Disorders of the Scalp and Hair

January 2018

Marwa Abdallah, Constantin E. Orfanos

androgenetic alopecia AGA minoxidil finasteride dutasteride hypertrichosis hirsutism alopecia areata corticosteroids JAK inhibitors scarring alopecias traumatic alopecias fibrosis topical corticosteroids surgical options Rogaine Propecia

From the encyclopedia

Minoxidil →

An essential vasodilator with some anti-androgenic effects

Finasteride →

Frontline, gold standard treatment for combatting androgenic alopecia

Dutasteride →

Heavy duty finasteride that comes with higher risks

Studysummary Different scalp and hair disorders are more common in certain ethnic groups, with the most common being androgenetic alopecia, which is treated with medications like minoxidil and finasteride.

Our plain-language summary. Not medical advice or a treatment recommendation. Consult a qualified healthcare professional before changing treatment. Full disclaimer

The document from 2018 examines various scalp and hair disorders, noting that characteristics and prevalence of these conditions vary among ethnic groups. It states that androgenetic alopecia (AGA) is the most common form of hair loss, with a higher incidence in Caucasians and a lower incidence in Asians and dark-skinned Africans, and that its prevalence increases with age. The document outlines the genetic predisposition of AGA and its management, which includes topical minoxidil and oral finasteride or dutasteride. It also covers hypertrichosis and hirsutism, detailing their management through hair removal and treatment of underlying causes. Additionally, the document discusses alopecia areata, an autoinflammatory disorder with treatments such as corticosteroids and JAK inhibitors, and scarring alopecias, which are common in black-skinned populations due to hairstyling practices. For traumatic alopecias, early intervention can reverse hair loss, but persistent cases may lead to permanent loss and require treatments to stabilize fibrosis and scarring, including topical corticosteroids, minoxidil, and potentially surgical options.

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Research cited in this study

39 / 39 results

research Tofacitinib 2% Ointment, a Topical Janus Kinase Inhibitor, for the Treatment of Alopecia Areata: A Pilot Study of 10 Patients

48 citations , November 2017 in “Journal of the American Academy of Dermatology”

Tofacitinib 2% ointment helped hair regrow in 3 out of 10 patients with alopecia areata, but caused side effects like scalp irritation and raised cholesterol in some.

research Safety and Efficacy of the JAK Inhibitor Tofacitinib Citrate in Patients with Alopecia Areata

222 citations , September 2016 in “JCI insight”

This research overview highlights that although JAK inhibitors show promise as potential treatments for alopecia areata based on recent insights into the disease mechanism, their efficacy has not yet been thoroughly evaluated in a systematic manner.

research Hirsutism in Polycystic Ovary Syndrome: Pathophysiology and Management

47 citations , July 2016 in “Current pharmaceutical design”

This review summarizes hair growth aspects, treatment options, and management strategies for hirsutism in women with polycystic ovary syndrome, without presenting new clinical findings.

research Interventions for Female Pattern Hair Loss

21 citations , May 2016 in “The Cochrane library”

This review found that while topical minoxidil is effective for treating female pattern hair loss, finasteride showed no more effectiveness than placebo, and low-level laser therapy increased hair count but with inconsistent results.

Differential Expression Between Human Dermal Papilla Cells from Balding and Non-Balding Scalps Reveals New Candidate Genes for Androgenetic Alopecia

research Differential Expression Between Human Dermal Papilla Cells from Balding and Non-Balding Scalps Reveals New Candidate Genes for Androgenetic Alopecia

46 citations , April 2016 in “Journal of Investigative Dermatology”

This study suggests that down-regulation of vasculature-related genes in dermal papilla cells from balding scalps might contribute to the development of androgenetic alopecia.

research Clinician vs Self-Ratings of Hirsutism in Patients With Polycystic Ovarian Syndrome

52 citations , March 2016 in “JAMA dermatology”

This study found that hirsutism significantly negatively impacts quality of life, with self-assessed severity more strongly linked to quality-of-life impact and depressive symptoms than clinician assessments.

research Interventions for Hirsutism Excluding Laser and Photoepilation Therapy Alone: Abridged Cochrane Systematic Review Including GRADE Assessments

30 citations , February 2016 in “British journal of dermatology/British journal of dermatology, Supplement”

This review found moderate to very low-quality evidence that spironolactone, flutamide, and cyproterone acetate combined with oral contraceptives may reduce hirsutism more effectively than placebo or metformin, though results vary among other treatments.

research Infantile Generalized Hypertrichosis Caused by Topical Minoxidil

10 citations , February 2016 in “Anais Brasileiros de Dermatologia”

This case report describes a 5-year-old child in Brazil who developed generalized hypertrichosis after using topical minoxidil, suggesting caution when using it in children.

research Topical Ruxolitinib for the Treatment of Alopecia Universalis

96 citations , December 2015 in “JAMA dermatology”

This article discusses the potential of topical ruxolitinib as a treatment for alopecia universalis and acknowledges the need for alternatives to systemic JAK inhibitors due to the risk of serious side effects.

research Black Women's Hair: The Main Scalp Dermatoses and Aesthetic Practices in Women of African Ethnicity

32 citations , August 2015 in “Anais Brasileiros de Dermatologia”

This review discusses the side effects and diseases related to hairstyles and hair treatments among black women, highlighting the need for thorough examination by dermatologists, but reports no new clinical results.

research Hair Loss in Patients with Skin of Color

16 citations , June 2015 in “Seminars in Cutaneous Medicine and Surgery”

This article discusses the challenges of diagnosing and managing hair disorders in patients with skin of color, especially conditions more prevalent in those of African descent, and provides no new clinical results.

research Ethnic Hair Disorders: Diagnosis and Management

17 citations , January 2015 in “Current problems in dermatology”

This chapter reviews cultural practices and morphological differences in ethnic hair, relating them to specific disorders seen in these populations, without presenting new clinical results.

research Alopecia Areata Is Driven by Cytotoxic T Lymphocytes and Is Reversed by JAK Inhibition

701 citations , August 2014 in “Nature medicine”

This study found that JAK inhibitors promote hair regrowth in both mice and human alopecia areata cases by blocking key immune pathways involved in disease development.

research Killing Two Birds with One Stone: Oral Tofacitinib Reverses Alopecia Universalis in a Patient with Plaque Psoriasis

185 citations , June 2014 in “Journal of Investigative Dermatology”

This case report describes complete hair regrowth in a patient with alopecia universalis and improved psoriasis after treatment with the oral Janus kinase inhibitor, tofacitinib.

research Follicular and Scarring Disorders in Skin of Color: Presentation and Management

30 citations , May 2014 in “American Journal of Clinical Dermatology”

This review discusses follicular and scarring disorders in skin of color and highlights the need for patient education and tailored therapeutic strategies, but does not report new clinical findings.

research Investigation of Four Novel Male Androgenetic Alopecia Susceptibility Loci: No Association with Female Pattern Hair Loss

21 citations , December 2013 in “Archives of Dermatological Research”

No link found between new male baldness genes and female hair loss.

research Non-Scarring Patchy Alopecia in Patients with Systemic Lupus Erythematosus Differs from That of Alopecia Areata

30 citations , October 2013 in “Lupus”

This study identified distinct clinical and dermatoscopic features to differentiate non-scarring patchy alopecia in SLE from alopecia areata, emphasizing the value of serological tests in diagnosis.

The Efficacy and Safety of 5α-Reductase Inhibitors in Androgenetic Alopecia: A Network Meta-Analysis and Benefit–Risk Assessment of Finasteride and Dutasteride

research The Efficacy and Safety of 5α-Reductase Inhibitors in Androgenetic Alopecia: A Network Meta-Analysis and Benefit–Risk Assessment of Finasteride and Dutasteride

66 citations , June 2013 in “Journal of Dermatological Treatment”

This study reported no significant difference in efficacy or sexual dysfunction risk between 5α-reductase inhibitors and placebo for androgenetic alopecia, suggesting that dutasteride 0.5 mg may be considered pending further research.

Epidemiology, Diagnosis, and Management of Hirsutism: A Consensus Statement by the Androgen Excess and Polycystic Ovary Syndrome Society

research Epidemiology, Diagnosis, and Management of Hirsutism: A Consensus Statement by the Androgen Excess and Polycystic Ovary Syndrome Society

378 citations , November 2011 in “Human reproduction update”

This review discusses the epidemiology, causes, diagnosis, and management of hirsutism in women, noting that effective treatment requires addressing the root cause as well as the hair growth.

research Androgen Receptor Gene Polymorphisms and Risk for Androgenetic Alopecia: A Meta-Analysis

41 citations , October 2011 in “Clinical and Experimental Dermatology”

This meta-analysis suggests that the G allele of AR StuI polymorphism might be a potential risk factor for AGA, particularly in white populations.

A Randomized Double-Blind Placebo-Controlled Pilot Study to Assess the Efficacy of a 24-Week Topical Treatment by Latanoprost 0.1% on Hair Growth and Pigmentation in Healthy Volunteers with Androgenetic Alopecia

research A Randomized Double-Blind Placebo-Controlled Pilot Study to Assess the Efficacy of a 24-Week Topical Treatment by Latanoprost 0.1% on Hair Growth and Pigmentation in Healthy Volunteers with Androgenetic Alopecia

81 citations , August 2011 in “Journal of The American Academy of Dermatology”

In this study, latanoprost significantly increased hair density in young men with mild androgenetic alopecia after 24 weeks, suggesting it may stimulate hair follicle activity and treat hair loss.

Efficacy, Safety, and Tolerability of Dutasteride 0.5 mg Once Daily in Male Patients with Male Pattern Hair Loss: A Randomized, Double-Blind, Placebo-Controlled, Phase III Study

research Efficacy, Safety, and Tolerability of Dutasteride 0.5 mg Once Daily in Male Patients with Male Pattern Hair Loss: A Randomized, Double-Blind, Placebo-Controlled, Phase III Study

92 citations , June 2010 in “Journal of The American Academy of Dermatology”

This study found that 0.5 mg of dutasteride significantly improved hair growth compared to placebo and was well tolerated over six months in men with male pattern hair loss.

research Latanoprost in the Treatment of Eyelash Alopecia in Alopecia Areata Universalis

50 citations , December 2009 in “Journal of The European Academy of Dermatology and Venereology”

This study found that latanoprost may be effective for treating eyelash alopecia areata, achieving cosmetically acceptable regrowth in 45% of patients.

research Approach to Hair Loss in Women of Color

19 citations , June 2009 in “Seminars in cutaneous medicine and surgery”

This article discusses diagnostic challenges and management approaches for hair loss in women of color, emphasizing the importance of clinical examinations and education to prevent and manage traction alopecia.

research Central Centrifugal Cicatricial Alopecia: Past, Present, and Future

75 citations , March 2009 in “Journal of The American Academy of Dermatology”

This review discusses the evolution and ongoing debate about the causes of central centrifugal cicatricial alopecia in African American women, without presenting new clinical findings.

research Prevalence and Types of Androgenetic Alopecia in Shanghai, China: A Community-Based Study

66 citations , February 2009 in “British Journal of Dermatology”

This study found that the prevalence of androgenetic alopecia in Chinese men was lower than in Caucasian men, similar to Korean men, and most commonly presented as type III vertex.

research Clinical Significance of Dermoscopy in Alopecia Areata: Analysis of 300 Cases

196 citations , June 2008 in “International Journal of Dermatology”

This study found that dermoscopic indicators like black dots and tapering hairs are valuable markers for diagnosing and assessing the severity and activity of alopecia areata in Asian patients.

research Genome-Wide Scan and Fine-Mapping Linkage Study of Androgenetic Alopecia Reveals a Locus on Chromosome 3q26

62 citations , March 2008 in “American Journal of Human Genetics”

This study located a potential genetic link for androgenetic alopecia on chromosome 3q26, marking an early step in identifying new susceptibility genes for male pattern baldness.

research A Randomized Bilateral Vehicle-Controlled Study of Eflornithine Cream Combined with Laser Treatment Versus Laser Treatment Alone for Facial Hirsutism in Women

125 citations , February 2007 in “Journal of the American Academy of Dermatology”

This study found that adding topical eflornithine to laser hair removal significantly improved the reduction of unwanted facial hair in women over a 6-month period, compared to laser treatment alone.

research Development of Alopecia Areata Universalis in a Patient Receiving Adalimumab

69 citations , December 2006 in “Archives of dermatology”

This entry contains no research abstract, so no scientific findings or conclusions are reported.

research Randomized, Double-Blind Clinical Evaluation of the Efficacy and Safety of Topical Eflornithine HCl 13.9% Cream in the Treatment of Women with Facial Hair

133 citations , July 2006 in “International Journal of Dermatology”

This study found that topical eflornithine HCl 13.9% cream effectively reduced facial hair in women, with a favorable safety profile.

research Hair Loss: Is There a Relationship with Hair Care Practices in Nigeria?

57 citations , September 2005 in “International Journal of Dermatology”

This study reported that chemical relaxants and hair styling practices were associated with scarring hair loss, particularly among women with central centrifugal cicatricial alopecias.

research Prevalence of Male and Female Pattern Hair Loss in Maryborough

193 citations , August 2005 in “Journal of Investigative Dermatology Symposium Proceedings”

This study found that the prevalence of androgenetic alopecia increases with age among both men and women in Maryborough, Australia, with 57% of women and 73.5% of men aged 80 and over affected.

research Frontal Fibrosing Alopecia: A Survey in 16 Patients

123 citations , August 2005 in “Journal of the European Academy of Dermatology and Venereology”

In this study, the researchers observed that treatment with intralesional and topical corticosteroids, finasteride, and minoxidil may stop the progression of frontal fibrosing alopecia in postmenopausal and premenopausal women.

research Genetic Variation in the Human Androgen Receptor Gene Is the Major Determinant of Common Early-Onset Androgenetic Alopecia

195 citations , June 2005 in “American Journal of Human Genetics”

Genetic variation in the androgen receptor gene mainly causes early-onset hair loss, with maternal inheritance playing a key role.

Medical and Surgical Therapies for Alopecias in Black Women