Androgenetic Alopecia

April 2021 in “ Uludağ Üniversitesi Tıp Fakültesi dergisi ”

Gökhan ŞAHİN, Hilal Ozdemir, Fatma Aydın

androgenetic alopecia follicular miniaturization potassium ion channel modifiers topical minoxidil oral minoxidil 5α reductase inhibitors oral finasteride topical finasteride oral dutasteride androgen receptor antagonists combination therapies androgenic alopecia hair follicle shrinkage minoxidil Rogaine Propecia Avodart

TLDR The review provided information on various treatments to stop hair thinning and increase hair density in people with common genetic hair loss.

Three years ago, a review was conducted on the management of androgenetic alopecia, a common form of hair loss in genetically predisposed individuals. The review noted that there was no standard treatment guideline for this condition, with the goal of management being to halt follicular miniaturization and increase hair density. Various therapies were used, including potassium ion channel modifiers (like topical and oral minoxidil), 5α reductase inhibitors (like oral finasteride, topical finasteride, and oral dutasteride), androgen receptor antagonists, other medical treatments, physical treatments, complementary therapies, and combination therapies. The review aimed to provide information about these current treatment methods for both men and women.

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research Minoxidil 1 mg Oral Versus Minoxidil 5% Topical Solution for the Treatment of Female-Pattern Hair Loss: A Randomized Clinical Trial

53 citations , January 2020 in “Journal of The American Academy of Dermatology”

Oral minoxidil and topical minoxidil 5% both effectively improve female-pattern hair loss with safe side effects.

research Finasteride Use and Risk of Male Breast Cancer: A Case-Control Study Using Individual-Level Registry Data from Denmark, Finland, and Sweden

7 citations , May 2019 in “Cancer Epidemiology, Biomarkers & Prevention”

Finasteride use is not clearly linked to an increased risk of male breast cancer.

research New Drugs Under Investigation for the Treatment of Alopecias

26 citations , January 2019 in “Expert Opinion on Investigational Drugs”

New treatments for hair loss show promise, but more research is needed to confirm their safety and effectiveness.

research Female Pattern Hair Loss: A Clinical, Pathophysiologic, and Therapeutic Review

66 citations , December 2018 in “International Journal of Women's Dermatology”

No cure for female pattern hair loss, but various effective treatments exist.

research Characterization of Follicular Minoxidil Sulfotransferase Activity in a Cohort of Pattern Hair Loss Patients from the Indian Subcontinent

8 citations , October 2018 in “Dermatologic Therapy”

About 41% of Indian hair loss patients have low enzyme activity that affects hair loss treatment effectiveness, with men affected more than women. Testing for this can guide treatment.

research Microneedling for the Treatment of Hair Loss

58 citations , April 2018 in “Journal of The European Academy of Dermatology and Venereology”

Microneedling can help stimulate hair growth, especially when used with other treatments, but it's not better than existing therapies.

research Efficacy of Platelet-Rich Plasma in the Treatment of Androgenetic (Male-Patterned) Alopecia: A Pilot Randomized Controlled Trial

61 citations , October 2016 in “Journal of Cosmetic and Laser Therapy”

Platelet-rich plasma (PRP) was found not effective in treating male-patterned hair loss.

research Androgenetic Alopecia: An Update Of Treatment Options

110 citations , August 2016 in “Drugs”

Minoxidil is the only FDA-approved topical drug for treating male or female pattern hair loss, and other medications like finasteride and dutasteride can also increase hair growth.

research Interventions for Female Pattern Hair Loss

21 citations , May 2016 in “The Cochrane library”

Topical minoxidil helps treat female pattern hair loss, but more research needed for other treatments.

research Hunting the Genes in Male-Pattern Alopecia: How Important Are They, How Close Are We and What Will They Tell Us?

46 citations , April 2016 in “Experimental Dermatology”

Genes play a significant role in male-pattern baldness, and understanding them could lead to new treatments and insights into related health issues.

research Randomized Placebo-Controlled, Double-Blind, Half-Head Study to Assess the Efficacy of Platelet-Rich Plasma on the Treatment of Androgenetic Alopecia

136 citations , April 2016 in “Dermatologic Surgery”

PRP treatment helps hair growth and density in androgenetic alopecia patients.

research Male Pattern Baldness and Risk of Colorectal Neoplasia

7 citations , January 2016 in “British Journal of Cancer”

Men with certain types of baldness at age 45 may have a higher risk of colon cancer and colorectal adenoma.

research Pharmacologic Inhibition of JAK-STAT Signaling Promotes Hair Growth

159 citations , October 2015 in “Science Advances”

Blocking JAK-STAT signaling can lead to hair growth.

research Demographics of Women with Female Pattern Hair Loss and the Effectiveness of Spironolactone Therapy

26 citations , October 2015 in “Journal of The American Academy of Dermatology”

Spironolactone may effectively treat female hair loss, especially with hyperandrogenism signs.

research Clinical Use of Conditioned Media of Adipose Tissue-Derived Stem Cells in Female Pattern Hair Loss: A Retrospective Case Series Study

83 citations , June 2015 in “International Journal of Dermatology”

ADSC-CM treatment improved hair density and thickness in women with hair loss, safely and effectively.

research Topical Valproic Acid Increases Hair Count in Male Patients with Androgenetic Alopecia: A Randomized, Comparative, Clinical Feasibility Study Using Phototrichogram Analysis

37 citations , April 2014 in “Journal of Dermatology”

Valproic acid increases hair count in men with hair loss.

research Efficacy and Safety of a Low-Level Laser Device in the Treatment of Male and Female Pattern Hair Loss: A Multicenter, Randomized, Sham Device-Controlled, Double-Blind Study

147 citations , January 2014 in “American Journal of Clinical Dermatology”

Laser device increases hair density, safe for treating hair loss in men and women.

research Androgenetic Alopecia and Risk of Prostate Cancer: A Systematic Review and Meta-Analysis

34 citations , June 2013 in “Journal of The American Academy of Dermatology”

Vertex pattern hair loss linked to higher prostate cancer risk.

research New Investigational Drugs for Androgenetic Alopecia

48 citations , April 2013 in “Expert Opinion on Investigational Drugs”

Possible new treatments for common hair loss include drugs, stem cells, and improved transplants.

research Topical Melatonin for Treatment of Androgenetic Alopecia

39 citations , October 2012 in “International Journal of Trichology”

Melatonin solution helps treat hair loss in men and women.

research A Randomized Double-Blind Placebo-Controlled Pilot Study to Assess the Efficacy of a 24-Week Topical Treatment by Latanoprost 0.1% on Hair Growth and Pigmentation in Healthy Volunteers with Androgenetic Alopecia

81 citations , May 2012 in “Journal of The American Academy of Dermatology”

Latanoprost 0.1% may effectively treat hair loss.

research Prostaglandin D2 Inhibits Hair Growth and Is Elevated in Bald Scalp of Men with Androgenetic Alopecia

205 citations , March 2012 in “Science Translational Medicine”

PGD2 stops hair growth and is higher in bald men with AGA.

research The Effect of a 1550 Nm Fractional Erbium-Glass Laser in Female Pattern Hair Loss

47 citations , December 2011 in “Journal of The European Academy of Dermatology and Venereology”

Laser treatment increases hair density and thickness safely in women with hair loss.

research The Latest Innovations in Hair Transplantation

32 citations , July 2011 in “Facial Plastic Surgery”

New hair transplant methods offer more natural results and better graft survival, with ongoing research to increase donor hair options.

research Persistent Sexual Side Effects of Finasteride for Male Pattern Hair Loss

185 citations , June 2011 in “The Journal of Sexual Medicine”

Finasteride for hair loss can cause long-lasting sexual side effects like low libido and erectile dysfunction.

research Role of Genetics and Sex Steroid Hormones in Male Androgenetic Alopecia and Female Pattern Hair Loss: An Update

87 citations , May 2011 in “Australasian Journal of Dermatology”

Genetics and hormones play a role in male and female hair loss, but more research is needed to fully understand it.

research Prospective Cohort Study on the Effects and Tolerability of Flutamide in Patients with Female Pattern Hair Loss

42 citations , April 2011 in “Annals of Pharmacotherapy”

Flutamide effectively treats female pattern hair loss with low doses showing good liver tolerance.

research 5 mg/Day Finasteride Treatment for Normoandrogenic Asian Women with Female Pattern Hair Loss

64 citations , February 2011 in “Journal of The European Academy of Dermatology and Venereology”

Finasteride improves hair density and thickness in women with hair loss.

research Trichoscopy for Common Hair Loss Diseases: Algorithmic Method for Diagnosis

89 citations , December 2010 in “The Journal of Dermatology”

The conclusion is that an algorithm using trichoscopy helps diagnose different types of hair loss but may need updates and a biopsy if results are unclear.

research Efficacy and Safety of Finasteride Therapy for Androgenetic Alopecia

152 citations , October 2010 in “Archives of Dermatology”

Finasteride helps hair growth but may cause sexual side effects.

research Androgenetic Alopecia and Cardiovascular Risk Factors in Men and Women: A Comparative Study

110 citations , September 2010 in “Journal of The American Academy of Dermatology”

Hair loss linked to higher heart disease risk in both men and women.

research Efficacy, Safety, and Tolerability of Dutasteride 0.5 mg Once Daily in Male Patients with Male Pattern Hair Loss: A Randomized, Double-Blind, Placebo-Controlled, Phase III Study

92 citations , August 2010 in “Journal of The American Academy of Dermatology”

Dutasteride 0.5 mg daily improves hair growth safely in men with hair loss.

research Innovative Use of Spironolactone as an Antiandrogen in the Treatment of Female Pattern Hair Loss

53 citations , July 2010 in “PubMed”

Spironolactone helps regrow hair in women with hair loss.

research Mesotherapy in the Management of Hair Loss: Is It of Any Use?

25 citations , January 2010 in “International Journal of Trichology”

Mesotherapy for hair loss lacks evidence of effectiveness and safety and should not be used without further scientific support.

research Successful Treatment of Female-Pattern Hair Loss with Spironolactone in a 9-Year-Old Girl

26 citations , May 2009 in “Australasian Journal of Dermatology”

Spironolactone successfully treated hair loss in a 9-year-old girl.

research Hair Loss in Women: Comprehensive Overview and Treatment Options

81 citations , March 2009 in “Seminars in Cutaneous Medicine and Surgery”

Effective hair loss treatment in women requires correct diagnosis and can include medications like minoxidil, antiandrogens, and treatments for underlying conditions like PCOS.

research Comparing the Therapeutic Effects of Finasteride Gel and Tablet in Treatment of Androgenetic Alopecia

57 citations , January 2009 in “Indian Journal of Dermatology, Venereology and Leprology”

research Follicular Streamers (Stelae) in Scarring and Non-Scarring Alopecia

29 citations , October 2008 in “Journal of Cutaneous Pathology”

Hair root sheaths are more common in non-scarring hair loss and help diagnose the type of hair loss.

research A Multicenter, Randomized, Placebo-Controlled, Double-Blind Clinical Trial of a Novel Formulation of 5% Minoxidil Topical Foam Versus Placebo in the Treatment of Androgenetic Alopecia in Men

142 citations , November 2007 in “Journal of The American Academy of Dermatology”

New 5% minoxidil foam effectively promotes hair growth and is safe for use.

research The Importance of Dual 5α-Reductase Inhibition in the Treatment of Male Pattern Hair Loss: Results of a Randomized Placebo-Controlled Study of Dutasteride Versus Finasteride

215 citations , December 2006 in “Journal of The American Academy of Dermatology”

Dutasteride more effective for hair growth, but has more side effects than finasteride.

research Finasteride Induced Depression: A Prospective Study

99 citations , October 2006 in “BMC clinical pharmacology”

Finasteride may cause slight depression and anxiety.

research Effects of Finasteride (1 mg) on Hair Transplant

23 citations , October 2005 in “Dermatologic Surgery”

Finasteride improves surrounding scalp hair and increases hair density after hair transplant.

research Health-Related Quality of Life and Physical Well-Being Among a 63-Year-Old Cohort of Women With Androgenetic Alopecia: A Finnish Population-Based Study

24 citations , August 2005 in “Health and Quality of Life Outcomes”

Women with androgenetic alopecia experience worse physical well-being and quality of life, but similar mental health compared to those without it.

research Androgenetic Alopecia in Children: Report of 20 Cases

72 citations , March 2005 in “British Journal of Dermatology”

AGA can occur in children with family history; early diagnosis and treatment important.

research Evaluation and Treatment of Male and Female Pattern Hair Loss

203 citations , February 2005 in “Journal of The American Academy of Dermatology”

Early diagnosis and treatment, using finasteride, minoxidil, or hair transplantation, improves hair loss outcomes.

research The Treatment of Female Pattern Hair Loss and Other Applications of Surgical Hair Restoration in Women

4 citations , May 2004 in “Facial Plastic Surgery Clinics of North America”

Hair transplantation helps women with hair loss; understanding and empathy lead to happy patients.

research Finasteride Treatment of Patterned Hair Loss in Normoandrogenic Postmenopausal Women

72 citations , January 2004 in “Dermatology”

Finasteride can slow hair loss and promote growth in postmenopausal women.

research A Randomized Clinical Trial of 5% Topical Minoxidil Versus 2% Topical Minoxidil and Placebo in the Treatment of Androgenetic Alopecia in Men

269 citations , September 2002 in “Journal of The American Academy of Dermatology”

5% minoxidil works better for hair growth and density, with minor irritation.

research Fluridil, A Rationally Designed Topical Agent For Androgenetic Alopecia: First Clinical Experience

17 citations , August 2002 in “Dermatologic Surgery”

Fluridil safely promotes hair growth in men with androgenetic alopecia.

research Comparative Efficacy of Various Treatment Regimens for Androgenetic Alopecia in Men

80 citations , August 2002 in “Journal of Dermatology”

Best hair growth results from combining finasteride and minoxidil.

research Effects of Minoxidil 2% vs. Cyproterone Acetate Treatment on Female Androgenetic Alopecia: A Controlled, 12-Month Randomized Trial

149 citations , June 2002 in “British Journal of Dermatology”

Minoxidil works better for female hair loss, but cyproterone reduces scalp oiliness and causes menstrual issues.

research Female Pattern Hair Loss

226 citations , September 2001 in “Journal of The American Academy of Dermatology”

Hair loss in women is genetic, diagnosed by examination and biopsy, and treated with minoxidil, finasteride, or transplantation.

research The Prevalence and Types of Androgenetic Alopecia in Korean Men and Women

157 citations , July 2001 in “British Journal of Dermatology”

AGA more common in men, Koreans have lower rates and unique patterns.

research Incidence of Female Androgenetic Alopecia (Female Pattern Alopecia)

6 citations , January 2001 in “Dermatologic Surgery”

Female pattern alopecia is common, starts in late 20s, and is not androgen dependent.

research Lack of Efficacy of Finasteride in Postmenopausal Women with Androgenetic Alopecia

239 citations , November 2000 in “Journal of The American Academy of Dermatology”

Finasteride doesn't effectively treat hair loss in postmenopausal women.

research The Psychosocial Consequences of Androgenetic Alopecia: A Review of the Research Literature

180 citations , September 1999 in “British Journal of Dermatology”

Hair loss affects self-esteem and quality of life; treatments can help.

research Prevalence of Male Pattern Hair Loss in 18–49 Year Old Men

50 citations , December 1998 in “Dermatologic Surgery”

Hair loss is more common in men aged 18-49 and increases with age.

research Minoxidil Upregulates the Expression of Vascular Endothelial Growth Factor in Human Hair Dermal Papilla Cells

192 citations , March 1998 in “British Journal of Dermatology”

Minoxidil boosts growth factor in hair cells, potentially promoting hair growth.

research Ketoconazole Shampoo: Effect of Long-Term Use in Androgenic Alopecia

92 citations , January 1998 in “Dermatology”

Ketoconazole shampoo improves hair growth and reduces oil similarly to minoxidil in male pattern hair loss.

research Different Levels of 5α-Reductase Type I and II, Aromatase, and Androgen Receptor in Hair Follicles of Women and Men with Androgenetic Alopecia

416 citations , September 1997 in “Journal of Investigative Dermatology”

People with hair loss have more androgen receptors and enzymes in certain follicles, with men and women showing different patterns.

research Diagnostic and Predictive Value of Horizontal Sections of Scalp Biopsy Specimens in Male Pattern Androgenetic Alopecia

309 citations , May 1993 in “Journal of The American Academy of Dermatology”

Horizontal scalp biopsy sections effectively diagnose and predict MPAA, with follicular density and inflammation impacting hair regrowth.

research Classification of the Types of Androgenetic Alopecia (Common Baldness) Occurring in the Female Sex

666 citations , September 1977 in “British Journal of Dermatology”

Common baldness, also known as Androgenetic Alopecia, is caused by a combination of genetic factors and hormones called androgens.