Scalp Microbiome Alterations in Androgenetic Alopecia: Patterns and Emerging Mechanistic Insights

The document reviews the alterations in the scalp microbiome associated with androgenetic alopecia (AGA), emphasizing the consistent finding of Cutibacterium acnes enrichment, particularly in males, and the inconsistent variations in other microbial taxa due to factors like sex and geography. It suggests a potential interaction between the microbiome, lipids, and the immune system that may contribute to perifollicular inflammation, although causality is not established. The review highlights the complexity of AGA pathophysiology and the need for further research to clarify the role of the scalp microbiome in hair loss, as microbiome-targeted interventions remain investigational.