45) μg/L in the study group and 67.75 (52.63, 143.83) μg/L in the control group ( Z=0.70, P=0.484). The results of multivariate logistic regression analysis showed that the risk of FPHL was increased by the high level of DHEA-S and thyroid-stimulating hormone, and the low level of 25-hydroxyvitamin D (all P<0.05). Conclusion:Abnormal level of DHEA-S, thyroid-stimulating hormone, and 25-hydroxyvitamin D may be risk factors for FPHL.

Senile trichiasis is primarily manifested by eyelid laxity, decreased horizontal elasticity and tension of the eyelids, leading to friction between the eyelashes and the cornea, which subsequently causes corneal damage and vision decline. Surgical treatment is currently the best solution for senile trichiasis. This article elaborates on the epidemiological characteristics, pathological mechanisms, and clinical manifestations of senile trichiasis and systematically reviews the surgical treatment method for upper and lower eyelid trichiasis, including traditional surgical techniques and emerging minimally invasive combined with personalized therapies. Through a literature review, the effectiveness and recurrence rates of surgical treatment are summarized, emphasizing the importance of preoperative assessment and individualized treatment. Additionally, strategies and recommendations for preventing senile trichiasis are proposed.

Senile trichiasis is primarily manifested by eyelid laxity, decreased horizontal elasticity and tension of the eyelids, leading to friction between the eyelashes and the cornea, which subsequently causes corneal damage and vision decline. Surgical treatment is currently the best solution for senile trichiasis. This article elaborates on the epidemiological characteristics, pathological mechanisms, and clinical manifestations of senile trichiasis and systematically reviews the surgical treatment method for upper and lower eyelid trichiasis, including traditional surgical techniques and emerging minimally invasive combined with personalized therapies. Through a literature review, the effectiveness and recurrence rates of surgical treatment are summarized, emphasizing the importance of preoperative assessment and individualized treatment. Additionally, strategies and recommendations for preventing senile trichiasis are proposed.