Advanced Medical Therapies in the Management of Non-Scarring Alopecia: Areata and Androgenic Alopecia

Abstract

Alopecia is a challenging condition for both physicians and patients. Several topical, intralesional, oral, and surgical treatments have been developed in recent decades, but some of those therapies only provide partial improvement. Advanced medical therapies are medical products based on genes, cells, and/or tissue engineering products that have properties in regenerating, repairing, or replacing human tissue. In recent years, numerous applications have been described for advanced medical therapies. With this background, those therapies may have a role in the treatment of various types of alopecia such as alopecia areata and androgenic alopecia. The aim of this review is to provide dermatologists an overview of the different advanced medical therapies that have been applied in the treatment of alopecia, by reviewing clinical and basic research studies as well as ongoing clinical trials.

Amphiregulin promotes hair regeneration of skin‐derived precursors via the PI3K and MAPK pathways

“…Its pathogenesis varies and leads to symptoms, such as androgenetic alopecia, alopecia areata, diffuse alopecia and therapy‐induced hair loss 5 . Several oral, surgical, topical and intralesional treatments have been progressively developed in recent decades to achieve delayed hair loss or hair restoration in alopecic areas 6 …”

“…5 Several oral, surgical, topical and intralesional treatments have been progressively developed in recent decades to achieve delayed hair loss or hair restoration in alopecic areas. 6 Although hair transplantation is regarded as the gold standard for creating natural-appearing hair in androgenic alopecia (AGA), 7 there is an unavoidable controversy surrounding autologous transplantation owing to the limited source of donor hair, the decreased viability of cells extracted in this time-consuming procedure, and, most importantly, the impermanent outcomes as the disease progresses. 1,3 Regarding oral medicines, drugs approved by the Food and Drug Administration (FDA), such as finasteride, dutasteride and minoxidil for AGA, vary greatly in efficacy from person to person and provide partial and temporary benefits, as well as side effects.…”

Current Advanced Therapies Based on Human Mesenchymal Stem Cells for Skin Diseases

“…Other important cutaneous diseases not included in this review are alopecia and toxic skin injuries. In the first case, our group has recently published a comprehensive review where many advanced therapy has been analyzed including those using hMSCs ( Martinez-Lopez et al, 2020 ). In the case of toxic skin conditions, many chemical agents could impair skin barrier and another review could be wrote about their possible treatment, however, in recent years, skin injuries generated by sulfur mustard (SM) agent have been analyzed ( Rose et al, 2018 ) and the potential use of hMSCs-based advanced therapy could be interested because SM damage DNA of mesenchymal stem cells provoking less proliferative and migratory capacities ( Schmidt et al, 2018 ; Schreier et al, 2018 ).…”

The Role of Exosomes Derived From Mesenchymal Stromal Cells in Dermatology

“…Alopecia areata and androgenic alopecia are challenging conditions for dermatologists nowadays, with a lack of effective treatments. Advanced therapies are a promising therapeutic option that have shown good results ( Martinez-Lopez et al, 2020 ). Although few studies have focused on the use of exosomes to stimulate hair growth, the findings so far are promising.…”