A Review of Medical and Surgical Treatment Options for Androgenetic Alopecia

Rousso, Daniel E.; Kim, Sang Woon

doi:10.1001/jamafacial.2014.316

Cited by 49 publications

(44 citation statements)

References 34 publications

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“…In severe AGA, management option is hair transplantation surgery which involves removal of hair follicles from the occipital scalp, which is relatively androgen resistant, and their reimplantation into the bald vertex and frontal scalp . Prerequisite for the procedure is sufficient hair on the occipital scalp; a scalp density of 100 follicular U/cm 2 is considered excellent . Follicular unit transplant (FUT) is considered the gold standard because it preserves the natural architecture of the hair units and gives natural results.…”

Section: Surgical Managementmentioning

confidence: 99%

“…There is also a progressive miniaturization of the entire follicular apparatus, leading to gradual conversion of terminal hairs into vellus hairs with a progressive reduction in hair density. The pattern of loss follows the scale developed by Hamilton , and later extended by Norwood which defines seven distinct categories. Three areas of the scalp are affected preferentially: the temples, vertex and mid frontal scalp, whereas the occipital region is spared.…”

Section: Introductionmentioning

confidence: 99%

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Multi-therapies in androgenetic alopecia: review and clinical experiences

Rossi

Anzalone

Fortuna

et al. 2016

Dermatologic Therapy

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Androgenetic alopecia (AGA) is a genetically determined progressive hair-loss condition which represents the most common cause of hair loss in men. The use of the medical term androgenetic alopecia reflects current knowledge about the important role of androgens and genetic factors in its etiology. In addition to androgen-dependent changes in the hair cycle, sustained microscopic follicular inflammation contributes to its onset. Furthermore, Prostaglandins have been demonstrated to have the ability in modulating hair follicle cycle; in particular, PGD2 inhibits hair growth while PGE2/F2a promote growth. Due to the progressive nature of AGA, the treatment should be started early and continued indefinitely, since the benefit will not be maintained upon ceasing therapy. To date, only two therapeutic agents have been approved by the Food and Drug Administration and European Medicines Agency for the treatment of AGA: topical minoxidil and oral finasteride. Considering the many pathogenetic mechanisms involved in AGA, various treatment options are available: topical and systemic drugs may be used and the choice depends on various factors including grading of AGA, patients' pathological conditions, practicability, costs and risks. So, the treatment for AGA should be based on personalized therapy and targeted at the different pathophysiological aspects of AGA.

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Section: Surgical Managementmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Multi-therapies in androgenetic alopecia: review and clinical experiences

Rossi

Anzalone

Fortuna

et al. 2016

Dermatologic Therapy

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“…In men, hair is lost in defined patterns described most commonly by the Norwood and Hamilton scales and often leads to complete baldness [3]; however, FPHL is characterized by diffuse thinning that rarely results in complete baldness [4]. Several therapies have been proposed for the treatment of AGA, but to date, only oral finasteride, topical minoxidil (2% and 5% solutions or foams), and low level laser have been approved by the US Food and Drug Administration (FDA) to combat MPHL [5,6]. Minoxidil 5% foam is also approved by the FDA for female pattern hair loss FPHL.…”

Section: Introductionmentioning

confidence: 99%

“…Originally formulated as an antihypertensive, minoxidil is hypothesized to arrest follicular miniaturization and increase anagen duration, both of which counteract the AGA hair loss process [5]. As a result, 60% of users (male or female) show increased hair counts when a 2% topical solution is applied daily [12,13].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Not-Activated and Activated PRP in Hair Loss Treatment: Role of Growth Factor and Cytokine Concentrations Obtained by Different Collection Systems

Gentile

Cole²,

Cole³

et al. 2017

IJMS

153

229

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Platelet rich plasma (PRP) was tested as a potential therapy for androgenetic alopecia (AGA) through two different clinical protocols in which one population (18 participants) received half-head treatment with autologous non-activated PRP (A-PRP) produced by CPunT Preparation System (Biomed Device, Modena, Italy) and the other half-head with placebo, and a second separated population in which all participants (n = 6, 3 participants per group) received treatment with calcium-activated PRP (AA-PRP) produced from one of two different PRP collection devices (Regen Blood Cell Therapy or Arthrex Angel System). For the A-PRP study, three treatments were administered over 30-day intervals. Trichoscan analysis of patients, three months post-treatment, showed a clinical improvement in the number of hairs in the target area (36 ± 3 hairs) and in total hair density (65 ± 5 hair cm2), whereas negligible improvements in hair count (1.1 ± 1.4 hairs) and density (1.9 ± 10.2 hair cm2) were seen in the region of the scalp that received placebo. Microscopic evaluation conducted two weeks after treatment showed also an increase in epidermal thickness, Ki67+ keratinocytes, and in the number of follicles. The AA-PRP treatment groups received a singular set of injections, and six months after the treatments were administered, notable differences in clinical outcomes were obtained from the two PRP collection devices (+90 ± 6 hair cm2 versus −73 ± 30 hair cm2 hair densities, Regen versus Arthrex). Growth factor concentrations in AA-PRP prepared from the two collection devices did not differ significantly upon calcium activation.

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“…The number of hair follicles that can be obtained from donor areas limits its usefulness. In addition, hair follicle transplantation is time‐consuming, invasive, and costly, all of which limit its acceptance . Other treatment options, including laser therapy, some natural ingredients, and cell culture‐derived conditioned medium, are limited by transient results, unpredictable effects, and controversy.…”

Section: Introductionmentioning

confidence: 99%

The mechanism of activated platelet‐rich plasma supernatant promotion of hair growth by cultured dermal papilla cells

Xiao

Wang

Chen

et al. 2019

J of Cosmetic Dermatology

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Summary Background Platelet‐rich plasma (PRP) is an innovative treatment of androgenic alopecia in the early stages of development, and its mechanism of action is not well investigated. Objective The objective was to investigate the promotion of hair growth by activated PRP supernatant in cultured dermal papilla cells (DPCs). Methods and Materials Human DPCs were isolated and grown in culture with or without activated PRP supernatant. The expression of phosphorylated growth factor receptors (GFRs) in cultured DPCs was assayed by immunofluorescence and Western blotting. Signal pathways mediated by GFRs were identified by a human phosphokinase array. Results Activated PRP supernatant enhanced the expression of phosphorylated fibroblast growth factor receptor (FGFR)‐1, platelet‐derived growth factor receptor (PDGFR)α, and PDGFRβ in cultured DPCs. Activated PRP supernatant activated mitogen‐activated protein kinase (MAPK) and protein kinase B (Akt) signaling pathways that promoted proliferation of DPCs. Downregulation of glycogen synthase kinase‐3 was consistent with the involvement of Wnt signaling. Activated PRP supernatant increased the hair growth promoting ability of DPCs by activating the Wnt signaling pathway. Conclusion Autologous activated PRP supernatant promoted signaling in cultured human DPCs via pathways known to be involved in hair growth. The results warrant further study of PRP for the clinical treatment of androgenic alopecia.

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A Review of Medical and Surgical Treatment Options for Androgenetic Alopecia

Cited by 49 publications

References 34 publications

Multi-therapies in androgenetic alopecia: review and clinical experiences

Multi-therapies in androgenetic alopecia: review and clinical experiences

Evaluation of Not-Activated and Activated PRP in Hair Loss Treatment: Role of Growth Factor and Cytokine Concentrations Obtained by Different Collection Systems

The mechanism of activated platelet‐rich plasma supernatant promotion of hair growth by cultured dermal papilla cells

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