Androgens and Hair Loss: An In-Depth Analysis of Androgenetic Alopecia

June 2009 in “ Current Opinion in Endocrinology, Diabetes and Obesity ”

Adel Alsantali, Jerry Shapiro

androgenetic alopecia AGA dutasteride finasteride topical liposomal finasteride minoxidil hair transplantation gene therapy Propecia Rogaine

TLDR The document concludes that hair transplantation and gene therapy may be important for future hair loss treatment.

The 2009 document provides an in-depth analysis of androgenetic alopecia (AGA), detailing its genetic basis, pathogenesis, and treatment options. It identifies AGA as a polygenic condition with genetic associations on chromosomes 20p11 and 3q26. The document reports that dutasteride is more effective than finasteride in treating AGA, with a new topical liposomal finasteride formulation showing promise in vitro. It also reviews the only two approved medical therapies at the time: finasteride, which leads to hair regrowth in a significant percentage of patients and prevents further hair loss in most, and minoxidil, which has been associated with a substantial increase in hair regrowth. The document discusses the prevalence of AGA, its association with various diseases, and its psychological impact. It concludes by noting the importance of hair transplantation and the potential for gene therapy in future AGA management.

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research Prevalence and Types of Androgenetic Alopecia in Shanghai, China: A Community-Based Study

66 citations , March 2009 in “British Journal of Dermatology”

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111 citations , October 2008 in “Nature Genetics”

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82 citations , September 2008 in “Journal of Investigative Dermatology”

EDA2R gene linked to hair loss.

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150 citations , July 2008 in “Journal of The American Academy of Dermatology”

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research Genome-Wide Scan and Fine-Mapping Linkage Study of Androgenetic Alopecia Reveals a Locus on Chromosome 3q26

62 citations , March 2008 in “American Journal of Human Genetics”

Hair loss gene found on chromosome 3q26.

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A substance called DKK-1 increases in balding areas and causes hair cells to die when exposed to DHT.

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

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research Expression of Androgen Receptor Coactivator ARA70/ELE1 in Androgenic Alopecia

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The protein ARA70/ELE1 is involved in male pattern baldness, and lower levels of its short form may lead to hair thinning.

research Genetic Variation in the Human Androgen Receptor Gene Is the Major Determinant of Common Early-Onset Androgenetic Alopecia

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Genetic variation in the androgen receptor gene mainly causes early-onset hair loss, with maternal inheritance playing a key role.

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Hormones like testosterone affect skin functions and can cause skin issues when in excess; treatments to manage these effects are only somewhat effective.

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Men with a family history of hair loss are more likely to experience it themselves, especially if both parents have hair loss.

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Oral finasteride works better than topical minoxidil for hair growth, both are safe.

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Balding men seen as older, less attractive, and less confident.

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Hair loss needs more research for better treatments.

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190 citations , October 2002 in “The FASEB journal”

Androgens may cause hair loss by increasing TGF-beta1 from scalp cells, which inhibits hair cell growth.

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.

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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 Early Onset of Androgenetic Alopecia Associated With Early Severe Coronary Heart Disease: A Population-Based, Case-Control Study

56 citations , June 2001 in “European journal of cardiovascular prevention & rehabilitation”

Early balding linked to higher heart disease risk.

research Sebocytes Are the Key Regulators of Androgen Homeostasis in Human Skin

196 citations , May 2001 in “The journal of investigative dermatology/Journal of investigative dermatology”

Sebocytes play a key role in controlling androgen levels in human skin.

research Chronic Treatment with Finasteride Daily Does Not Affect Spermatogenesis or Semen Production in Young Men

104 citations , October 2000 in “The Journal of Urology”

Finasteride doesn't harm male fertility or sperm quality, but may slightly reduce ejaculate volume.

research Finasteride Increases Anagen Hair in Men with Androgenetic Alopecia

129 citations , October 2000 in “British Journal of Dermatology”

Finasteride helps increase hair growth in men with hair loss.

research Early Androgenetic Alopecia as a Marker of Insulin Resistance

115 citations , September 2000 in “The Lancet”

Early hair loss may indicate risk of insulin resistance.

research Management of Androgenetic Alopecia

22 citations , May 2000 in “American Journal of Clinical Dermatology”

Treatments for common hair loss include minoxidil, finasteride, and hair transplantation.

research Immunohistochemical Localization of Types 1 and 2 5α-Reductase in Human Scalp

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

The study found that two enzymes linked to hair loss are located in different parts of the scalp, supporting a common treatment's effectiveness.

research The Risk of Coronary Heart Disease in Men with Androgenetic Alopecia

34 citations , March 1999 in “Journal of The European Academy of Dermatology and Venereology”

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Finasteride safely and effectively treats male pattern hair loss, but may cause reversible sexual issues and harm male fetuses.

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Men with enlarged prostates often have more severe baldness.

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

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research Balding Hair Follicle Dermal Papilla Cells Contain Higher Levels of Androgen Receptors Than Those From Non-Balding Scalp

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Cells from balding scalps have more androgen receptors than cells from non-balding scalps.

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

research The Psychological Effects of Androgenetic Alopecia in Men

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Hair loss can cause low self-esteem, anxiety, and depression in men.

research The Transverse Anatomy of Androgenic Alopecia

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The study found that horizontal sections of scalp biopsies are better for analyzing hair loss, showing fewer hairs and more fine hairs in balding areas.

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Longer contact time increases minoxidil absorption, but doesn't affect metabolism.

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research Alterations in Scalp Blood Flow After the Epicutaneous Application of 3% Minoxidil and 0.1% Hexyl Nicotinate in Alopecia

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Minoxidil didn't increase scalp blood flow for hair growth, but hexyl nicotinate did.

research Topical Minoxidil in Male Pattern Baldness: Effects of Discontinuation of Treatment

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Stopping minoxidil treatment resumes balding; continuous use needed for results.

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research Minoxidil Stimulates Cutaneous Blood Flow in Human Balding Scalps: Pharmacodynamics Measured by Laser Doppler Velocimetry and Photopulse Plethysmography

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10 / 10 results

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Two people lost hair unexpectedly after getting a common hair loss treatment with a drug called Dutasteride.

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The review found that women using hair loss drugs like finasteride and dutasteride rarely reported sexual side effects.

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