Conflicting Reports Regarding the Histopathological Features of Androgenic Alopecia: Are Biopsy Location, Hair Diameter Diversity, and Relative Hair Follicle Miniaturization Partly to Blame?

The study hypothesized that conflicting histopathological findings in androgenic alopecia (AGA) were due to variations in biopsy location, hair diameter diversity (HDD), and relative hair follicle miniaturization (HFM). It proposed that during early HFM stages, hair follicles exhibited low fibrosis but increased inflammation and prostaglandin activity, while mid- to late-stages showed increased fibrosis and sustained prostaglandin levels. The authors suggested a novel classification system and methodological adjustments to account for HDD and HFM, which could clarify inconsistent reports. They also highlighted the need for non-invasive methods to measure inflammation, fibrosis, and prostaglandins to improve research accuracy.