A Review of Metabolic Dysregulation in Lymphocytic Cicatricial Alopecia: Exploring the Connections and Therapeutic Implications

March 2025 in “ Journal of Investigative Dermatology ”

Aaron Bao, Lindsey A. Bordone, Crystal Aguh

lymphocytic primary cicatricial alopecia metabolic dysregulation diabetes dyslipidemia peroxisome proliferator-activated receptor γ adenosine monophosphate-activated protein kinase pioglitazone metformin glucagon-like peptide-1 agonists PPARγ AMPK GLP-1 agonists

TLDR Metabolic issues may trigger lymphocytic cicatricial alopecia, and treatments targeting these issues could help.

This review discusses the link between lymphocytic primary cicatricial alopecia (LPCA) and metabolic dysregulation, such as diabetes and dyslipidemia, suggesting that metabolic dysfunction might be a primary trigger for LPCA. It identifies disruptions in metabolic pathways, including peroxisome proliferator-activated receptor γ signaling and adenosine monophosphate-activated protein kinase activation, in affected hair follicles. Preliminary treatments like pioglitazone and metformin show potential in normalizing lipid metabolism and reducing inflammation. The review recommends metabolic screening for LPCA patients and considers therapies like glucagon-like peptide-1 agonists to enhance treatment outcomes.

View this study on jidonline.org →

Discuss this study in the Community →

Research cited in this study

23 / 23 results

research Low-Dose Metformin and Profibrotic Signature in Central Centrifugal Cicatricial Alopecia

September 2024 in “JAMA Dermatology”

Low-dose metformin may help hair regrowth and reduce inflammation in CCCA.

research GLP-1 Agonists and Hair Loss: A Call for Further Investigation

May 2024 in “International Journal of Dermatology”

More research is needed to understand if GLP-1 agonists affect hair health.

research A Systematic Review And Bayesian Network Meta-Analysis Of Medical Therapies For Lichen Planopilaris

4 citations , October 2023 in “Dermatology”

The best treatment for lichen planopilaris is a combination of clobetasol, hydroxychloroquine, and N-acetylcysteine.

research Treatment Modalities for Lymphocytic and Neutrophilic Scarring Alopecia

August 2023 in “Journal of The American Academy of Dermatology”

Early treatment is key for permanent hair loss disorders, with options ranging from medications and phototherapy to immunomodulators and antibiotics, depending on severity and type.

research Clinical Factors and Hair Care Practices Influencing Outcomes in Central Centrifugal Cicatricial Alopecia

May 2023 in “Archives of dermatological research”

Some factors like thyroid disease, diabetes treatment, hair dryers, natural hairstyles, and scalp conditions can affect the treatment results for a hair loss condition called CCCA.

research Consumption of Fish Oil High-Fat Diet Induces Murine Hair Loss via Epidermal Fatty Acid Binding Protein in Skin Macrophages

6 citations , December 2022 in “Cell reports”

Eating a high-fat fish oil diet caused mice to lose hair due to a specific immune cell activity in the skin linked to a protein called E-FABP.

Metformin Promotes the Hair-Inductive Activity of Three-Dimensional Aggregates of Epidermal and Dermal Cells Self-Assembled In Vitro

research Metformin Promotes the Hair-Inductive Activity of Three-Dimensional Aggregates of Epidermal and Dermal Cells Self-Assembled In Vitro

5 citations , December 2021 in “Skin Pharmacology and Physiology”

Metformin helps lab-grown skin and hair cells work better to create hair.

research Epidermal PPARγ Is a Key Homeostatic Regulator of Cutaneous Inflammation and Barrier Function in Mouse Skin

9 citations , August 2021 in “International journal of molecular sciences”

PPARγ is essential for maintaining healthy skin, controlling inflammation, and ensuring proper skin barrier function.

research Glucose Metabolism Regulates Expression of Hair-Inductive Genes of Dermal Papilla Spheres via Histone Acetylation

6 citations , March 2020 in “Scientific reports”

Hair growth genes work better with more glucose due to changes in gene-regulating markers.

research Hair Regrowth in Two Patients with Recalcitrant Central Centrifugal Cicatricial Alopecia After Use of Topical Metformin

24 citations , January 2020 in “JAAD Case Reports”

Topical metformin helped regrow hair in two women with a hard-to-treat scarring hair loss condition.

research The Role of Diet as an Adjuvant Treatment in Scarring and Nonscarring Alopecia

17 citations , January 2020 in “Skin appendage disorders”

Certain diets may help with hair growth in people with different types of hair loss.

research Stimulation of Hair Growth by Small Molecules That Activate Autophagy

88 citations , June 2019 in “Cell reports”

Certain small molecules can promote hair growth by activating a cellular cleanup process called autophagy.

research Sebaceous Gland Abnormalities in Fatty Acyl CoA Reductase 2 (Far2) Null Mice Result in Primary Cicatricial Alopecia

14 citations , October 2018 in “PloS one”

Deleting the Far2 gene in mice causes sebaceous gland issues and patchy hair loss.

research Differential Expression of mTOR Signaling Pathway Proteins in Lichen Planopilaris and Frontal Fibrosing Alopecia

5 citations , September 2018 in “Acta histochemica”

The mTOR pathway proteins are altered in the hair follicles of patients with Lichen Planopilaris and Frontal Fibrosing Alopecia.

research Fibroproliferative Genes Are Preferentially Expressed in Central Centrifugal Cicatricial Alopecia

25 citations , June 2018 in “Journal of The American Academy of Dermatology”

Genes linked to fibrosis are more active in people with central centrifugal cicatricial alopecia.

research Treatment of Alopecia Areata with Simvastatin and Ezetimibe

21 citations , December 2017 in “The journal of investigative dermatology. Symposium proceedings/The Journal of investigative dermatology symposium proceedings”

Simvastatin/ezetimibe may help treat new cases of alopecia areata but not long-term cases.

research Simvastatin/Ezetimibe Therapy for Recalcitrant Alopecia Areata: An Open Prospective Study of 14 Patients

13 citations , January 2017 in “Annals of dermatology/Annals of Dermatology”

Simvastatin/ezetimibe may help some patients with severe alopecia areata regrow hair.

research Primary Cicatricial Alopecia: Treatment Approaches and Classification

95 citations , November 2016 in “Journal of The American Academy of Dermatology”

Treatments for permanent hair loss from scarring aim to stop further loss, not regrow hair, and vary by condition, with partial success common.

Lichen Planopilaris Treated by the Peroxisome Proliferator-Activated Receptor-γ Agonist Pioglitazone: Lack of Lasting Improvement or Cure in the Majority of Patients

research Lichen Planopilaris Treated by the Peroxisome Proliferator-Activated Receptor-γ Agonist Pioglitazone: Lack of Lasting Improvement or Cure in the Majority of Patients

33 citations , October 2013 in “Journal of The American Academy of Dermatology”

Pioglitazone usually doesn't effectively treat or cure lichen planopilaris.

research Primary Cicatricial Alopecia: Diagnosis and Treatment

48 citations , May 2013 in “Canadian Medical Association Journal”

Primary cicatricial alopecia, a rare disorder causing permanent hair loss, is hard to diagnose and treat, with treatments like anti-inflammatory drugs and steroids offering varied results and no guaranteed cure. Psychological support for patients is important, and future research should aim to identify causes of the condition.

Sterol Intermediates of Cholesterol Biosynthesis Inhibit Hair Growth and Trigger an Innate Immune Response in Cicatricial Alopecia

research Sterol Intermediates of Cholesterol Biosynthesis Inhibit Hair Growth and Trigger an Innate Immune Response in Cicatricial Alopecia

22 citations , June 2012 in “PLOS ONE”

Cholesterol-related compounds can stop hair growth and cause inflammation in a type of scarring hair loss.

research Cicatricial Alopecia Symposium 2011: Lipids, Inflammation, and Stem Cells

4 citations , May 2012 in “Journal of Investigative Dermatology”

The symposium concluded that a specific lipid might cause hair loss, inflammation is a key factor, and stem cells in bald scalps aren't working right, suggesting new treatment targets.

research Normal Fur Development and Sebum Production Depend on Fatty Acid 2-Hydroxylase Expression in Sebaceous Glands

40 citations , June 2011 in “Journal of biological chemistry/The Journal of biological chemistry”

FA2H is essential for normal fur and sebum production in mice.

Similar Research

5 / 1000+ results

research Cardiovascular Risk in Patients With Scarring and Nonscarring Alopecias: Assessing the Current State of Evidence

September 2023 in “JEADV Clinical Practice”

People with common hair loss conditions may have a higher risk of heart disease and related health issues.

Cholesterol Homeostasis: Links to Hair Follicle Biology and Hair Disorders

research Alopecia and Thyroid Disease

January 2008 in “Springer eBooks”

Thyroid disease can cause hair loss and treating thyroid problems might help with hair disorders.