Androgenetic alopecia: An update

Abstract

Androgenetic alopecia (AGA) is one of the commonest reasons for dermatological consultation. Over the last few years our understanding of the pathophysiology of AGA has improved and this has paved way for better diagnostic and therapeutic options. Recent research has dwelled on the role of stem cells in the pathophysiology of AGA and has also identified newer genetic basis for the condition. Dermoscopy/trichoscopy has emerged as a useful diagnostic tool for AGA. While the major treatment options continue to be topical minoxidil, systemic Finasteride and hair transplantations, newer modalities are under investigation. Specific diagnostic and treatment recommendations have also been developed on evidence based principles. This article reviews the recent concepts in relation to AGA. With regards to the pathophysiology we have tried to stress on recent knowledge of the molecular and genetic basis of AGA. We have emphasized on an evidence based approach for treatment and diagnosis.

Cosmetic Procedures in the Treatment of Alopecia

“…AGA is characterized by progressive hair follicle miniaturization and its treatment is quite challenging [66,67]. The two medications approved by Food and Drug Administration (FDA) are minoxidil and finasteride.…”

Androgenetic Alopecia: a Review and Emerging Treatments

“…An VEGF mRNA is strongly expressed in DP cells during anagen phase with a substantial decrease of expression during catagen and telogen phases Topical minoxidil on the hair follicle can increased the expression of VEGF mRNA, presented in the DP cells [49,73,74].…”

“…Other effects of minoxidil to induce hair regrowth could be the activation of activation of cytoprotective prostaglandin synthase-1 and increased expression of HGF, both hair growth promoters [49,74,75].…”

Alopecia androgénica femenina: nuevos factores fisiopatológicos y futuras tendencias para un abordaje clínico más integral

“…En la piel, la 5α-reductasa de tipo 1 se expresa en las glándulas sebáceas y en los folículos pilosos, mientras que la de tipo 2 se expresa en las papilas del folículo pilosebáceo y en las células fusiformes interfoliculares de la dermis. Por órganos y sistemas, la 5α-reductasa de tipo 1 predomina en el hígado, la piel y el cuero cabelludo, y la de tipo 2 se encuentra más en la piel del tórax y la barba y en los órganos genitourinarios masculinos 8,15,16 . La distribución de los receptores para la testosterona en el cuero cabelludo, así como la de las enzimas 5α-reductasa de los tipos 1 y 2 y el citocromo P-450 aromatasa, que convierte los andró-genos en estrógenos, es distinta en la mujer y en el hombre y varía también en las distintas áreas del cuero cabelludo.…”