Hormones: Underestimated Problem in Dermatology. Part I. Diseases Connected with Excessive Androgenization

Dihydrotestosterone (DHT) impacts various skin conditions, including Androgenetic alopecia and seborrheic dermatitis, by causing overactivity in sebaceous glands. Topical medications Tacrolimus and Clobetasol can reduce these inflammatory conditions, and treatments like RU58841, Minoxidil, and Finasteride may also be beneficial.

DHT may inhibit hair growth by affecting mitochondrial function, leading to hair follicle miniaturization. Treatments like minoxidil and PP405 may promote hair growth by altering metabolic pathways, potentially counteracting DHT's effects.

An 18-year-old experiencing hair loss and seborrheic dermatitis has tried finasteride, dutasteride, and various shampoos without success. They are considering anti-androgens like RU58841 and KX-826 for oil control and dandruff reduction.

Hair loss is linked to cellular physiology and the IGF-1 to TGF-B1 ratio, not just androgen sensitivity. The theory lacks evidence, while finasteride and minoxidil are effective treatments.

Increased Malassezia and Cutibacterium in the scalp microbiome are linked to higher sebum production and inflammation in androgenetic alopecia (AGA). Treatments include ciclopirox shampoo, benzoyl peroxide shampoo, clobetasol propionate, calcipotriol, minoxidil, finasteride, and dutasteride.

Elevated bile acids can inhibit the enzyme AKR1C2, leading to increased DHT levels, which may accelerate hair loss in those predisposed to androgenetic alopecia. Treatments mentioned include topical minoxidil and finasteride.