Androgenetic Alopecia Research Articles

Exosomes derived from Umbilical cord mesenchymal stem cell promote hair regrowth in C57BL6 mice through upregulation of the RAS/ERK signaling pathway

Abstract Background and Objectives Androgenetic alopecia is one of the common types of hair loss and has become a medical and social problem due to its increasingly young onset. Existing therapies, although effective, have serious side effects and therefore better treatments need to be sought. The aim of this study was to evaluate the efficacy of umbilical cord mesenchymal stem cell-derived exosomes in the treatment of androgenetic alopecia and to investigate the mechanism of exosome regulation of hair growth. Methods First, we randomly divided 20 C57BL/6J mice into blank group, model group, positive control group and exosomal hydrogel group, and mice were treated with hair removal on the back. The mice were injected intraperitoneally with dihydrotestosterone solution except for the blank group. At the end of the experiment, new hairs were collected and the differences in length, diameter and number of hair follicles were compared among the groups; the histopathological changes of hair follicles were observed by HE staining; the expression of androgen receptor mRNA and protein in skin tissues were compared; and the skin tissues were analyzed by real-time PCR, western blotting, immunofluorescence staining and transcriptome sequencing. Finally, the results of transcriptome sequencing experiments were verified by real-time PCR, western blotting and other techniques for the corresponding genes and proteins. Results Compared with the blank group, mice in the model group had shorter hair length and reduced hair diameter, and pathological observation showed that the total number of hair follicles was significantly reduced and the hair follicles were miniaturized; compared with the model group, mice in the positive control and exosome groups had longer hair length, larger hair diameter and more hair follicles; the androgen receptor mRNA content and protein expression in the skin tissue of mice in the model group were significantly higher than those in the blank group, and the protein expression in the exosome gel group was lower than that in the model group. Similarly, compared with the model group, the expression of stemness-related proteins K15 and CD200 in the skin tissues of mice in the exosome group increased, and the expression of PCNA, a protein related to cell proliferation, increased. The KEGG data showed that the differential genes were mainly enriched in the RAS/ERK pathway. Conclusions In this study, we demonstrated the therapeutic effect of umbilical cord MSC-derived exosomes on androgenetic alopecia and verified that exosomes regulate hair follicle stem cell stemness through the RAS/ERK pathway to promote hair proliferation and thus hair growth in mice with androgenetic alopecia, providing a potential therapeutic strategy for androgenetic alopecia.

Multistage Transdermal Nitric Oxide Delivery System for the Efficient Treatment of Androgenic Alopecia

Multistage Transdermal Nitric Oxide Delivery System for the Efficient Treatment of Androgenic Alopecia

Design of Nanocrystalline Suspension of Dutasteride for Intramuscular Prolonged Delivery

The aim of the study is to formulate an injectable nanocrystalline suspension (NS) of dutasteride (DTS), a hydrophobic 5α-reductase inhibitor used to treat benign prostatic hyperplasia and scalp hair loss, for parenteral long-acting delivery. A DTS-loaded NS (DTS-NS, 40 mg/mL DTS) was prepared using a lab-scale bead-milling technique. The optimized DTS-NS prepared using Tween 80 (0.5% w/v) as a nano-suspending agent, was characterized as follows: rod/rectangular shape; particle size of 324 nm; zeta potential of −11 mV; and decreased drug crystallinity compared with intact drug powder. The DTS-NS exhibited a markedly protracted drug concentration-time profile following intramuscular injection, reaching a maximum concentration after 8.40 days, with an elimination half-life of 9.94 days in rats. Histopathological observations revealed a granulomatous inflammatory response at the injection site 7 days after intramuscular administration, which significantly subsided by day 14 and showed minimal inflammation by day 28. These findings suggest that the nanosuspension system is a promising approach for the sustained release parenteral DTS delivery, with a protracted pharmacokinetic profile and tolerable local inflammation.

Re: The risk of psychiatric disorders in finasteride users with benign prostatic hyperplasia (BPH) and androgenetic alopecia (AGA): A population-based case-control study.

Re: The risk of psychiatric disorders in finasteride users with benign prostatic hyperplasia (BPH) and androgenetic alopecia (AGA): A population-based case-control study.

Efficacy and Safety of Laser Therapy and Phototherapy in Cicatricial and NonCicatricial Alopecia: A Systematic Review Study.

In recent years, the application of various light and laser devices in the treatment of different types of alopecia has been established. This systematic review aims to assess the efficacy and safety of laser therapy and phototherapy in cicatricial and non-cicatricial alopecia. A comprehensive search was conducted on PubMed, Scopus, Science Direct, and Google Scholar. Articles were evaluated across four subgroups: alopecia areata, androgenic alopecia, telogen effluvium, and cicatricial alopecia. Included studies were published in English or Persian between January 2010 and September 2023, focusing on interventional, cohort, or case series research that achieved a minimum score of 75% on the EBL checklist. Exclusion criteria encompassed animal and in vitro studies, review articles, case reports, duplicated or irrelevant research, as well as studies that did not meet the designated EBL score. Editorial letters and case studies were also excluded. Initially, 965 records were collected, resulting in the inclusion of 58 studies in the final review: 26 on alopecia areata, 26 on androgenic alopecia, five on cicatricial alopecia, and one on telogen effluvium. Narrow-band ultraviolet B, 308-nm excimer laser, and psoralen ultraviolet A therapy showed varying effectiveness; specifically, the excimer laser was notably effective for patients with shorter disease duration. In androgenic alopecia, erbium-glass and thulium lasers effectively increased hair density but showed a gradual decline posttreatment. Low-level light/laser therapy also increased hair density and diameter and exhibited potential benefits when used alongside minoxidil, but did not significantly enhance outcomes in telogen effluvium treatment. Light/laser therapy can serve as an additive treatment for cicatricial alopecia, particularly lichen planopilaris, but has limited efficacy in treating telogen effluvium. Overall, light/laser therapies exhibit a significant positive effect on increasing hair density and diameter across various alopecia types.

Red and Green LED Light Therapy: A Comparative Study in Androgenetic Alopecia.

Androgenetic alopecia (AGA) affects both men and women, characterized by progressive hair thinning. While current treatments like minoxidil and finasteride have efficacy limitations and side effects, low-level light therapy (LLLT) using red or near-infrared light has emerged as a promising alternative. Recent animal studies suggest potential benefits from green LED light, though human data are sparse. This study utilized an innovative LED helmet emitting red and green LED light on respective halves of the frontal scalp, delivering an energy density of 40 J/cm2 over 20 min. Clinical photography, physician evaluations on a 7-point scale, patient satisfaction, and measurements of hair density and hair diameter were employed. Data were analyzed using linear mixed-effects models, with significance set at p < 0.05. Seventeen participants (47.1% male, 52.9% female, average age 46.47 years) demonstrated notable improvements after 6 months of treatment. Red and green LEDs both significantly increased hair diameter, non-vellus hair density, and satisfaction scores. Notably, the red LED therapy resulted in a statistically significant decrease in vellus hair density and achieved a greater increase in hair diameter compared to the green LED therapy. Minimal adverse effects were reported, primarily consisting of tolerable scalp heat and mild redness. Both red and green LED therapies effectively enhanced hair growth, increasing density and thickness over 6 months. Red LED demonstrated superior improvements in specific measures. Consequently, both therapies present safe and viable alternatives for the management of AGA, expanding the repertoire of available treatment options.

An Overview of Commonly Used Natural Alternatives for the Treatment of Androgenetic Alopecia, with Special Emphasis on Rosemary Oil

An Overview of Commonly Used Natural Alternatives for the Treatment of Androgenetic Alopecia, with Special Emphasis on Rosemary Oil

Therapeutic Efficacy of Platelet-Rich Plasma Combining with Microneedling and Topical Minoxidil in Refractory Severe Androgenic Alopecia

Therapeutic Efficacy of Platelet-Rich Plasma Combining with Microneedling and Topical Minoxidil in Refractory Severe Androgenic Alopecia

Stem Cell Therapy in Androgenetic Alopecia: A Review of Dermatology Literature from 2012-2022

Androgenetic alopecia is considered the most frequent form of progressive hair loss. In this disease, an alteration of the hair cycle dynamics leads to progressive miniaturization of the hair follicle and possible baldness as a final outcome. A few treatments have been proposed to reduce the progression of hair loss. In this study, a search for relevant literature was performed using PubMed. We reviewed about 165 articles from 2012 to 2022 using the keywords “regenerative medicine”, “stem cells” and “androgenetic alopecia”. As a result, we described the hair follicle cycle, assessed how a change in its homeostasis can impact androgenetic alopecia and investigated the advent of new therapeutic techniques for hair regrowth, highlighting the use of stem cells and its impact on androgenetic alopecia prognosis.

Filling the Gaps: Vitamin D Status in Diffuse Hair Fall Among Pakistanis

Introduction: Hair loss can happen for various reasons, including emotional stress, physical strain, certain medical issues, and nutritional gaps. When it comes to nutrition, a lack of vitamin D3 could be linked to diffuse hair loss. Objectives: The aim was to look for the frequency of vitamin D3 deficiency with diffuse hair fall especially in Pakistani population. Methods: A total of 120 patients of both genders and all ages presenting to the Dermatology Clinic with complaints of non-scarring alopecia and loss of over 100 strands of hair within a 24-hour period (counted by patient), of any duration and positive hair pull test were advised to take serum vitamin D3. Tests and results were then analyzed by SPSS statistical software package (version 19.0 for Windows). Results: The mean age of participants enrolled in the study was 28.56 ± 11.62 years. The majority of the patients, i.e., 77 (63.64%) were ≤30 years of age. Among the 120 patients, 17 were males and 103 were females. Mean serum vitamin D3 levels were 17.33 ± 5.43 ng/ml. Frequency of vitamin D3 deficiency in patients with diffuse hair fall was seen in 95 (79.17%) patients with 37 patients having female pattern hair loss, 7 patients with male pattern hair loss, 7 patients with diffuse alopecia areata, and 44 patients with telogen effluvium. Conclusions: This study concluded that there is considerable frequency of vitamin D3 deficiency in individuals with diffuse hair fall. So, we recommend that there should be early recognition and treatment of this condition in these particular patients in order to reduce hair fall.

Trichoscopic Evaluation of Focal Non-Cicatricial Alopecia in Egyptian Children

Introduction: Dermoscopy is a noninvasive diagnostic tool that allows the recognition of morphologic structures not visible to the naked eye. Trichoscopy is useful for the diagnosis and follow-up of hair and scalp disorders. Objective: The aim of the present study is to evaluate the causes of focal non-cicatricial alopecia in Egyptian children and to assess the importance of the trichoscope in the diagnosis of each disease. Methods: This study was done with 200 Egyptian children patients aged from 2 to 18 years who suffered from focal non-cicatricial alopecia. Clinical and dermoscopic evaluations were performed for all patients, and informed consent was obtained from their parents. Results: The most prevalent diagnoses were alopecia areata (42%) and tinea capitis (40.5%), followed by trichotillomania (8%) and tractional alopecia (7%). Congenital triangular alopecia (1.5%) and patchy androgenetic alopecia (1%) were less common. Trichoscopy revealed distinct features in alopecia areata cases, such as short vellus hair, exclamation mark hair, black dots, broken hair, pigtail hair and upright regrowing hair. The most common trichoscopic features of tinea capitis were comma hair, corkscrew hair, broken hair, bent hair, zigzag hair, morse code hair, perifollicular scaling, and diffuse scaling. These findings contribute to understanding the etiology and clinical presentation of childhood alopecia, facilitating accurate diagnosis and appropriate management. Conclusion: The routine use of dermoscopy in the clinical evaluation of scalp and hair disorders enhances diagnostic capabilities beyond simple clinical inspection. Dermoscopy reveals disease features that contribute to accurate diagnosis and improved management.

The Impact of Smoking and Lifestyle Factors on Hair Transplant Outcomes in Patients with Androgenic Alopecia

Background: Hair transplantation is a popular treatment for androgenic alopecia, a common form of hair loss that significantly affects self-esteem and quality of life. However, it is important to note that smoking can potentially have a detrimental impact on the efficacy of this procedure. Objectives: The objective of this study is to examine the influence of smoking, alcohol consumption, and water pipe usage on hair density and growth rate in individuals with alopecia who have undergone hair transplantation at the Jordan Clinic in Tehran, Iran. Methods: A retrospective analysis was conducted on 23 smoker and 97 non-smoker patients who underwent hair transplantation at the Jordan Clinic between 2011 and 2013. A convenience sampling method was employed in the study. Data on smoking status, hair growth, and complications were collected and analyzed. The study included 94.2% male and 5.8% female patients. Data analysis was performed using SPSS software, version 13. The repeated measures ANOVA test was used for statistical analysis, with a significance level of five percent. Results: The results showed that smokers experienced spontaneous bleeding at the implant site after surgery, resulting in hairless areas following crust formation, a complication not observed in non-smokers (P &gt; 0.05). Smokers also had significantly lower hair density and growth compared to non-smokers (P &gt; 0.05). Additionally, alcohol users demonstrated significantly less hair growth than non-drinkers. Conclusions: Smoking—including cigarettes, hookah, and combined smoking—and alcohol consumption negatively impacted hair transplant outcomes in patients with androgenic alopecia treated at the Jordan Clinic. These findings underscore the importance of addressing lifestyle factors, such as smoking and alcohol consumption, in the management of androgenic alopecia and hair transplantation.

Research work of Prof. De-Eknamkul, including the mechanistic synergy of hair growth promotion by the Avicennia marina extract and its active constituent (avicequinone C) in dermal papilla cells isolated from androgenic alopecia patients

Androgenetic alopecia (AGA) is a genetically-predetermined disorder that affects many people around the world, leading to progressive hair loss. This baldness can negatively impact people’s perceptions of themselves and scientists are searching for a cure. There are only two US Food and Drug Administration-approved drugs used to treat AGA and they both have side effects. If a natural anti-AGA product could be developed with the ability to be effective minus negative side effects, this could be a game-changer for people with AGA. Professor Wanchai De-Eknamkul, Department of Pharmacognosy and Pharmaceutical Botany, Chulalongkorn University, Thailand, an expert in plant natural product biotechnology, is working to develop a natural anti-AGA product. He is a professor at the University’s Natural Product Biotechnology Research Unit, where research is underway to: elucidate the biosynthesis of bioactive natural products by searching for enzymes and genes involved in their biosynthetic pathways; discover bioactive natural compounds from medicinal plants by either enzyme-based or cell-based screening followed by studying their mechanism of actions; and develop high-performance thin-layer chromatography (HPTLC) as a tool for quick screening and identification of bioactive compounds. De-Eknamkul have been working to shed light on the genes and enzymes involved in the biosynthesis of the diterpenoid ‘plaunotol’ in Croton stellatopilosus. In another line of investigation, they are searching for natural compounds with anti-AGA and anti-grey hair activities and a further area of focus is the development of a technique for direct detection of compounds with anti-diabetes, anti-gonorrhoea and anti-AGA activities.

Comparative proteomic analysis of male and female androgenetic alopecia: elucidating gender-specific molecular patterns.

This study presents a comprehensive comparative proteomic analysis aimed at elucidating the molecular mechanisms underlying male androgenetic alopecia (AGA) and female AGA. Scalp samples from both male AGA and female AGA patients, along with their respective normal controls, were subjected to proteomic analysis, followed by bioinformatics investigations. Our findings revealed distinct proteomic profiles between male AGA and female AGA, with a total of 68 differentially expressed proteins identified in male AGA and 84 in female AGA. Among these, specific proteins were altered in male AGA and female AGA, highlighting the sex-specific molecular pathways involved in the pathogenesis of pattern hair loss. Protein-protein interaction network analyses further delineated the most impacted biological processes, including cytoskeleton organization, stress response, and metabolic pathways, with particular emphasis on the differing altered stress responses and metabolic states associated with hair loss between sexes. Our study not only uncovered the complex molecular landscape of male AGA and female AGA but also identified potential biomarkers and therapeutic targets, offering new insights into the sex-specific pathogenesis of pattern hair loss.

Characterizing clinical and hormonal profiles of acne in north African women with polycystic ovary syndrome.

Polycystic ovary syndrome (PCOS) is the leading endocrine disorder in young women of childbearing age. Dermatological issues, particularly acne, are a major reason for medical consultations. The aim of this study is to determine the prevalence of PCOS in patients presenting with acne as their main dermatological complaint and to compare the metabolic and hormonal clinical characteristics of acne patients with PCOS to those with isolated acne. This was a prospective study with analytical aims, carried out in the Endocrinology Department and the Dermatology Department of Farhat Hached University Hospital in Sousse. The study included patients seeking treatment for acne from January 2023 to January 2024, divided into two groups: those with confirmed PCOS (G1) and those with isolated acne (G2). All patients underwent hormonal assessment and ovarian ultrasound. We conducted a study involving 212 patients. We found that 65.6% of acne patients had been diagnosed with PCOS. Nodular lesions were significantly more frequent in 'PCOS' (p = 0.02). Acne was linked with hirsutism, which was more prevalent in 'PCOS' (94.2% 'PCOS' vs. 67.1% 'isolated acne'), as well as androgenic alopecia (51% 'PCOS' vs. 21.9% 'isolated acne') (p < 10- 3). 'PCOS' showed evidence of biological hyperandrogenism, with a mean testosterone level of 0.72 ± 0.27 ng/mL, significantly higher than in 'isolated acne'. The LH/FSH ratio was greater than 1 in 72.7% of cases in 'PCOS', demonstrating a significant difference compared to 'isolated acne', where it was greater than 1 in 24.7% of cases (p < 10- 3). In our study, acne in 'PCOS' appeared to be more severe and was associated with hypertestosteronemia (p = 0.041) and hyperprolactinemia (p = 0.008). According to our results, phenotype A was the most likely to cause severe acne (p = 0.043). Our work is unique in that it brings to light this hidden aspect of the dermatological impact of PCOS, prompting physicians to screen for this endocrine disorder in all adult women seeking acne treatment.

Autologous Micrografts Containing Nanovesicles, Exosomes, and Follicle Stem Cells in Androgenetic Alopecia: In Vitro and In Vivo Analysis Through a Multicentric, Observational, Evaluator-Blinded Study.

The use of micrografts (MCGs) containing human follicle mesenchymal stem cells (HF-MSCs) is a hair loss (HL) treatment that needs to be standardized as seems to have promising effects on hair regrowth (HR-G) also thanks to the presence of extracellular vesicles (EVs). The study aims to report both the in vivo results, obtained in patients affected by androgenic alopecia (AGA) treated using MCGs, and in vitro analysis characterizing the EVs. A multicentric, retrospective, observational, evaluator-blinded study was conducted. Eighty-three AGA patients were initially enrolled [52 suffering from male pattern hair loss (MPHL) at stages I-III vertex by the Norwood-Hamilton scale and 31 suffering from female PHL (FPHL) at stages I-II by the Ludwig scale]. Sixty patients (20 females and 40 males) were treated and analyzed after exclusion and inclusion criteria assessment. The in vivo HR-G was evaluated through photography, physician's, and patient's global assessment scales, in addition to standardized photo-trichograms, during a follow-up for 1 year, while the in vitro analysis was performed through a quantitative, morphological, and dimensional characterization of the EVs population using transmission electron microscopy (TEM) and fluorescent microscopy. A hair density (HD) increase of 28 ± 4hairs/cm2 at T4 after 12 months in the targeted area (TA) of FPHL, compared with the baseline, was observed using computerized trichograms with a statistically significant difference (SSD) in hair regrowth (HR-G) (p = 0.0429). Regarding MPHL, an HD increase of 30 ± 5hairs/cm2 at T4 after 12 months in the TA was observed with an SSD in HR-G (p = 0.0012). The presence of EVs and their interaction with the surrounding cellular population were demonstrated. MCGs containing HF-MSCs and exosomes may fill in as a safe and viable alternative treatment against HL in mild and moderate degrees of AGA both in MPHL and in FPHL. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Case report: exome sequencing identified mutations in the LRP5 and LGR4 genes in a case of osteoporosis with recurrent fractures and extraskeletal manifestations

BackgroundGenetic mutations have been reported in a number of bone disorders with or without extra-skeletal manifestations. The purpose of the present study was to investigate the genetic cause in a middle-aged woman with osteoporosis, recurrent fractures and extraskeletal manifestations.MethodsA 56-year-old Indian woman presented to the clinic with complaints of difficulty in walking, recurrent fractures, limb bending, progressive skeletal deformities, and poor overall health. At the age of 37, she had experienced severe anemia with diarrhea, significant weight loss, knuckle pigmentation, and a significant loss of scalp hair. She had received multiple blood transfusions and parenteral iron supplementation with normalization of hemoglobin. Subsequently, she had premature menopause at the age of 37. She died at the age of 61 due to liver failure. Exome sequencing followed by Sanger sequencing were undertaken to identify the potential pathogenic mutations.ResultsGenetic investigation identified likely pathogenic mutations in the LRP5 and LGR4 genes. Out of the two mutations, the heterozygous mutation (c.1199C&amp;gt;T) in the LRP5 gene resulted in a non-synonymous substitution of alanine with valine at the 400th position, and the second mutation (c.1403A&amp;gt;C) in the LGR4 gene led to a non-synonymous substitution of tyrosine with serine at the 468th residue of the protein. The minor allele frequencies of the c.1199C&amp;gt;T (LRP5) substitution in the 1000 genomes and IndiGenomes databases are 0.0003 and 0.001, while the c.1403A&amp;gt;C (LGR4) substitution has not been reported in these databases. Various in silico prediction tools suggested LGR4 mutation to be pathogenic and LRP5 mutation to be likely pathogenic.ConclusionHeterozygous mutations in the LRP5 and LGR4 genes had additive deteriorative effects on BMD, resulting in recurrent fractures and bone deformities, and extended the effect to extraskeletal sites, contributing to the poor overall health in this patient.

Corrigendum: Stimulation of hair regrowth in an animal model of androgenic alopecia using 2-deoxy-D-ribose

Corrigendum: Stimulation of hair regrowth in an animal model of androgenic alopecia using 2-deoxy-D-ribose

Micronutrients and Androgenetic Alopecia: A Systematic Review.

Hair loss is a common problem that can negatively impact individuals' psychological well-being. Androgenetic alopecia (AGA) is one of the most prevalent types of nonscarring hair loss. This review summarizes the existing evidence on the relationship between AGA and various micronutrients, including vitamin B, vitamin D, vitamin A, vitamin C, iron, selenium, zinc, manganese, and copper. A literature search was conducted to identify relevant articles published between 1993 and 2023. The search identified 49 relevant articles. The findings suggest that deficiencies or imbalances in these micronutrients may contribute to the pathogenesis of AGA and represent modifiable risk factors for hair loss prevention and treatment. Vitamin B, vitamin D, iron, and zinc appear to play critical roles in hair growth and maintenance. Deficiencies in these micronutrients have been associated with increased risk of AGA, while supplementation with these nutrients has shown potential benefits in improving hair growth and preventing hair loss. However, the current evidence is not entirely consistent, with some studies reporting no significant associations. Deficiencies or imbalances in specific vitamins and minerals, especially vitamin B, vitamin D, Fe, Se, and Zn are involved in the pathogenesis of AGA and may represent modifiable risk factors for the treatment and prevention of this condition.

Patient-Reported Hair Loss and Its Impacts as Measured by the Alopecia Areata Patient Priority Outcomes Instrument in Patients Treated with Ritlecitinib: The ALLEGRO Phase 2b/3 Randomized Clinical Trial.

The ALLEGRO phase 2b/3 study investigated the efficacy and safety of ritlecitinib in patients with alopecia areata (AA). To describe the impact of ritlecitinib on patient-reported hair loss using the Alopecia Areata Patient Priority Outcomes (AAPPO) instrument and evaluate the relationship between clinically meaningful hair regrowth and improvements in patient-reported impacts. In ALLEGRO-2b/3, patients aged ≥ 12 years with AA and ≥ 50% scalp hair loss received once-daily ritlecitinib 50 or 30 mg (± 4-week 200-mg daily loading dose), 10 mg, or placebo for 24 weeks andthen continued ritlecitinib or switched from placebo to ritlecitinib 200/50 or 50 mg for 24 weeks. The AAPPO instrument evaluated improvement in hair loss, emotional symptoms (ES), and activity limitations (AL) from weeks 4 to 48 (secondary endpoint). Mean changes in ES and AL domain scores and individual items at weeks 24 and 48 were calculated for Severity of Alopecia Tool (SALT) score ≤ 20 responders and nonresponders (exploratory endpoint). Overall, 718 patients were randomized. At week 24, 5-36% of patients receiving ritlecitinib 10-200/50 mg reported improvement in scalp hair loss versus 9% receiving placebo. The results for eyebrow, eyelash, and body hair loss were similar. Mean change from baseline in ES and AL scores at weeks 24 and 48 was small and similar between groups. Mean change was larger for individual hair loss and ES items at weeks 24 and 48 in SALT score ≤ 20 responders versus nonresponders. The AAPPO instrument demonstrated the beneficial impact of ritlecitinib on patient-reported hair growth, which was consistent with improvements in clinician-reported outcomes. NCT03732807. INFOGRAPHIC.