Aromatase inhibitors induce ‘male pattern hair loss’ in women?

Rossi, Alfredo; Iorio, Alessandra; Scali, Elisabetta; Fortuna, Maria Caterina; Mari, Elena; Maxia, Cristina; Gerardi, M.; Framarino, Marialuisa; Carlesimo, Marta

doi:10.1093/annonc/mdt170

Cited by 26 publications

(31 citation statements)

References 5 publications

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“…Estrogens are potent hair growth modulators and hair protective factors and derive from the conversion of androstenedione to estrone and testosterone to estradiol by aromatase (P450arom), the levels of which in frontal and occipital follicles of women are higher than in the same areas of men. The block of this enzyme induces a relative enhancement in the activity of 5α‐reductase which leads to a relative increase in amount of testosterone available for conversion to DHT …”

Section: Introductionmentioning

confidence: 99%

Chemotherapy‐induced alopecia management: Clinical experience and practical advice

Rossi

Fortuna

Caro

et al. 2017

J of Cosmetic Dermatology

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Chemotherapy-induced alopecia (CIA) is probably one of the most shocking aspects for oncological patients and underestimated by physicians. Among hair loss risk factors there are treatment-related aspects such as drug dose, administration regimen and exposure to X-rays, but also patient-related characteristics. At the best of our knowledge no guidelines are available about CIA management. With this paper, based on literature background and our clinical experience, we would like to propose a list of actions in order to estimate the risk of hair loss before starting chemotherapy and to manage this condition before, during and after drug administration and to create a sort of practical guide for dermatologists and oncologist. There is an urgent need for prospective studies in order to clarify the mechanistic basis of alopecia associated to these drugs and consequently to design evidence-based management strategies.

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Section: Introductionmentioning

confidence: 99%

Chemotherapy‐induced alopecia management: Clinical experience and practical advice

Rossi

Fortuna

Caro

et al. 2017

J of Cosmetic Dermatology

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“…Pseudo male pattern androgenetic alopecia is a clinical condition, induced by aromatase inhibitor (AI). Women in menopausal status, receiving aromatase inhibitors, show a recession of frontal and parietal hairlines and hair loss . AI induces a relative enhancement activity of 5AR, resulting in a relative increase of testosterone, available for conversion into Dihydrotestosterone, causing a male pattern hair loss, mimicking a female androgenetic alopecia (FAGA) with male patterns.…”

Section: Pseudo Androgenetic Alopecia With Male Pattern By Aromatase mentioning

confidence: 99%

“…Women in menopausal status, receiving aromatase inhibitors, show a recession of frontal and parietal hairlines and hair loss. 20 AI induces a relative enhancement activity of 5AR, resulting in a relative increase of testosterone, available for conversion into Dihydrotestosterone, causing a male pattern hair loss, mimicking a female androgenetic alopecia (FAGA) with male patterns. Trichoscopy reveals HF miniaturization in fronto-temporal area behind the scalp area sensible to aromatase, with normal hair diameter and hair density (Fig.…”

Section: Pseudo Androgenetic Alopecia With Male Pattern By Aromatase mentioning

confidence: 99%

Conditions simulating androgenetic alopecia

Rossi

Iorio

Nunno

et al. 2015

Acad Dermatol Venereol

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Androgenetic alopecia is a common form of hair loss, characterized by a progressive hair follicular miniaturization, caused by androgen hormones on a genetically susceptible hair follicle, in androgenic-dependent areas. Characteristic phenotype of androgenetic alopecia is also observed in many other hair disorders. These disorders are androgenetic-like diseases that cause many differential diagnosis or therapeutic error problems. The objective of this review was to systematically analyse the greatest number of conditions that mimic the AGA pattern and explain their disease pathogenesis.

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“…For regimens given every 2‐3 weeks, hair loss begins approximately 2 weeks after therapy initiation. Hair is completely lost by the end of the second cycle, 4 weeks after starting chemotherapy . An initial, partial hair regrowth occurs after 3 months, and total hair regrowth usually happens after 6‐month treatment cessation…”

Section: Introductionmentioning

confidence: 99%

“…Hair is completely lost by the end of the second cycle, 4 weeks after starting chemotherapy. 11 An initial, partial hair regrowth occurs after 3 months, and total hair regrowth usually happens after 6-month treatment cessation. 10 Dermoscopy of hair and scalp, also named trichoscopy, is a fast, In vivo reflectance confocal microscopy (RCM) offers the possibility of a real-time, noninvasive microscopic examination of the tissue for the assessment of neoplastic and inflammatory skin diseases.…”

mentioning

confidence: 99%

Dermoscopy and confocal microscopy for different chemotherapy‐induced alopecia (CIA) phases characterization: Preliminary study

Franceschini

Garelli

Persechino

et al. 2019

Skin Research and Technology

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Background Chemotherapy‐induced alopecia (CIA) affects 65% of patients receiving chemotherapy regimens and is often identified with the massive hair loss stage. Reflectance confocal microscopy (RCM) is a noninvasive technique used in alopecia assessment for disease characterization and state of activity. Objective To describe RCM features of CIA in different timing and identify specific phases of alopecia development. Methods A total of 16 patients treated with chemotherapy underwent dermoscopy and RCM evaluations four times during the observation: 2 and 4‐6 weeks after starting and 3 and 6 months after the end of chemotherapy. Ten examinations for each stage were performed. Results Four phases of CIA have been identified. Initial hair loss showed specific dots not previously described, named CIA dots. massive hair loss phase was characterized by black dots (10/10 pt), CIA dots (8/10 pt) and hair shaft abnormalities. Three months after the end of chemotherapy, during the partial regrowth phase, 10/10 patients showed thin hair in regrowth and 8/10 presented black and yellow dots. At 6 months, normal hair in regrowth appears in all patients (total regrowth phase). Conclusions Chemotherapy‐induced alopecia has to be considered as a dynamic process with specific phases characterized by distinctive dermoscopic and confocal features.

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Aromatase inhibitors induce ‘male pattern hair loss’ in women?

Cited by 26 publications

References 5 publications

Chemotherapy‐induced alopecia management: Clinical experience and practical advice

Chemotherapy‐induced alopecia management: Clinical experience and practical advice

Conditions simulating androgenetic alopecia

Dermoscopy and confocal microscopy for different chemotherapy‐induced alopecia (CIA) phases characterization: Preliminary study

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