Destruction of the Arrector Pili Muscle and Fat Infiltration in Androgenic Alopecia

    March 2014 in “ British Journal of Dermatology
    Niloufar Torkamani, Nicholas W Rufaut, L. Jones, Robert Sinclair
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    TLDR Hair loss in male pattern baldness involves muscle degeneration and increased scalp fat.
    The 2014 study examined the arrector pili muscle (APM) in individuals with androgenic alopecia (AGA), telogen effluvium (TE), and normal controls, involving scalp biopsies from 8 AGA patients, 5 TE patients, and 5 controls. It found that in AGA, the APM degenerates and is replaced by adipose tissue, particularly in smaller follicles, suggesting a link to follicle miniaturization. Quantitative analysis showed a significant decrease in muscle volume and an increase in fat volume in AGA compared to controls. The study concluded that APM degeneration and fat replacement are specific to AGA and may be related to the loss of stem or progenitor cells, potentially explaining AGA's resistance to treatment.
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