Androgenetic Alopecia In Women Research Articles

Medicinal and cosmetic products used in treatment of hair loss

Abstract Hair loss or alopecia is a reduction in the volume or complete loss of hair and is a fairly common clinical problem, especially in the geriatric population. Androgenetic alopecia (AGA) is the most common type of hair loss in men. Androgenetic alopecia in women most often occurs before the age of 60. We also distinguish androgenetic alopecia in postmenopausal women and scarring, areata, telogen and drug-induced alopecia. The aim of the study was to analyze the composition of medicinal and cosmetic preparations available on the Polish market, recommended for people struggling with alopecia. In 2022, the composition of preparations used in alopecia available in pharmacies and drugstores was analyzed. In total 57 medicinal and cosmetic preparations recommended for people suffering from alopecia have been identified. The most common active substance in the analyzed preparations is finasteride. Frequently used active substances are biotin and minoxidil, rarely prednisolone. Conclusions: 1. In preparations intended for people with alopecia, the most frequently used active substance is finasteride. 2. Statistically, preparations for hair loss are most often in the form of tablets and shampoos. 3. The analyzed preparations for alopecia belong to the category of prescription drugs and cosmetics, less often in the category of OTC drugs or dietary supplements.

A practical approach to the management of hair loss in patients with polycystic ovary syndrome.

Female patterned hair loss (FPHL) is a common form of androgenetic alopecia in women and is characterized by a hormonally directed diffuse hair loss on the scalp. Management of FPHL is well described in the literature; however, treatment of FPHL in patients with co-morbid polycystic ovarian syndrome (PCOS), an endocrinologic condition found in reproductive-aged women, has not yet been reviewed. Due to the different pathomechanism of the diseases and complexity of FPHL in PCOS patients, this study aimed to review current diagnosis and management approaches for hair loss in PCOS patients specifically and highlight the growing need for more research in this growing patient population.

Androgenetic alopecia in woman treated with botulinum toxin

Background: Androgenetic alopecia (AGA) is the most common type of alopecia. AGA in women is called Female Pattern Hair Loss (FHPL). FHPL occurs in 50% of adolescence women. Case Description: A 29-year-old woman presented with hair thinning on the top of her head in the last 3 years. Dermatological status in the parietal region showed a diffuse and ill-define patch of alopecia, and hair thinning was found along the midline of the scalp. The hair pull test in frontal, temporal, and parietal regions was negative. The Severity of Alopecia Tool (SALT) score is 10, and patient belonged to stage 2 according to The Sinclair Scale. Dermoscopy examination revealed scattered white dots over the vertex of the scalp with various hair diameters. Miniaturized hair and vellus hair were found in several areas. The ratio of terminal to vellus hair was 20:6 or 3:1. Injection of 100-unit botulinum toxin in the alopecia area was done every 3 months. After 1 month of treatment, the hair thinning was reduced. Conclusion: Appropriate treatment will affect the prognosis of AGA patients. Appropriate treatment that based on the pathophysiology of the disease and the patient's genetics will provide a good therapeutic response.

Female patients with androgenetic alopecia: immunohistochemical picture of scalp biopsies

The aim of the research. To expand the knowledge about immunohistochemical changes in female patients with androgenetic alopecia (AGA) focusing on non-androgenic co-factors of pathogenesis of the disease, as this may serve as a basis for improving therapeutic regimens.
 Materials and methods. Scalp biopsies of female patients with androgenetic alopecia were examined by immunohistochemical method. The study included two groups: the main group of 30 female patients aged 22 to 40 years, average age 32,13±5,03 years, and the control group that included 20 skin samples from women aged 25–40 years (average age 34,75±4,19 years) who underwent autopsies.
 Results. It was found that AGA in women is characterized by a number of immunomorphological manifestations: the inflammatory infiltrate that consists of immunocompetent T-lymphocytes CD3+, CD4+ and CD8+, macrophages (CD68+); imbalance of growth polypeptides VEGF, TGF-β1, EGFR; accumulation of oxidative stress enzymes eNOS and iNOS; accumulation of pathological fraction of Collagen IV.
 Conclusions. The data obtained by this study helps to improve the concept of morphogenesis of AGA, and also can become a base to improve the standards of treatment of the disease. The pathological triade “oxidative stress-microinflammation- fibrosis” should be considered as a possible treatment target, as well as the imbalance of growth peptides.

Modern concept of the etiology and pathogenesis of androgenetic alopecia

Introduction. The understanding of the etiology and pathogenesis of androgenetic alopecia (AGA) has formed modern therapeutic strategies for the treatment of this trichopathy. However, the significant prevalence of this pathology, limited therapeutic success, and differences in the response to standard therapy in male and female patients determine the interest in a more in-depth study and search for new links in the etiopathogenesis of AGA. Goal. Using a review of scientific publications in recent years on AGA in male and female patients, analyze and formulate the modern concept of the etiology and pathogenesis of this disease in order to further search for new treatment methods. Materials and methods. We searched and analyzed publications for the query «androgenetic alopecia, etiology, pathogenesis», the search was carried out using Google Scholar, considered articles that have been published since 2016. Results. The effect of androgens on hair follicles in androgen-dependent areas of the scalp under conditions of genetic predisposition is considered as the most studied and proven concept of AGA etiopathogenesis. However, recent studies have also revealed nonandrogenic cofactors, among which the pathological cascade of events «oxidative stress-microinflammation-fibrosis», which are determined at different stages of disease progression, is potentially interesting for further study. Knowledge of the phenomenon of apoptosis as an important factor in the disturbance of the dynamics of the hair cycle has been expanded. The management of perifollicular microinflammation and apoptosis can allow the control of the processes of sequential hair miniaturization and give a pronounced clinical result during the treatment of AGA. Thus, the nonandrogenic mechanisms of AGA pathobiology require further study. Conclusions. New data on the causes and mechanism of development of androgenetic alopecia in women and men have expanded our understanding of these processes. The need to supplement knowledge on this topic causes significant scientific interest and is very relevant, since they can be used to improve treatment for use in practical medicine.

Platelet-Rich Plasma for Androgenetic Alopecia in Women: A Single-Center Case Series Study in Qatar

Abstract Objective: Androgenetic alopecia (AA) is a progressive hair loss disorder mediated by systemic androgens and genetic factors. A variety of AA treatments have been investigated. Currently, there is emerging evidence and growing interest in the use of platelet-rich plasma (PRP) for AA. This study describes a single-center experience using PRP to treat AA in women. Methods: A retrospective observational study design was employed. The study cohort comprised 20 women >18 years of age who were diagnosed with AA. PRP was prepared using a commercially available PRP kit. Each patient received six PRP treatment sessions at 4-week intervals. The severity of alopecia tool (SALT) scoring system was used to measure the severity of alopecia, and a paired t-test was used to calculate significance levels. Results: The mean pre-intervention and post-intervention total SALT score was 27.5 ± 6.35 and 9.41 ± 3.71, respectively. The difference in the total mean SALT score was 18.33 ± 1.64 and the effect size was 3.52. The scalp area with the largest effect size was the vertex (Cohen d = 2.53). The effect size was similar across other scalp areas (Cohen d = 1.91–2.09). There were no serious adverse effects of the treatment; only mild transient adverse effects were reported. Conclusion: The present study demonstrated the efficacy and safety of PRP injections in treating AA in women. However, these findings require confirmation in well-designed studies using standardized treatment protocols and evaluation methods.

Androgenetic alopecia in women and men: Italian guidelines adapted from European Dermatology Forum/European Academy of Dermatology and Venereology guidelines.

Androgenetic alopecia (AGA) is the most common form of alopecia, affecting up to 80% of men and 50% of women in the course of their life. AGA is caused by a progressive reduction in the diameter, length and pigmentation of the hair, resulting from the effects of the testosterone metabolite dihydrotestosterone (DHT) on androgen-sensitive hair follicles. Clinical presentation is different in men and women. Trichoscopy is used routinely in patients with androgenetic alopecia, for diagnosis and differential diagnosis with other diseases, allowing staging of severity and monitoring the progress of the disease and the response to treatment. Medical treatment of AGA includes topical minoxidil, antiandrogen agents, 5-alpha reductase inhibitors and many other options. This guideline for the treatment of androgenetic alopecia has been developed by an Italian group of experts taking into account the Italian pharmacological governance. The article is adapted from the original of the European Dermatology Forum (EDF) in collaboration with the European Academy of Dermatology and Venereology (EADV). It summarizes evidence-based and expert-based recommendations (S3 level).

Androgenetic alopecia present in the majority of patients hospitalized with COVID-19: The “Gabrin sign”

Androgenetic alopecia present in the majority of patients hospitalized with COVID-19: The “Gabrin sign”

Prolonged use of finasteride-induced gonadal sex steroids alterations, DNA damage and menstrual bleeding in women.

The aim of the present study was to examine the effect of prolonged use of finasteride on serum levels of dihydrotestosterone (DHT), estradiol (E2), progesterone, testosterone and androstenedione in women during the menstrual period. Further, to screen and compare the 5α-reductase activities through the expression of SRD5A1, SRD5A2 and AR gene and to determine the level of VEGF, VKOR and SAA gene expression and DNA damage. A total of 30 Saudi women aged between 25 and 35 years were enrolled in the study. The selected women were divided into two groups. The first group (n = 15) received 5 mg finasteride/day for prolonged period of one year and second group (n = 15) was taken as a healthy control. ELISA technique was used for measuring the serum levels of the targeted hormones, and Comet assay was used for checking the DNA integrity. Our findings revealed significant decrement of DHT, E2, progesterone and androstenedione levels and elevated levels of testosterone in group treated with daily oral doses of 5 mg finasteride/day compared with the control subjects. mRNA expression suggested that finasteride has concrete effects on the gene expression of the selected genes from the treated group in comparison with the control group. In addition, finasteride induced DNA damage, and heavy menstrual bleeding was noted in women treated with finasteride. In conclusion, the present findings revealed that finasteride has adverse health effects in women associated with gonadal sex steroids alterations, DNA damage and heavy menstrual bleeding with no consensus in the treatment of androgenetic alopecia in women.

A perspective on predictive markers of alopecia

Hair is a primary characteristic of mammals and is an immune-privileged structure. Autoimmune attack of the hair follicle characterizes a disease called alopecia areata (AA), an auto-immune disorder, targeting the anagen-stage hair follicle. Erythroid differentiation regulator 1 is one of the presently investigated biomarkers for hair loss disorders. There are majorly two types of AA, namely diffuse and focal. Androgenetic alopecia (AGA) is a common androgen-induced progressive disorder, the pathways of which are regulated by local genetic codes and hormonal control. AA incognita is a type of diffuse hair fall with no confirmatory diagnostic test. AGA in women is a common pathology, the systemic inflammation in AGA has not been extensively studied, but it raises the possibility of identifying new cardiovascular risk factors among female patients with AGA. Other biomarkers for hair loss disorders are C-reactive protein, fibrinogen, VSH, tumor necrosis factor-α, and interleukin-6. This review attempts to give a perspective on the predictive markers of alopecia, their significance, and implications for future research.

Androgenetic alopecia in women. Trichoscopy as a diagnostic method to simplify the proper diagnosis — case report

Hair loss is a common problem seen in dermatology. Both women and men are affected. Androgenetic alopecia is one of the most frequent type of hair loss observed in women. The diagnostic process is complex and includes different noninvasive procedures, laboratory tests and sometimes requires scalp biopsy. Trichoscopy is fairly new and useful diagnostic method that enables making the right diagnosis. Treatment of hair loss is often complicated and long‑lasting but in some cases it may be helpful to follow recommendations of various scientific boards. Here, we present a case of a woman with diffuse hair loss whose trichoscopic examination allowed to diagnose androgenetic alopecia.

A Study of Correlation of Angiographic Evaluation of Coronary Artery Disease with Androgenetic Alopecia - TricoHeart Study.

Background:Research on the association between androgenetic alopecia (AGA) and coronary artery disease (CAD) in women, with a focus on the evaluation of their angiographic association in the form of the severity of disease, has been lacking.Aim:The study aimed to evaluate the relation between CAD and AGA in women and to study their severity.Methods:This study, carried out with 438 women within 55 years of age and admitted for coronary angiography, had the case group (participants with CAD; n = 219) and control group (those without CAD; n = 219). The clinical and paraclinical data were collected after clinical history, physical examination, and review of the patients' records (family, past, and personal history of the participants). The coronary risk profiles such as diabetes mellitus, blood pressure, and serum cholesterol level were also noted, and the diagnosis of AGA was performed, and participants were grouped using the Ludwig's baldness grading system. Statistical analysis was performed by studying association between the variable using the Chi-square test (R i386.3.5.1 software).Results:In the study group, 74 (33.79%) participants were treadmill test positive, 55 (25.11%) had unstable angina, 40 (18.26%) had ST-segment elevation myocardial infarction (STEMI), and 50 (22.83%) had non-ST-STEMI (NSTEMI). In the case group, Grade II female AGA was evidenced in 38 (43.18%) participants, whereas Grade III was present in 30 (34.09%) participants. Further on, 27 patients with triple vessel disease had Grade III female AGA. Whereas, in the control group, Grade I female AGA was evidenced in 23 (65.71%) participants.Conclusion:The hypothesis that female pattern baldness is a marker for increased risk of CAD events has been studied and established as part of the present study. Further, extensive studies on the effect of other variables with a larger sample size need to be conducted.

Vitmain D level in female pattern hair loss with normal androgen level

Objectives The aim of this study was to assess serum vitamin D level in women with female pattern hair loss (FPHL) to approve its relation in this disorder. Background FPHL is the main cause of diffuse hair loss in adult women and majorly affects patient's personal satisfaction. FPHL is the preferred term for androgenetic alopecia in women as the relation between androgens and this illness is not proved. Androgen excess has not been demonstrated in FPHL. The connection between serum 25-hydroxy vitamin D and FPHL has not been considered altogether. Patients and methods In this case–control study, we studied serum vitamin D level concentration among 31 FPHL patients aged 20–40 years in comparison with 31 healthy female controls matched for age, skin phototype, socioeconomic level, and outdoor exposure. Measurements were conducted by enzyme-linked immunosorbent assay. The study was conducted within a 4-month period, from July to October 2016. Results The mean serum vitamin D level was significantly lower in FPHL patients (18 ± 7.57 ng/ml) than in controls (35.09 ± 15.39 ng/ml; P Conclusion The lack or inadequacy vitamin D may assume a conceivable part in the pathogenesis of FPHL.

Changes in the hair growth cycle in women with non-scarring alopecia

One of the key elements in the pathophysiological process of androgenetic alopecia and telogen hair loss is the change of hair cycle. Growth factors controlling the development and cycle of the hair follicle have thus far been established. However, the role of growth factors in the pathogenesis of alopecia remains to be revealed.Objective. This study was aimed at investigating the expression of the VEGF, KGF, EGF and TGF-01 growth factors in women with androgenetic alopecia and telogen hair loss, as well as their role in the development of alopecia.Materials and methods. 60 female patients diagnosed with telogen hair loss (30 women) and androgenetic alopecia (30 women) were observed. In order to investigate the expression of the VEGF, KGF, EGF and TGF-01 growth factors, we conducted an immunofluorescent analysis of skin samples obtained by punch biopsy (4 mm) from the frontoparietal scalp area of patients with androgenetic alopecia and telogen hair loss. 15 samples obtained from healthy people were used as a reference group.Results. A change in the expression of the VEGF, KGF and TGF-01 growth factors in women with androgenetic alopecia and telogen hair loss was established in comparison with healthy individuals. A correlation was found between the expression of the growth factors under study, age (p ≤ 0.05), as well as the character and duration of the disease (p ≤ 0.05) in women with non-scarring alopecia. The expression of the growth factors is found to be dependent on the clinical form of alopecia (p 0.001).Conclusion. The VEGF growth factor is established to have the most significant effect on the development of androgenetic alopecia in women, with the KGF, TGF-01 and EGF factors being less significant as the predictors of this disorder. The VEGF growth factor is shown to affect telogen hair loss to a greater extent compared to the EGF factor. Our study confirms differences in the pathogenesis of androgenetic alopecia and telogen hair loss in women. The findings suggest that the VEGF and KGF growth factors, as well as TGF-01 inhibitors may be used as potential pharmacological agents for treating patients suffering from androgenetic alopecia and telogen hair loss.

The role of correction of metabolic disorders in the treatment of androgenetic alopecia in women

The problem of androgenetic alopecia in women is considered by experts of various specialties, however there are few reviews about metabolic processes in these patients. Objective: to increase the efficiency of treatment of androgenetic alopecia in view of metabolic abnormalities. Material and methods. 80 female patients with androgenetic alopecia were examined to identify the features of the clinical course and hormonal metabolic deviations. Results. It was found that women with the androgenetic alopecia have abnormalities in carbohydrate and lipid metabolism in the majority of cases. Combined therapy with metformin helped to increase the clinical efficacy in the treatment of women with androgenetic alopecia.

Antiandrogenic therapy with ciproterone acetate in female patients who suffer from both androgenetic alopecia and acne vulgaris

Background.Androgenetic Alopecia in Women (AGA) occurs due to an underlying susceptibility of hair follicles to androgenic miniaturization, caused by androgens. Clinically, AGA is characterized by progressive hair loss, with a marked hair thinning in the fronto-parietal area so that the scalp can be easily seen.Acne vulgaris is androgen-dependent and often affects the skin that has an increased number of oil glands: face, back and chest. Although the sebaceous glands are present on the scalp too, it is very rare to get acne at this site, as the hair acts as a wig and allows the sebum to drain and does not block the pores.Both AGA and Acne Vulgaris are signs of hyperandrogenism. Cyproterone acetate/ethinyl estradiol (2mg/0.035mg) products are authorized for the treatment of androgenetic symptoms in women, such as acne, seborrhea, mild forms of hirsutism and androgenetic alopecia.Our study had a double purpose: - To evaluate the result of the study regimen Melleva 35 (one pill per day, for 3 consecutive months) in patients with moderate to severe acne, suffering also from Androgenetic Alopecia;- To establish the efficacy of the drug on acne and alopecia improvement, both from the doctor’s and patient’s point of view.Patients and methods.After being informed of the aims and procedures of the study, participants provided a written informed consent. A number of 35 female subjects with moderate to severe acne vulgaris remained in the study. The subjects had also been diagnosed as suffering from AGA, on the basis of clinical criteria, including the pattern of hair loss and trichoscopy assessment.Results83% of study subjects reported that their hair did not continue to fall after 3 months of antiandrogen therapy. The females were evaluated using trichoscopy and the doctor noticed hair regrowth in 77% of the cases. Regarding the improvement of acne lesions after the treatment, 40% of study subjects recorded good improvement and 26% recorded excellent results with Melleva 35.The acceptance of the treatment was very high, 86% patients were compliant with the study therapy. The rate of adverse events (5 cases) was within the limits of the treatment tested by the study.Almost a third of the total number of subjects (28.5%) reached a good satisfaction level after the treatment, while 37.1% claimed moderate satisfaction.ConclusionThere was no correlation between the age of the subjects and the treatment for acne therefore our first hypothesis was rejected.As a conclusion, antiandrogenic therapy with Melleva 35, 1 pill per day, for 3 consecutive months, shows good results for patients who suffer from both Androgenetic Alopecia and Acne Vulgaris.

Androgenetic alopecia

Androgenetic alopecia (AGA) is among the most frequent diagnoses in a hair clinic. Multiple studies prove that life quality is significantly impaired in affected individuals, independent of severity, age or gender. A thorough and standardized diagnostic approach to AGA in women, men and children is an essential step in developing a successful therapeutic concept. Treatment options range from topical and systemic medications to cosmetic products, nutricosmetics, hair transplantation and other aesthetic-corrective approaches. The physician and patient must decide together on the best suited individualized therapy, considering the expected results, practicality and compliance. Further interdisciplinary evaluation must be decided individually, as must the development of coping strategies and the decision to employ psychological support. A professional atmosphere and sensitive approach to an emotionally difficult situation help develop a trusting relationship between patient and physician, which in turn leads to greater satisfaction and compliance. The S1 guidelines for diagnosis and the S3 guidelines for treatment of AGA offer the treating physician important tools for the successful evidence-based management of patients.

Evidence‐based (S3) guideline for the treatment of androgenetic alopecia in women and in men

Androgenetic alopecia is the most common hair loss disorder, affecting both men and women. Initial signs of androgenetic alopecia usually develop during teenage years leading to progressive hair loss with a pattern distribution. Moreover, its frequency increases with age and affects up to 80 % Caucasian men and 42 % of women. Patients diagnosed with androgenetic alopecia may undergo significant impairment of quality of life. Despite the high prevalence and the variety of therapeutic options available, there have been no national or international evidence-based guidelines for the treatment of androgenetic alopecia in men and women so far. Therefore, the European Dermatology Forum (EDF) initiated a project to develop an evidence-based S3 guideline for the treatment of andro-genetic alopecia. Based on a systematic literature research the efficacy of the currently available therapeutic options was assessed and therapeutic recommendations were passed in a consensus conference. The purpose of the guideline is to provide dermatologists as well as general practitioners with an evidence-based tool for choosing an efficacious and safe therapy for patients with androgenetic alopecia.

A randomized, single-blind trial of 5% minoxidil foam once daily versus 2% minoxidil solution twice daily in the treatment of androgenetic alopecia in women

Although twice-daily application of propylene glycol-containing 2% minoxidil topical solution (MTS) stimulates new hair growth, higher concentrations of minoxidil in a once-daily, propylene glycol-free formulation may improve efficacy and reduce unpleasant side effects. We sought to compare the efficacy, safety, and acceptability and to show noninferiority of once-daily 5% minoxidil topical foam (MTF) with twice-daily 2% MTS in women with androgenetic alopecia. A total of 113 women with androgenetic alopecia were randomized to 24 weeks of treatment with 5% MTF or 2% MTS. The primary efficacy parameter was change from baseline in nonvellus target area hair count at week 24. Secondary end points included change in nonvellus target area hair width, overall efficacy by global photographic review as assessed by treatment-blinded evaluators and the subject herself, adverse events, and participants' assessment of product aesthetics. After 24 weeks, women randomized to 5% MTF once daily showed noninferior target area hair count and target area hair width and experienced greater, but nonsignificant, improvements in target area hair count, target area hair width, and overall efficacy by global photographic review than those randomized to 2% MTS used twice daily. 5% MTF was significantly superior to 2% MTS in participants' agreement with "the treatment does not interfere with styling my hair" (P= .002). Women randomized to 5% MTF experienced significantly lower rates of local intolerance (P= .046) especially in pruritus and dandruff compared with 2% MTS. Because of differences in the formulations tested, study participants were not blinded to treatment. Once-daily 5% MTF is noninferior and as effective for stimulating hair growth as twice-daily 2% MTS in women with androgenetic alopecia and is associated with several aesthetic and practical advantages.

THERAPEUTIC HOTLINE: Genetic variations in the androgen receptor gene and finasteride response in women with androgenetic alopecia mediated by epigenetics

When studies of postmenopausal women with hair loss failed to reveal a response to the 5 alpha reductase inhibitor, finasteride, researchers began to question the existence of androgenetic alopecia in women and renamed the clinical entity female pattern hair loss. However, recently published reports of finasteride response in some women with hair loss suggest that an androgenic mechanism is mediating response in this group. Variant repeat nucleotide sequences in exon 1 of the androgen receptor (AR) gene have been shown to determine androgen sensitivity in a variety of androgenic conditions in men and women. In an effort to identify whether this AR variant may help determine which women are likely to respond to finasteride therapy, a pilot study was undertaken. In our 6-month pilot of 13 patients, women with greater androgen sensitivity (<24 cytosine, adenine, and guanine (CAG) repeats) were likely to have a significant response to finasteride 1 mg/day compared with patients treated with placebo, and compared with patients with normal androgen sensitivity (≥24 CAG repeats) based on epigenetic weighted evaluation of the CAG alleles. Results of the present pilot study support the hypothesis that AR-CAG repeats, in conjunction with epigenetic factors, can help determine which women with hair loss will respond to finasteride therapy.