Pathogenic Mechanisms And Mechanism-Directed Therapies For Androgenetic Alopecia: Current Understanding And Future Directions

Androgenetic alopecia (AGA) is a common form of hair loss linked to dysregulated androgen metabolism, oxidative stress, inflammation, and scalp microbiota imbalance. Current treatments like finasteride and minoxidil have limitations, leading to research into new therapies. Emerging strategies include targeting the DHT–PGD2 loop, oxidative stress, and lipid metabolism. Cetirizine shows promise by inhibiting PGD2, while exosome therapy with microneedling and maintaining scalp microbiome balance are potential treatments. The review suggests multitarget combination therapies to address AGA's complex causes and highlights the need for noninvasive biomarkers to enable personalized treatments.