Commentary 2

IGFBP‐rP1 shows potential for treating androgenic alopecia by influencing hair cycle transitions. Increasing IGF-1 levels may have similar effects to Minoxidil and 5-AR inhibitors in reducing hair loss.

Scalp biopsies are crucial for diagnosing hair loss conditions like Diffuse Unpatterned Alopecia (DUPA) and retrograde hair loss, as treatments like finasteride and dutasteride may not be effective if other conditions are present. Combining PPAR-GAMMA agonists with retinoids could improve treatments for conditions like Lichen Planopilaris.

A peptide from Japanese water chestnut fruit may help with hair loss by suppressing DHT's effect on hair follicle cell death, potentially serving as a finasteride alternative. The treatment's effectiveness and safety in humans remain uncertain.

Aminexil/Kopexil may help reduce hair loss by addressing perifollicular fibrosis in androgenetic alopecia, but it lacks the extensive clinical backing of finasteride and minoxidil. Some users find it effective, but availability and cost are issues, especially in the US where it's not FDA-approved.

Pelage Pharmaceuticals' PP405 aims to treat hair loss by reactivating dormant hair follicle stem cells, showing promising results in early trials. The company plans to present their findings at the American Academy of Dermatology Annual Meeting in 2026.

Lichen Planopilaris (LPP) is an autoimmune condition causing permanent hair loss and fibrosis, often misdiagnosed. Treatments include pioglitazone, topical corticosteroids, anti-inflammatory medication, and Jak inhibitors.