Hair Restoration in Androgenetic Alopecia: Looking Beyond Minoxidil, Finasteride and Hair Transplantation

Abstract

Patterned hair loss (PHL) is one of the most commonly encountered problems for dermatologists. PHL at an early age is often cosmetically unacceptable, tends to be persistent and inflicts a profound negative impact on one's quality of life. Androgenetic alopecia (AGA) affects both genders in a distinctive pattern of hair loss from the scalp (MPHL for male PHL and FPHL or female PHL). The etiopathogenesis of AGA is complex, so far the major factor emphasized to be involved has been the undesirable androgen metabolism at the hair follicle level. In this review article, we shall dwell upon the relatively newly understood pathophysiological factors behind the genesis of AGA apart from the hormonal factors like the Wnt/β-catenin pathway, follicular micro-inflammation, prostaglandin imbalance, loss of extracellular matrix and oxidative stress. Based on the sound understanding of these factors we will be elaborating upon therapies for treatment of AGA beyong minoxidil, finasteride and hair transplantation. Amongst the therapeutic options discussed include topical 5alpha reductase (AR) inhibitors like finasteride, oral 5AR inhibitor-dual receptor antagonist dutasteride, botanical 5AR inhibitors, oral anti-androgens and estrogens for FPHL like spiranolactone, drospirenone etc. Wnt/β-catenin activators like topical valproic acid, hair stem cell based therapies, prostaglandin based therapies, tetrapeptides, nutritional and anti-oxidants and many more.

Annurca Apple Polyphenols Protect Murine Hair Follicles from Taxane Induced Dystrophy and Hijacks Polyunsaturated Fatty Acid Metabolism toward β-Oxidation

“…Patients affected by glaucoma and receiving PGF2α analogues, claimed side effects such as cutaneous hypertrichosis and hyperpigmentation of eyelashes [ 32 ]. PGF2α analogues latanoprost and bimatoprost are being tested in clinical trials for Patterned Hair Loss and Androgenic Alopecia and are showing promising results [ 4 , 31 ].…”

“…Hair shaft extension is sustained by highly proliferating cells of the hair matrix (HMs). These differentiate into several cell lineages, (among these cells of the outer (ORS) and inner (IRS) root sheaths) all differently specialized in the production and modification of hair keratins [ 1 , 2 , 3 , 4 ].…”

Annurca Apple Polyphenols Ignite Keratin Production in Hair Follicles by Inhibiting the Pentose Phosphate Pathway and Amino Acid Oxidation

“…Anagen, the phase when hair shaft extension occurs, can last years in humans and is fueled by hair matrix cells (HMs) located in the hair bulb (HB). These highly proliferating cells are stimulated by the dermal papillas (DP) to differentiate into different lineages of cell including the outer (ORS) and inner (IRS) root sheaths, all differently involved in the production, deposition, protection and hardening of keratins [ 1 , 2 , 3 , 4 ].…”

“…Patterned hair loss (PHL) affects around 50% of the adult population worldwide. Independent of age and gender, this condition exerts a profound negative impact on some people’s quality of life [ 4 ] and, especially when occurring at an early age, it is frequently associated to depression [ 5 , 6 ]. During PHL, HFs undergo a premature miniaturization and shorten their permanence in anagen.…”

Estudo De Pré-Formulação De Shampoo Para Tratamento Da Alopecia Androgenética Contendo Cafeína Como Ativo

“…Esta enzima é encontrada naturalmente nos indivíduos e não há correlação com o aumento de sua atividade em pessoas acometidas pela calvície. São os fatores genéticos e/ou hormonais que promovem a apoptose celular e, assim, mais AMPc estaria disponível para a ação da fosfodiesterase (Bansal et al, 2012;Sonthalia, Daulatabad & Tosti, 2016).…”