An Updated Etiology of Hair Loss and the New Cosmeceutical Paradigm in Therapy: Clearing ‘the Big Eight Strikes’

Abstract

In this current review, research spanning the last decade (such as transcriptomic studies, phenotypic observations, and confirmed comorbidities) has been synthesized into an updated etiology of hair loss and applied to the new cosmeceutical paradigm of hair rejuvenation. The major etiological components in scalps with hair loss are denoted as the ‘big eight strikes’, which include the following: androgens, prostaglandins, overactive aerobic metabolism of glucose, bacterial or fungal over-colonization, inflammation, fibrosis, metabolism or circulation problems, and malnutrition. The relevance of the ‘big eight’ to nine categories of hair loss is explained. In cases of androgenetic alopecia or female pattern hair loss, both elevated DHT and increased frequency of androgen receptors lead to problems with the metabolism of glucose (sugar), redox imbalance, disruption to the electron transport chain, and PPAR-γ overactivity (the latter is unique to androgenetic alopecia, where the reverse occurs in other types of hair loss). These etiological factors and others from ‘the big eight’ are the focal point of our hypothetical narrative of the attenuative mechanisms of commercial cosmeceutical hair serums. We conclude that cosmeceuticals with the potential to improve all eight strikes (according to published in vitro or clinical data) utilize bioactive peptides and plant compounds that are either flavonoids (isoflavones, procyanidins, flavanols, and flavonols) or sterols/triterpenes. It is noteworthy that many therapeutic interventions are generic to the multiple types of hair loss. Lastly, suggestions are made on how scalp and hair health can be improved by following the cosmeceutical approach.

The Hormonal Background of Hair Loss in Non-Scarring Alopecias

“…AGA can be divided into male androgenetic alopecia (MAGA), otherwise known as male-pattern hair loss (MPHL), and female androgenetic alopecia (FAGA), otherwise known as female-pattern hair loss (FPHL) [ 23 , 24 ]. Excess DHT causes the miniaturization of hair, reducing the anagen phase and increasing the telogen phase, leading to hair loss and decreased hair density [ 25 ]. Typically, MPHL affects the frontal scalp and vertex, and its characteristic feature is a receding hairline [ 26 ].…”

Platelet-Rich Plasma in Dermatology: New Insights on the Cellular Mechanism of Skin Repair and Regeneration

“…Androgenetic alopecia, telogen effluvium, alopecia areata, trichotillomania, and anagen effluvium are examples of non-cicatricial alopecies. On the other hand, conditions like lichen planopilaris, frontal fibrosing alopecia, folliculitis decalvans, and cutaneous discoid lupus erythematosus contribute to cicatricial alopecia [266].…”

Topical Peroxisome Proliferator-Activated Receptor Agonist Induces Molecular Alterations Enhancing Barrier Function and Water-Holding Capacity of the Human Stratum Corneum In Vivo

“…PPAR-γ protects against excessive collagen synthesis and has antifibrotic [57], anti-inflammatory [58], and anti-obesity [59] activities in the skin. PPAR-γ activators stimulate the expression of aquaporin 3 in keratinocytes, which can influence the SC hydration and water binding properties [60] and is an essential element of hair follicle development [61] and stem cell biology [62].…”