Understanding Pattern Hair Loss: Hair Biology Impacted by Genes, Androgens, Prostaglandins, and Epigenetic Factors

Pattern hair loss (PHL) is the most common cause of hair loss in both men and women, accounting for 65% of consultations at hair referral centers. It is a hereditary, age-dependent condition characterized by progressive thinning of scalp hair, with distinct patterns varying by sex and age. The pathogenesis of PHL involves genetic factors, androgen metabolism, microbiomata, oxidative stress, and microinflammation. Despite numerous therapeutic molecules being patented, only two FDA-approved treatments—oral finasteride and topical minoxidil—are available, aimed at slowing hair thinning and increasing scalp coverage. The efficacy of antiandrogen treatments in women with normal androgen levels is questionable and poses health risks.