Vertex and Occipital Intermediate and Terminal Hair Follicles from Androgenetic Alopecia Patients are Differentially Affected by Testosterone Ex Vivo

This study challenges the belief that hair follicles (HFs) from the occipital scalp of male pattern androgenetic alopecia (mpAGA) patients are androgen-insensitive. Researchers treated intermediate and terminal HFs from both affected and occipital scalp regions with testosterone (T). They found that T treatment reduced dermal papilla (DP) inductivity and increased apoptosis in affected terminal HFs, while promoting keratinocyte proliferation and reducing apoptosis in occipital HFs. RNA sequencing showed distinct gene expression changes in both affected and occipital HFs, indicating that occipital HFs are not androgen-insensitive but have a unique androgen response compared to affected HFs. This study provides new insights into the differential impact of testosterone on hair follicles in mpAGA.