Guidance for the management of hirsutism.

Approximately 80% of women are affected by the presence of excessive hair growth in a 'male-like' pattern. Excessive facial hair in particular can be a source of distress to such women and can lead to psychological problems such as anxiety, depression and a reduced quality of life.Current cosmetic methods of hair removal include shaving, depilatories, waxing, plucking, laser, intense pulsed light (IPL) and electrolysis.A topical treatment cream such as eflornithine 11.5% can slow hair growth and thus reduce the frequency of the need for hair removal. This treatment can be used effectively in conjunction with hair removal methods.

Hair and nail relationship.

Hair and nails are often stated to have much in common in relation to their origin, anatomical structures, and common involvement in many diseases. Hair and nails are predominantly epithelial structures derived from primitive epidermis and made up of keratinous fibrils embedded in a sulfur-rich matrix. It was first noted early in the 20th century that the nail unit was comparable in several respects to a hair follicle sectioned longitudinally and laid on on its side. The epithelial components of hair follicle and nail apparatus are differentiated epidermal structures that may be involved jointly in several ways as congenital and hereditary anomalies and acquired conditions such as alopecia areata, lichen planus, iatrogenic causes, and fungal infection. Multielemental characterization of human hair and nails shows that even after sample washing, many elements are enriched in the surface of the nails.

Weathering of hair in trichoteiromania.

A 74-year-old woman presented with an 18-month history of broken vertex scalp hairs as a consequence of chronic rubbing. Light microscopy of the 1-2 cm hairs demonstrated distal brush-like splitting. Education and behavioural therapy were instituted. After 4 months of reduced rubbing of the vertex scalp hairs, the hairs re-grew with no evidence of persistent hair shaft abnormality.

Methods of evaluating hair growth.

For decades, scientists and clinicians have examined methods of measuring scalp hair growth. With the development of drugs that stem or even reverse the miniaturization of androgenetic alopecia, there has been a greater need for reliable, economical and minimally invasive means of measuring hair growth and, specifically, response to therapy. We review the various methods of measurement described to date, their limitations and value to the clinician. In our opinion, the potential of computer-assisted technology in this field is yet to be maximized and the currently available tools are less than ideal. The most valuable means of measurement at the present time are global photography and phototrichogram-based techniques (with digital image analysis) such as the 'TrichoScan'. Subjective scoring systems are also of value in the overall assessment of response to therapy and these are under-utilized and merit further refinement.

Onychomycosis of toenails: orthopaedic and podiatric considerations.

Onychomycosis is common, affecting approximately 5% of the population, and is the most resistant form of superficial fungal infection. Dermatologists often view the nail apparatus in static terms and unfortunately give little consideration to the functional aspects of the digit. In the case of toenails, it is important to consider the toes and foot as a closely integrated functional unit. It is essential that in any case of onychomycosis or onychodystrophy that, as clinicians, we have an understanding of foot dynamics, of structure/function relationships and of the implications of orthopaedic/podiatric factors when evaluating cases of nail dystrophy. When confronted with cases of possible onychomycosis, we must adopt a systematic and sometimes multidisciplinary approach in the evaluation and management of these patients to improve patient outcomes.