MitoQ upregulates CYP19A1 to protect dermal papilla cells from DHT-induced mitochondrial dysfunction and apoptosis in androgenetic alopecia.

Naringin promotes hair regeneration via wnt/β-catenin pathway: A dose-dependent study in C57BL/6J mice.

PCA: A tFNA-based targeted nucleic acid nanocomposite hydrogel for the treatment of androgenetic alopecia through the promotion of angiogenesis and hair follicle stem cell proliferation

The efficacy and safety of ritlecitinib, a dual inhibitor of Janus kinase 3 (JAK3) and tyrosine kinase expressed in hepatocellular carcinoma (TEC) family kinases, have been demonstrated in the ALLEGRO phase 2b/3 trial that enrolled patients aged ≥ 12 years with alopecia areata (AA) and ≥ 50% scalp hair loss. The present analysis evaluated the cost-effectiveness of ritlecitinib compared with no treatment for patients with AA and ≥ 50% scalp hair loss in Japan from a societal perspective. A Markov model stratified by health states based on the Severity of Alopecia Tool (SALT) was developed to estimate the lifetime costs, including productivity loss, and quality-adjusted life years (QALYs) associated with the treatment of AA. The comparator was no treatment, and clinical parameters were based on the ALLEGRO phase 2b/3 trial. Costs and QALYs were discounted at an annual rate of 2%, and the incremental cost-effectiveness ratio (ICER) was calculated. Over a lifetime horizon and with the base-case societal perspective, the incremental QALYs and incremental costs of ritlecitinib 50 mg were 1.09 QALYs and 5 262 471 Japanese yen (JPY) (34 766 United States dollars [USD]), respectively. The ICER was 4 816 589 JPY (31 820 USD) per QALY, which was below the cost-effectiveness threshold in Japan of 5 000 000 JPY (33 032 USD) per QALY. A one-way sensitivity analysis showed that parameters with the most notable effect on the ICER were the utility for patients with SALT score ≥ 50, percentage of work time missed due to presenteeism for patients with SALT score ≥ 50, and the discontinuation rate of ritlecitinib 50 mg. These results indicate that ritlecitinib 50 mg is cost-effective compared with no treatment for patients with AA and hair loss on ≥ 50% of the scalp from a societal perspective in Japan.

Chronic, persistent alopecia areata (CPAA), defined by an episode duration >12 months, tends not to remit spontaneously and patients with CPAA are candidates for systemic therapy. The burden of CPAA is not entirely explained by the severity of scalp hair loss. CPAA widely affects physical and psychosocial aspects of health and well-being. Exploring patients' perspectives on these domains of impact among those commencing systemic treatments will shed light on patient expectations from systemic treatments and the most relevant patient-reported outcomes. To understand patients' perspective on the key impact domains of CPAA that are the most important motives for patients when deciding whether to commence a systemic therapy. Patients receiving systemic therapy for CPAA who completed an online survey that included two patient-reported questionnaires, the Quality of Life-8D (AQoL-8D) and the Patient Priority Outcomes (AAPPO), were invited to participate in a focus group to explore the key impact domains of AA, beyond scalp hair loss severity, that had led them to commence systemic therapy. Focus groups were transcribed and thematically analysed using NVivo. Quantitative data were analysed using SPSS. Quantitative data (n=44) revealed significant impairment in psychosocial dimensions, contrary to physical dimensions, in our patients, based on AQoL-8D. None of the health-related QoL (HRQoL) dimensions were associated with the extent of scalp hair loss, assessed by the AAPPO.Focus groups (n=31) revealed AA-related physical and psychosocial priorities emerged as thirteen subthemes within three main themes: physical, psycho-emotional, and social. Eyelash and eyebrow appearance were the most frequent physical impacts. Sense of frustration/despair and the impact of long-term camouflaging in social activities were the most frequent sub-themes within their attributed themes. Facial hair loss and various psychosocial domains of HRQoL are key impact domains of AA, other than scalp hair loss, in patients commencing systemic treatments. Perceived domains that were considered important by patients can serve as a foundation of patient-centred criteria of candidacy for systemic treatments, contributing to the timely initiation of systemic treatments in patients suffering from considerable disease burden. Further research should aim at the integration of our findings into the clinical setting.

Alopecia areata (AA) is an autoimmune disease characterized by nonscarring hair loss that may impact quality of life (QoL). After 2021, new therapies were approved to treat severe AA in Taiwan; however, there is no global definition of severe AA. Dermatologists may use other criteria in addition to scalp hair loss (SHL) when estimating severity. This study evaluates the impact of AA on patient QoL and how dermatologists assessed disease severity and managed AA in Taiwan prior to availability of new therapies. Dermatologists completed the Adelphi Real World AA Disease Specific Programme™ cross-sectional survey. Each provided their perspective on assessing AA severity and available AA treatments, and information on patients consulting with AA. Results were analyzed descriptively and stratified by dermatologist-assessed AA severity. Fifty dermatologists reported median (interquartile range) SHL of 45% (31-51%) and 76% (51-90%) as typical of "severe" and "very severe" AA, respectively, based on 285 patients. Multiple factors were considered, including SHL, disease duration, and prior treatment responses. Mean (SD) time on current therapy was 8.3 (13.0) months. Patients with severe/very severe disease received varied first- and second-line treatments and had more severe QoL impacts, including anxiety/worry, depression, and impairments in daily life and activities. Most dermatologists felt confident in diagnosing AA; however, few were satisfied with treatment options for patients with severe AA. Dermatologists in Taiwan did not define AA disease severity solely based on extent of SHL, and many felt there was an unmet need for effective treatments for severe disease.

Complication following treatment with a microneedling technique for a female pattern hair loss: hair dye-induced tattoo-like pigmentation

Background: Androgenic alopecia (AGA) is characterized by hair follicle miniaturization and chronic inflammation mediated by dihydrotestosterone (DHT). Current therapies primarily target hormonal pathways and do not adequately address inflammatory dysregulation. Exosomes derived from hypoxia-conditioned mesenchymal stem cells (EH-MSCs) exhibit enhanced immunomodulatory properties. However, their effects on key inflammatory mediators in AGA remain unclear. This study evaluated the effects of EH-MSCs on CXCL12 and IL-10 expression in a DHT-induced AGA mouse model.Materials and methods: Male C57BL/6 mice were allocated into five groups: healthy control, DHT-induced alopecia without treatment, DHT-induced alopecia treated with topical minoxidil, and EH-MSCs administered at 100 or 200 µL/kgBW. Alopecia was induced by subcutaneous DHT injection for 17 days. Following model validation, treatments were administered on days 25 and 32. CXCL12 and IL-10 expression in dorsal skin tissue was analyzed using RT-PCR on day 39.Results: DHT induction significantly increased CXCL12 expression and reduced IL-10 levels (p<0.05). EH-MSC administration dose-dependently downregulated CXCL12 (1.73±0.57 and 1.54±0.44 fold-change) and upregulated IL-10 expression (3.10±0.75 and 3.29±0.67 fold-change), demonstrating greater immunomodulatory effects compared with minoxidil.Conclusion: EH-MSCs effectively modulated inflammatory biomarkers by suppressing CXCL12 and enhancing IL-10 expression in a DHT-induced AGA model, suggesting their potential as an immunoregenerative therapeutic strategy for androgenic alopecia.Keywords: androgenic alopecia, mesenchymal stem cells, exosomes, hypoxia, CXCL12, IL-10

Prostate cancer (PCa) is one of the most common malignancies in men worldwide. Androgens influence both prostate growth and hair patterns. Androgenic alopecia (male-pattern baldness) and excessive male-pattern body hair (hypertrichosis) have been hypothesized as clinical markers of long-term androgen exposure. Previous Western studies have reported mixed results on whether early-onset or severe androgenic alopecia correlates with increased prostate cancer risk. Data in South Indian (Dravidian) populations is lacking. To examine the association between androgenic hypertrichosis, androgenic alopecia, and prostate cancer in Dravidian men from the Cauvery Delta region of Tamil Nadu, India. We conducted an age-stratified, population-based case-control study among men in the Cauvery Delta. The cases consisted of 117 men with pathologically confirmed adenocarcinoma of the prostate (diagnosed 2010-2015). Controls were 123 men with benign prostatic hyperplasia (BPH) from the same hospital registries, frequency-matched by age. Individuals with incomplete data or non-Dravidian (North Indian) ancestry were excluded. Trained investigators performed face-to-face interviews, directly observing and recording postpubertal body hair growth (indicative of androgenic hypertrichosis) and scalp hair loss (androgenic alopecia classified by the Norwood scale). Statistical analysis included multivariate discriminant analysis (Wilks' Lambda), one-way ANOVA for continuous variables, chi-square cross-tabulation, and computation of Cramer's V statistic to assess association strength. A two-tailed p-value of <0.05 was considered statistically significant. The age distributions of cases and controls were comparable. The prevalence of androgenic hypertrichosis and alopecia did not differ significantly between prostate cancer cases and BPH controls. Cramer's V analysis showed that prostate cancer status accounted for only 1.1% of the variance in hypertrichosis (Cramer's V ≈ 0.011) and 1.5% of the variance in alopecia (Cramer's V ≈ 0.015). In this case-control study of Dravidian men from Tamil Nadu, we observed no significant association between androgenic alopecia or hypertrichosis and prostate cancer. These findings contrast with data from Western cohorts, suggesting that interethnic variation in androgen receptor polymorphisms, follicular sensitivity, and environmental exposures may modulate prostate cancer risk differently. Further research is needed to elucidate how androgenic traits influence prostate carcinogenesis across different ethnic groups.

Multiomics Mendelian Randomization Reveals Causal Oxidative Stress Genes in Androgenetic Alopecia.

Hair follicle-targeted baicalin nanocrystal delivery using microneedles for long-acting treatment of androgenetic alopecia.

Clinical observations indicate that some male patients with androgenic alopecia show varying degrees of hairline recession in the frontal and temporal regions on both sides, often with noticeable asymmetry between the left and right, which suggests a potential link to certain lifestyle habits. In this study, 161 male patients with androgenic alopecia were included, all exhibiting an "M"-shaped hairline. Patients' sleeping positions and combing directions were recorded and the areas of hairline recession in the frontal and temporal regions were calculated. Analysis of variance showed a significant difference in the ratio of the left and right receding hairline areas among patients with different sleeping positions (left lateral 1.19 ± 0.15 vs. right lateral 0.90 ± 0.10 vs. supine 1.00 ± 0.15 vs. no fixed position 1.00 ± 0.14, F = 24.84, p < 0.01). However, no significant difference in hairline recession was observed between patients who combed their hair to the left and those who combed to the right (p = 0.47). In conclusion, sleeping position may be an independent factor that influences the pattern of hairline recession of male patients with androgenic alopecia, particularly those with "M"-shaped hairlines, whereas combing direction appears to have no impact.

Female pattern hair loss.

Finasteride, an inhibitor of the enzyme 5alpha-reductase, prescribed for benign prostatic hyperplasia and androgenetic alopecia, induces a wide variety of side effects during treatment and upon withdrawal, like sexual dysfunction and cognitive and psychological disorders, inducing the so-called post-finasteride syndrome (PFS). Here, we explored the behavioral effects of this drug in adult male rats after subchronic finasteride treatment (20 days) and at drug discontinuation (1 month). We employed multiple behavioral paradigms, including the open field test and elevated plus maze to assess locomotor activity and anxiety, and a novelty-seeking test to evaluate exploratory behavior and approach-avoidance tendencies. Our results revealed a dichotomy between immediate and delayed finasteride effects. While effects after subchronic treatment were mild, significant behavioral alterations emerged at the withdrawal. In particular, pronounced hyperactivity, decreased center exploration in the open field, and marked avoidance of novel stimuli, collectively indicating an anxiety-like behavioral phenotype, were revealed. These results, showing a picture of increased vulnerability, are in agreement with clinical reports in PFS, highlighting the relevance of our model for this condition. Moreover, the data here described strengthen the importance of monitoring patients not only during treatment but also following discontinuation of finasteride therapy.

Androgenic alopecia (AGA) is a cosmetically disfiguring condition, which accounts for most cases of diffuse hair loss among females, negatively impacting their quality of life. Combining Fractional CO 2 (FCO 2 ) or Fractional Microneedling Radiofrequency (FMRF) with topical minoxidil 5% could achieve a better clinical outcome. To compare efficacy and safety of FCO 2 and FMRF, combined with minoxidil, for the treatment of female AGA. Thirty patients with female AGA were randomly assigned to 2 groups (simple computerized randomization). Group A patients received FCO 2 to 1 randomly selected side of the scalp, and Group B patients received FMRF to 1 randomly selected side of the scalp (picking masked labeled cards). Patients received minoxidil 5%. Significant increase in trichoscopic hair counts and density was found after treatment with each modality whether minoxidil 5% alone, minoxidil combined with FCO 2 , or minoxidil combined with FMRF. A significantly greater increase in trichoscopic hair counts and density followed the treatment with minoxidil + FMRF, compared to either minoxidil + FCO 2 or minoxidil alone. It can be proposed that combining FMRF with minoxidil for the treatment of female AGA could be associated with higher efficacy and tolerability, compared to the other treatment modalities.

A0366 Comparative effects of finasteride and dutasteride on semen parameters in young men with androgenic alopecia: A randomized controlled study

Managing androgenic alopecia with individualised homeopathic medicine and biochemic remedies- An evidence based single case report

The current terminology of male and female pattern hair loss may be obsolete.

Research objective: The objective of this study was to evaluate the current state of evidence regarding the efficacy, safety, and clinical relevance of mesotherapy as an adjunctive treatment for androgenetic alopecia (AGA). Methodology: A narrative literature review was conducted using the PubMed database as the sole source of scientific data. The analysis included studies assessing mesotherapy in androgenetic alopecia, with particular attention to injected substances, treatment protocols, clinical outcomes, and reported adverse effects. Main conclusions: The available evidence suggests that mesotherapy may have a beneficial supportive role in the management of androgenetic alopecia, with reported improvements in hair density, hair thickness, and patient satisfaction. The treatment is generally well tolerated, with adverse effects typically limited to mild and transient local reactions. However, the heterogeneity of study designs and treatment protocols limits the strength of current conclusions. Application of the study: The findings may support clinicians in considering mesotherapy as an adjunctive option in the treatment of androgenetic alopecia and highlight areas where standardized protocols and evidence-based guidelines are currently lacking. Originality/Novelty of the study: This study provides a structured synthesis of existing literature on mesotherapy in androgenetic alopecia, emphasizing methodological variability and identifying key gaps in evidence that warrant further standardized, randomized clinical research.

Androgenetic alopecia (AGA) manifests as progressive hair follicle (HF) miniaturization; however, its drivers remain poorly elucidated. Combining spatial and single-cell transcriptomics, we generate a concise single-cell atlas of anagen HFs in male AGA, revealing early changes in cell subpopulations, altered HF stem cell fate determination, and disrupted cell-cell communications. Through ex vivo HF organ culture and humanized mouse models, we demonstrate that hypercontractility of connective tissue sheath (CTS) activates the mechanosensitive channel PIEZO1 in anagen HFs. This mechanotransduction induces ectopic apoptosis of HF progenitor cells and suppresses matrix/ORS cell proliferation, depleting progenitor pools and impairing HF growth, thereby driving progressive miniaturization. Critically, pharmacological inhibition of CTS contraction via ML-7, a selective myosin light chain kinase (MLCK) inhibitor, improves HF growth in both male AGA patient-derived ex vivo models and humanized mice. Our study delineates the cellular dynamics underlying male AGA pathogenesis and identifies mechanopathologically activated CTS as a key driver of HF miniaturization, positioning the peri-follicular CTS as a promising therapeutic target for AGA intervention.