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          "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">The hairs covering scalp area analyzed before &#40;A&#41; and after &#40;D&#41; 36-hours to obtain hair growth speed&#46; &#42; &#40;A&#41; Picture obtained before initially&#46; &#40;B&#41; Picture A with median filtering&#46; &#40;C&#41; Segmentation of the hairs from the initial picture in A&#46; &#40;D&#41; Picture obtained 38-hours after A of the same area&#46; &#40;E&#41; Picture D with median filtering&#46; &#40;F&#41; Segmentation of the hairs from the initial picture in D&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">The impact on the quality of life of those who suffer from hair disorders is comparable to those who have skin diseases such as psoriasis in plaques&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> On the other hand&#44; individuals without any capillary disorder look for treatments to increase hair growth and thickness&#44; in addition to strengthening the shaft from products marketed for this purpose but without any scientific proof&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Minoxidil is an established medication in the treatment of some hair disorders<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;3</span></a> and biotin is a vitamin that may interfere with the hair cycle&#46;<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#44;5</span></a> However&#44; there is a lack of literature data that supports biotin use with or without minoxidil to accelerate hair growth&#44; especially in individuals without hair diseases&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">We performed a study with the aim of evaluating the effectiveness of oral biotin 5&#8239;mg daily&#44; application of topical 5&#37; minoxidil twice daily&#44; and associated use of both&#44; during a period of 14 days each course&#44; in increasing the speed of hair growth &#40;HG&#41;&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">A randomized&#44; open&#44; self-controlled&#44; crossover clinical trial was performed&#46; Ten healthy male participants&#44; without hair disorders and not using any systemic or topical medication were recruited by convenience&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">All participants were submitted to the three interventions &#40;topical minoxidil only&#44; oral biotin only&#44; and both drugs combined&#41;&#46; At inclusion&#44; participants were allocated to all interventions&#44; but in randomized sequence &#40;crossover&#41; performed by a computer program&#46; Before starting medication use&#44; a scalp shaving in the occipital region of a 1&#8239;cm<span class="elsevierStyleSup">2</span> area was made&#44; followed by local phototrichoscopy&#44; which was repeated after a mean time of 38&#8239;hours&#44; in order to determine the baseline hg rate &#40;HGR&#41;&#46; The interventions were then applied for a period of 14 days&#46; Immediately after&#44; shaving and rephotographing the area 38&#8239;hours later was repeated to measure HGR under intervention&#46; At the end of each cycle&#44; the participants were reallocated between the remaining intervention groups&#46; Therefore&#44; all ten individuals participated in the three proposed interventions in a crossover protocol &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; There was a 14 days washout interval between interventions&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">The occipital area was chosen by having a lower aesthetic impact on participants during the study and is less frequently affected by hair disorders&#44; as we aimed to study healthy individuals&#8217; hair&#46; As the elimination half-life of minoxidil is four hours and biotin is two hours&#44; the washout time of 14 days between interventions was regarded as sufficient to prevent the influence of previous medications on the subsequent results&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Each image obtained was analyzed by the ImageJ&#174; software&#58; ten anagen hairs&#8217; length was measured in pixels&#44; as well as the image area covered by hairs was evaluated using a software plugin to determine the HGR&#46; 120 images were obtained and 1200 anagen hairs were analyzed&#46; The average HGR was based on the difference between the lengths divided by time&#44; in seconds&#44; between the photographs&#46; The difference in the percentual area of pictures covered by hair shafts was also divided by time to get the coverage area growth rate &#40;<a class="elsevierStyleCrossRefs" href="#fig0010">Figs&#46; 2 and 3</a>&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0040" class="elsevierStylePara elsevierViewall">Continuous variables were expressed as mean and standard deviation or median and quartiles after normality tests&#46; The HGR and the area covered by shafts were compared using generalized mixed linear models&#46; Statistical significance was adopted with p&#8239;&#60;&#8239;0&#46;05&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">The median age was 29&#46;7 years&#46; The average HGR of the participants&#44; before interventions&#44; was 2&#46;35&#8239;mm per week &#40;SD&#8239;&#61;&#8239;0&#46;39&#8239;mm&#41;&#44; consistent with the literature data&#46; There was a significant increase &#40;p&#8239;&#61;&#8239;0&#46;02&#41; both in HGR and in the photographic area covered by hair &#40;p&#8239;&#60;&#8239;0&#46;01&#41; only in the group that used the combination of topical minoxidil and oral biotin &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0050" class="elsevierStylePara elsevierViewall">Minoxidil increases hair thickness&#44; prolongs the anagen phase&#44; and promotes alternation from the telogen to anagen phase in patients with androgenetic alopecia&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;3</span></a> A recent review suggests that its topical application activates molecular signaling pathways&#44; such as beta-catenin&#44; and stimulates prostaglandin E2 receptors&#44; contributing to its positive effects on the hair cycle and growth&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;6</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">Biotin is a cofactor in multiple metabolic pathways&#44; with probable importance in nail growth and thickness&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> Notwithstanding&#44; few studies have examined the efficacy of biotin in treating hair and nail disorders&#44;<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#44;7</span></a> with most of the case series regarding its use in hair diseases&#46; Randomized trials studying biotin supplementation in hair disorders are lacking&#44; and its prescription still occurs without robust evidence&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">In our study&#44; the isolated use of both substances did not present a positive result in increasing growth velocity&#46; It&#8217;s possible to deduce that biotin may act as a cofactor in the hair cycle&#44; with a potential synergistic effect&#44; modulating the effect of minoxidil or anticipating its effects on hair growth&#46; Nevertheless&#44; there is no previous study supporting this information&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">We cite as limitations of the study the sample size&#44; the influence of seasonality&#44; and the sample group being formed exclusively by adult men&#44; which limits the generalization of the results&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">With this study&#44; we were able to verify the synergistic effect of the use of topical minoxidil and oral biotin in healthy men in increasing HGR in the first 14 days of use&#46; More studies are needed to analyze the benefit of long-term use of the combination&#44; as well as to evaluate the isolated use of such medications in longer periods&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Financial support</span><p id="par0075" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Authors&#8217; contributions</span><p id="par0080" class="elsevierStylePara elsevierViewall">Fl&#225;via de Oliveira Valentim&#58; Conception and design of the study&#59; data collection&#59; article writing&#59; critical review of the literature&#59; final approval of the final version of the manuscript&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Anna Carolina Miola&#58; Conception and design of the study&#59; article writing&#59; critical review of the literature&#59; final approval of the final version of the manuscript&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">He&#769;lio Amante Miot&#58; Conception and design of the study&#59; statistical analysis&#59; article writing or critical review of important intellectual content&#59; final approval of the final version of the manuscript&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Juliano Vilaverde Schmitt&#58; Conception and design of the study&#59; data analysis and interpretation&#59; statistical analysis&#59; article writing or critical review of important intellectual content&#59; effective participation in research guidance&#59; final approval of the final version of the manuscript&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflicts of interest</span><p id="par0100" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0015">Study conducted at the Department of Infectology&#44; Dermatology&#44; Imaging Diagnosis and Radiotherapy&#44; Faculty of Medicine&#44; Universidade Estadual Paulista&#44; Botucatu&#44; SP&#44; Brazil&#46;</p>"
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          "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">The same hair shafts&#8217; length analyzed before &#40;A&#41; and after &#40;B&#41; 36&#8239;hours to obtain hair growth speed&#46; &#42; Ten individual shafts were measured in each picture&#44; for each intervention&#46;</p>"
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Intervention&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p<a class="elsevierStyleCrossRef" href="#tblfn1015"><span class="elsevierStyleSup">c</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " colspan="4" align="left" valign="\n
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                  \t\t\t\t">Evaluated by difference in hair length<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Topical minoxidil 5&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">2&#46;63 &#40;SD&#8239;&#61;&#8239;0&#46;43&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">2&#46;57 &#40;SD&#8239;&#61;&#8239;0&#46;46&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleBold">0&#46;02</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Evaluated by difference in area covered by hair shafts<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t"><span class="elsevierStyleBold">&#60;0&#46;01</span>&nbsp;\t\t\t\t\t\t\n
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                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "D&#46; Williamson"
                            1 => "M&#46; Gonzalez"
                            2 => "A&#46;Y&#46; Finlay"
                          ]
                        ]
                      ]
                    ]
                  ]
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                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Eur Acad Dermatol Venereol"
                        "fecha" => "2001"
                        "volumen" => "15"
                        "paginaInicial" => "137"
                        "paginaFinal" => "139"
                      ]
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                    0 => array:2 [
                      "titulo" => "Minoxidil and its use in hair disorders&#58; review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "P&#46; Suchonwanit"
                            1 => "S&#46; Thammarucha"
                            2 => "K&#46; Leerunyakul"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2147/DDDT.S214907"
                      "Revista" => array:6 [
                        "tituloSerie" => "Drug Des Devel Ther"
                        "fecha" => "2019"
                        "volumen" => "13"
                        "paginaInicial" => "2777"
                        "paginaFinal" => "2786"
                        "link" => array:1 [
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                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31496654"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
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                ]
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              "etiqueta" => "3"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Minoxidil 1 mg orally versus minoxidil 5&#37; solution topically for the treatment of female pattern hair loss&#58; a randomized clinical trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "P&#46;M&#46; Ramos"
                            1 => "R&#46;D&#46; Sinclair"
                            2 => "M&#46; Kasprzak"
                            3 => "H&#46;A&#46; Miot"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Am Acad Dermatol"
                        "fecha" => "2020"
                        "volumen" => "82"
                        "paginaInicial" => "252"
                        "paginaFinal" => "253"
                      ]
                    ]
                  ]
                ]
              ]
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