Physiopathology and current treatments of androgenetic alopecia: Going beyond androgens and anti‐androgens

Abstract

Androgenetic alopecia (AGA) is the most diagnosed hair loss dysfunction. Its physiopathology comprises a genetic predisposition affording an exacerbated response of the hair follicles cells to androgens aggravated by scalp inflammation and extrinsic factors. This paper presents a review of the mechanisms and extrinsic factors involved in the AGA physiopathology as well as its conventional and emerging treatments. The research focused on reports regarding AGA physiopathology and treatments published between January 2001 and July 2019 in medical and related journals. The most used medical treatments for AGA—minoxidil and finasteride—present non satisfactory results in some cases. Currently, the low‐level laser therapy is recognized as a safe and effective treatment for AGA. Some minimally invasive techniques—mesotherapy, microneedling, carboxytherapy, and platelet‐rich plasma—are also used to stimulate hair growth. Pharmaceutical substances with mechanisms differing from the anti‐androgen activity are under current investigation and many of them have botanical origins; however, formulations with higher performance are required, and the hair follicles ability of being a drug and nanoparticle reservoir has been researched. The association of different strategies, that is, substances with synergic mechanisms and the use of advantageous technologies associated with lifestyle changes could improve the treatment outcomes.

Favorable effects of microneedling on long‐standing androgenetic alopecia in an elderly man: A case report

“…Prevalence of AGA increases with age and affects over 58% of males aged 50 years or older 2 . It is a chronic, progressive, noncicatricial, and androgen‐dependent condition that affects genetically predisposed individuals, leading to progressive follicular miniaturization 3 . Currently, only topical minoxidil and oral finasteride are approved by the United States Food and Drug Administration for its treatment.…”

miR-140-5p in Small Extracellular Vesicles From Human Papilla Cells Stimulates Hair Growth by Promoting Proliferation of Outer Root Sheath and Hair Matrix Cells

“…The HF, a mammalian mini-organ, has an intrinsic stem cell niche that regulates prominent physiological growth cycling, making it a valuable model for studying cellular and signaling mechanisms underlying organ regeneration (Wang et al, 2015), as well as disorders of stem cells and their niche, as abnormal secretion from these cells results in hair loss (Ojeh et al, 2015;Pratt et al, 2017;Katzer et al, 2019). Although this issue affects millions of people, the available means of treatment remain limited (Katzer et al, 2019).…”

“…The appearance of alopecia can be ameliorated by existing treatments, such as minoxidil and hair transplant surgery. However, the medications are only effective for mild-to-medium hair loss, and surgery is limited by the viability of hair follicles (HFs) in the donor scalp (Ho and Zito, 2019;Katzer et al, 2019).…”

Otimização Do Processo De Cicatrização De Queimadura Após Procedimento De Criolipólise: Relato De Caso

“…Alguns recursos eletrotermofototerapêuticos podem ser utilizados para a otimização do processo de cicatrização da queimadura como a alta frequência que auxilia no tratamento de lesões cutâneas, pelo efeito cicatrizante, analgésico, anti-inflamatório, ação bactericida e antisséptico (7) . Durante a cicatrização, favorece no processo de neoformação, com aceleração dos fibroblastos e organização do colágeno (8) , bem como a Carboxiterapia, para melhora da cicatrização e aumento do fluxo sanguíneo (9) .…”