Androgenetic Alopecia

In 1994, androgenetic alopecia (AA) was recognized both clinically and histologically, with advancements in understanding cutaneous androgen metabolism contributing to knowledge about end organ sensitivity leading to AA. However, genetic factors required further research. Treatment was considered to be in its early stages, with Minoxidil showing promise in inducing hair regrowth and potentially slowing hair loss in both male pattern AA (MPAA) and female pattern AA (FPAA) when used correctly. Other potential treatments included diazoxide and pinacidil, while some, like viprostol and topical cyclosporine A, were ineffective. Antiandrogens like spironolactone and cyproterone acetate could help slow AA in women but had limited use in men due to side effects and were contraindicated in pregnancy. Finasteride, a 5α-reductase inhibitor, was under evaluation for MPAA but had precautions due to its presence in semen. A placebo effect, possibly due to chemically induced microscopic inflammation, was noted in some patients with less advanced AA in double-blind studies, necessitating careful analysis of topical study results.