Androgenetic Alopecia Research Articles

Efficacy and safety of ritlecitinib, an oral JAK3/TEC family kinase inhibitor, in adolescent and adult patients with alopecia totalis and alopecia universalis.

This post-hoc analysis of the ALLEGRO phase 2b/3 study (NCT03732807) evaluated the efficacy and safety of ritlecitinib, an oral Janus kinase 3/TEC family kinase inhibitor, in patients with alopecia totalis (AT) and alopecia universalis (AU). Patients aged ≥ 12 years with alopecia areata (AA) and ≥50% scalp hair loss received once-daily ritlecitinib 50 or 30 mg (± 4-week 200-mg loading dose) or placebo for 24 weeks. In a subsequent 24-week extension period, the ritlecitinib groups continued their doses and patients initially assigned to placebo switched to ritlecitinib (200/50 or 50 mg daily). In this analysis, clinician- and patient-reported hair regrowth outcomes were assessed at weeks 24 and 48 in four AA subgroups: AT/AU, AT, AU, and non-AT/AU. Safety was monitored throughout. Of the 718 randomized patients, 151 (21%) and 147 (20%) were defined as having AT or AU, respectively. At week 24, Severity of Alopecia Tool (SALT) score ≤20 (≤20% scalp hair loss) response rates were higher in the ritlecitinib-treated AT/AU, AT, and AU groups (7%-14%, 7%-21%, and 4%-10%, respectively) vs the placebo group (0% in the AT/AU, AT, and AU groups). The proportions of patients with a SALT score of ≤20 increased through week 48 (AT/AU, 13%-31%; AT, 11%-27%; AU, 6%-41%). Additionally, at week 24, 25%-43%, 32%-42%, and 12%-50% of patients with AT/AU, AT, and AU, respectively, who received ritlecitinib achieved a moderately or greatly improved response based on the Patient Global Impression of Change scale. Response rates generally increased through week 48 and were similar across AA subgroups. In patients with AT/AU, ritlecitinib was well tolerated with a safety profile consistent with that of the overall AA population. Ritlecitinib demonstrated clinical efficacy, patient-reported improvement, and an acceptable safety profile in patients with AT and AU through week 48. A plain language summary of this study is available at https://doi.org/10.25454/pfizer.figshare.26879161. Clinicaltrials.gov: NCT03732807.

Effectiveness of Chuzhi Shengfa Tablets Combined with Ketoconazole Shampoo and Chuzhi Shengfa Tablets Combined with 5% Minoxidil Foam in the Treatment of Male Androgenetic Alopecia

Effectiveness of Chuzhi Shengfa Tablets Combined with Ketoconazole Shampoo and Chuzhi Shengfa Tablets Combined with 5% Minoxidil Foam in the Treatment of Male Androgenetic Alopecia

The efficacy of light-guiding microneedle patch for stimulating hair growth in androgenetic alopecia.

Androgenetic alopecia (AGA) is the most common form of hair loss characterized by miniaturization of hair follicles. Low-level light therapy (LLLT) and microneedling have shown potential in promoting hair regrowth. This study aims to evaluate the efficacy of an innovative light-emitting diode (LED) helmet cooperated with a novel light-guiding microneedle patch (LMNP) for stimulating hair growth in AGA. In this randomized clinical trial, 16 AGA patients received treatments using light-guiding microneedle patches (LMNPs) illuminated by a LED helmet equipped with green (522nm) and red (633nm) LEDs, delivering 50mW/cm2 power and 40J/cm2 energy. Treatments were applied weekly for 24weeks, targeting the frontal recession area. The right side of the scalp was treated with green light and the left with red light, each combined with a LMNP featuring 900µm height needles at a density of 105 per square centimeter. Hair density and diameter, along with patient and physician satisfaction scores, were assessed monthly. Both red and green LED treatments with LMNP, significantly enhanced hair density and diameter. Satisfaction scores, as reported by both physicians and participants, increased over time. Comparative analyses revealed no statistically significant differences in average satisfaction scores or in changes in hair density and diameter between the groups by the end of the study. Additionally, no serious adverse effects were reported, highlighting the safety of the treatments. The combined Light sources which is portable LED helmet and LMNPs shows promise as a non-invasive, effective treatment for AGA, with similar efficacy between red and green wavelengths.

Effectiveness of 675-nm Wavelength Laser Therapy in the Treatment of Androgenetic Alopecia Among Indian Patients: Clinical Experimental Study.

Androgenetic alopecia (AGA) is the most prevalent cause of hair loss around the world. The purpose of this study was to evaluate the efficacy of laser stimulation with a 675-nm wavelength for the treatment of AGA in male and female Indian patients. A total of 20 Indian healthy patients aged 23-57 years who presented a grade of alopecia stage I to stage V underwent one single pass with a 675-nm laser to the scalp area twice a week for a total of 8 sessions, followed by once a week for 4 sessions and once in 2 weeks for 2 sessions. There are 14 laser treatments in total. Macro- and dermatoscopic images have been acquired at T0 (baseline) and T1 (4 months). The vertex, frontal, and parietal areas of the scalp were evaluated. Many parameters were analyzed including hair count and hair density of terminal; mean thickness; vellus follicles; total follicular units; units with 1 hair, 2 hairs, 3 hairs, 4 hairs, and >4 hairs; unit density; and average hair/unit. The macroimages and dermatoscopic evaluations showed good improvement over the entire treated area, with a clear increase in the number of hairs and hair thickness. General parameters such as hair count and hair density showed a percentage increase of around 17%. The hair mean thickness parameters showed a significant (P<.001) percentage increase of 13.91%. Similar results were obtained for terminal and vellus hair: terminal hair count and hair density significantly (P=.04 and P=.01, respectively) increased by 17.45%, vellus hair count increased by 16.67% (P=.06), and the density of vellus hair increased by 16.61% (P=.06). The study findings demonstrate that the 675-nm laser system improved AGA in Indian patients, facilitating the anagen phase and improving hair density and other positive hair parameters.

A Comparative Study on the Application of Robotic Hair Restoration Technology Versus Traditional Follicular Unit Excision in Male Androgenetic Alopecia

ABSTRACTBackgroundThe robotic hair transplant technology, ARTAS, has a series of fine mechanical structure and an intelligent recognition system that allows it to independently select hair follicular units (FUs) and effectively harvest hair. After entering China in 2016, ARTAS has attracted the attention of hair transplant surgeons and hair loss patients given its advantages in a short learning curve and simple operation.ObjectiveTo compare the efficacy and safety between the ARTAS system and follicular unit excision (FUE) in the treatment of male androgenetic alopecia (AGA) and to further promote the improvement and upgrading of ARTAS technology concerning hair transplantation.MethodsThirteen Chinese male patients with Norwood–Hamilton II–IV AGA aged 25–35 years were enrolled in this study. The donor site of each patient was randomly divided into left and right regions, receiving ARTAS on one side and FUE on the other. Yield, transection, and discard rates of hair FUs from both sides were compared. Safety of the procedures in whole, as well as follow‐up results were investigated and evaluated.ResultsThe total yield rate on the ARTAS side was lower than on the FUE side (82.05% vs. 90.03%, p &gt; 0.05); the total discard rate on the ARTAS side was higher than on the FUE side (10.71% vs. 5.46%, p &lt; 0.05); the total transection rate on the ARTAS side was lower than on the FUE side (13.17% vs. 13.96%, p &gt; 0.05). No significant difference was found in patient satisfaction (efficacy), and no side effects or complications were detected during or after all surgeries.ConclusionThe current iteration of Robotic hair transplant technology is effective and safe, and can be recommended for AGA hair transplantation surgery.

Facile fabrication of cedrol nanoemulsions with deep transdermal delivery ability and high safety for effective androgenic alopecia treatment

The successful treatment of androgenic alopecia (AGA) hinges on an effective transdermal drug delivery strategy, a challenge that requires urgent attention. In this study, we introduce a novel approach utilizing cedrol nanoemulsions (CD-NEs) for AGA treatment. Our findings demonstrate that cedrol (CD) effectively inhibits the expression of 5α-reductase 2 (5αR2), akin to the FDA-approved drug finasteride, while also surpassing it in terms of promoting cell proliferation. Through formulation optimization, we have developed stable CD-NEs suitable for large-scale production. Experimental and molecular dynamics simulations further reveal that CD-NEs enhance transdermal penetration by altering lipid organization, facilitating CD delivery to deeper skin layers via a trans-epidermal pathway. In vivo studies conducted on AGA model C57BL/6 mice demonstrate that CD-NEs significantly promote hair follicle regeneration, accelerating the transition of hair follicles from the telogen phase to the anagen phase. Moreover, CD-NEs treatment leads to a significant reduction in dihydrotestosterone (DHT) levels in the skin while maintaining stasis levels in serum, underscoring its efficacy in targeting androgenetic pathways with high safety. This comprehensive analysis sheds light on the efficacy and mechanism of action of CD-NEs in hair regeneration, offering valuable insights for future clinical applications in AGA treatment.

Association study reveals a susceptibility locus with male pattern baldness in the Han Chinese population.

Male pattern baldness (MPB), also known as androgenetic alopecia, represents the most prevalent form of progressive hair loss in humans. It is characterized by a distinctive pattern of hair loss progression from the scalp; however, its underlying mechanism remains elusive and is influenced by hereditary, immune, and environmental factors. Genome-wide association studies (GWASs) have uncovered numerous risk genes/loci among European individuals with MPB. However, the validation of these susceptibility genes/loci within Han Chinese men remains largely unexplored. The aim of this study was to investigate whether the 71 susceptibility loci identified in a recent GWAS among European men also confer risk for MPB in Chinese men. Forty-seven single nucleotide polymorphisms (SNPs) previously reported in GWASs of MPB were selected and genotyped in independent individuals comprising 499 Han Chinese cases and 1,489 controls using the Sequenom MassArray system. After stringent quality control measures, 25 SNPs were subjected to statistical analyses. Cochran-Armitage trend test was used to evaluate the association between SNPs and disease susceptibility. To address multiple tests, Bonferroni correction was conducted, setting the threshold for statistical significance at a p-value <2 × 10-3 (0.05/25). The rs13405699 SNP located at 2q31.1 exhibited a significant association with MPB in Han Chinese men (p = 4.84 × 10-5, OR = 1.37, 95% CI: 1.18-1.59). Moreover, the difference in rs13405699 genotype distribution between MPB cases and controls was statistically significant (p = 7.00 × 10-5). Genotype-based association analysis suggested that the recessive model provided the best fit for the rs13405699 polymorphism. This study represents the first confirmation of the association between the rs13405699 SNP at 2q31.1 and MPB within the Han Chinese population, thereby enhancing our understanding of the genetic underpinnings of MPB.

Use of growth factor concentrate using derma roller in treatment of androgenetic alopecia: A literature review

Androgenetic alopecia (AGA) is a common cause of hair loss in both men and women. Recent advances in regenerative medicine have led to the use of platelet-rich plasma (PRP) combined with micro-needling as a potential treatment for AGA. However, the clinical effectiveness of this combination therapy remains unclear. To evaluate the efficacy and safety of platelet-rich plasma (PRP) combined with micro-needling for the treatment of androgenetic alopecia through a systematic review and meta-analysis of available clinical studies. A systematic search was conducted in PubMed, Embase, and the Cochrane Library for studies published up to January 2024. Inclusion criteria were randomised controlled trials (RCTs) and cohort studies that assessed hair density, hair thickness, or patient satisfaction after treatment with PRP and micro-needling. Data were extracted and pooled using a random-effects model, and heterogeneity was assessed with the I² statistic. The quality of the studies was evaluated using the Cochrane Risk of Bias tool for RCTs and the Newcastle-Ottawa Scale for cohort studies. A total of 12 studies involving 546 participants were included. Meta-analysis showed that the combination of PRP and micro-needling significantly increased hair density (mean difference: 18.9 hairs/cm², 95% CI: 15.3-22.5, p &amp;#60; 0.001) and hair thickness (mean difference: 0.4 mm, 95% CI: 0.3-0.5, p &amp;#60; 0.01) compared to controls. Patient satisfaction was also higher in the treatment group. The most commonly reported adverse effects were mild scalp irritation and transient erythema, with no serious adverse events. Moderate heterogeneity was observed among the studies (I² = 42%). The combination of PRP and micro-needling is an effective and well-tolerated treatment for androgenetic alopecia, resulting in significant improvements in hair density and thickness. Further large-scale, high-quality trials are needed to confirm these findings and standardize treatment protocols.

Obacunone improves dihydrotestosterone-induced androgen alopecia by inhibiting androgen receptor dimerization

BackgroundDihydrotestosterone-induced androgen receptor activation and nuclear translocation was identified as the key event in androgen alopecia, which led to dermal papilla cell damage and hair growth cycle arrest. Inhibiting androgen receptor activation or nuclear translocation thus represents a potential therapeutic strategy for reducing dermal papilla cell damage and treating androgen alopecia. PurposeTo evaluate the effects of obacunone androgen alopecia and explore the potential underlying mechanisms. MethodsThe effects of obacunone on androgen receptor activation and changes in the properties of dermal papilla cells were investigated. Meanwhile, the effects of obacunone on transforming growth factor-β-induced hair follicle stem cell damage and on androgen alopecia mice induced by dihydrotestosterone were evaluated. ResultsObacunone can competitively bind to androgen receptors with dihydrotestosterone, thereby alleviating the androgen receptor dimerization and nuclear translocation. The negative effects of dihydrotestosterone on dermal papilla cell apoptosis, senescence, and cycle arrest were alleviated by obacunone. Obacunone also counteracted the proliferation and apoptosis of transforming growth factor-β-mediated hair follicle stem cells. In mice with androgen alopecia, treatment with obacunone promoted mice hair growth and inhibited TGF-β/smad signaling. ConclusionThus, inhibiting androgen receptor dimerization was found to be an effective strategy for alleviating androgen alopecia. Obacunone follows a novel mechanism and holds potential as a drug candidate for androgen alopecia through inhibition of the dimerization of the androgen receptor. This targeting strategy may provide a new avenue for the development of new drugs different from the existing therapeutic approaches.

Comparative analysis of low-dose oral minoxidil with spironolactone versus finasteride or dutasteride in female androgenetic alopecia management.

LDOM has enhanced treatment options for female AGA, yet its combined efficacy with therapies such as spironolactone, finasteride, or dutasteride remains inadequately explored. This study aims to compare the efficacy and safety of LDOM in combination with spironolactone versus LDOM with finasteride or dutasteride in women with AGA. Our analysis revealed that both combination therapies produced similar improvements in hair growth and had comparable safety profiles. Although the LDOM with finasteride/dutasteride group showed a greater average increase in hair width and density, these differences were not statistically significant. These results endorse the use of LDOM in combination with either spironolactone or finasteride/dutasteride for female AGA, and underscore the necessity for further research to validate these findings and assess long-term treatment outcomes.

Dutasteride for the Treatment of Androgenetic Alopecia: An Updated Review.

Androgenetic alopecia (AGA) is a common skin disease characterized by progressive hair loss, with negative psychological impacts on patients, especially young people. The primary pathogenesis of AGA involves the action of 5α-reductase converting testosterone to dihydrotestosterone, leading to gradual miniaturization of genetically susceptible hair follicles. Finasteride inhibits type II 5α-reductase, while dutasteride simultaneously inhibits type I and type II 5α-reductase. Currently, finasteride is approved by the Food and Drug Administration (FDA) for the treatment of AGA, but its efficacy remains poor in some patients. This article aims to review the treatment of androgenetic alopecia with dutasteride. Oral dutasteride, intradermal injection of dutasteride (mesotherapy) and other related treatment methods are included. We performed a Medical Subject Heading search in the PubMed database using "androgenetic alopecia" and "dutasteride". Compared to finasteride, oral dutasteride has better efficacy and comparable tolerability, and most adverse events are mild and reversible, making it an effective treatment option for AGA. Mesotherapy with dutasteride is a therapeutic option to reduce the systemic adverse effects of the drug, but there are no standardized treatment protocols and large-scale clinical trials. Microneedling combined with dutasteride solution also has its own unique efficacy for treating AGA. Liposomes or nanoparticles of dutasteride are still under development and may become a more optimized topical formulation in the future.

Quality of Life in Patients Living with Andro-gentic Alopecia: A Cross Sectional Observational Study

Alopecia is a chronic dermatological disorder in which people lose some or all of the hair on their head and sometimes on their body as well. It is a chronic inflammatory disease that affects the hair follicles. It is neither life threatening nor painful, though there can be irritation of the skin, as well as physical problems resulting from the loss of eyelashes and eyebrows.This study aim to improve the quality of life and prescription pattern in androgenic alopecia. The goal of the study was to assess the quality of life of subjects living androgenic alopecia and to assess the prescription pattern of subjects with androgenic alopecia.This was a cross sectional observational study. The study was conducted Outpatient department of Dermatology in ESI MC PGIMSR, Rajajinagar. All the subjects (n=36) meeting the inclusion and exclusion criteria were briefed about the purpose of the study and the informed consent was obtained. The subject’s demographic details and responses were collected with the help of a standardized questionnaire. The collected data were entered in Microsoft Excel and appropriate descriptive analysis was performed. It was observed that a majority of the subjects were prescribed with minoxidil 5% (58.33%). On comparing the QOL scores, in each domain it was found that emotion has the highest average while the function has lowest average. scores in subjects of different age groups, it was found that the subjects belonging to the age groups 26-35 groups had high average scores (32.84%) and 36-45 groups had low average scores (28.96%).From this study, we got to know that the quality of life of male gender is affected more rather than female. Minoxidil 5% was most commonly prescribed drug and overall dosage form prescribed were topical agent.

Improvement of androgenic alopecia by extracellular vesicles secreted from hyaluronic acid-stimulated induced mesenchymal stem cells

BackgroundAndrogenetic alopecia (AGA) is a common form of hair loss. Androgens, such as testosterone and dihydrotestosterone, are the main causes of AGA. Extracellular vesicles (EVs) derived from mesenchymal stem cells (MSCs) can reduce AGA. However, preparing therapeutic doses of MSCs for clinical use is challenging. Induced pluripotent stem cell-derived MSCs (iMSCs) are homogenous and easily expandable, enabling scalable production of EVs. Hyaluronic acid (HA) can exert various functions including free radical scavenging, immune regulation, and cell migration. Herein, we examined whether hyaluronic acid (HA) stimulation of iMSCs could produce EVs with enhanced therapeutic outcomes for AGA.MethodsEVs were collected from iMSCs primed with HA (HA–iMSC–EVs) or without HA (iMSC–EVs). The characteristics of EVs were examined using dynamic light scattering, cryo-transmission electron microscopy, immunoblotting, flow cytometry, and proteomic analysis. In vitro, we compared the potential of EVs in stimulating the survival of hair follicle dermal papilla cells undergoing testosterone-mediated AGA. Additionally, the expression of androgen receptor (AR) and relevant growth factors as well as key proteins of Wnt/β-catenin signaling pathway (β-catenin and phosphorylated GSK3β) was analyzed. Subsequently, AGA was induced in male C57/BL6 mice by testosterone administration, followed by repeated injections of iMSC–EVs, HA–iMSC–EVs, finasteride, or vehicle. Several parameters including hair growth, anagen phase ratio, reactivation of Wnt/β-catenin pathway, and AR expression was examined using qPCR, immunoblotting, and immunofluorescence analysis.ResultsBoth types of EVs showed typical characteristics for EVs, such as size distribution, markers, and surface protein expression. In hair follicle dermal papilla cells, the mRNA levels of AR, TGF-β, and IL-6 increased by testosterone was blocked by HA–iMSC–EVs, which also contributed to the augmented expression of trophic genes related to hair regrowth. However, no notable changes were observed in the iMSC–EVs. Re-activation of Wnt/β-catenin was observed in HA–iMSC–EVs but not in iMSC–EVs, as shown by β-catenin stabilization and an increase in phosphorylated GSK3β. Restoration of hair growth was more significant in HA–iMSC–EVs than in iMSC–EVs, and was comparable to that in mice treated with finasteride. Consistently, the decreased anagen ratio induced by testosterone was reversed by HA–iMSC–EVs, but not by iMSC–EVs. An increased expression of hair follicular β-catenin protein, as well as the reduction of AR was observed in the skin tissue of AGA mice receiving HA–iMSC–EVs, but not in those treated with iMSC–EVs.ConclusionsOur results suggest that HA–iMSC–EVs have potential to improve AGA by regulating growth factors/cytokines and stimulating AR-related Wnt/β-catenin signaling.

Impact of Previous Alopecia Areata Treatment on Efficacy Responses up to Week 48 Following Ritlecitinib Treatment: A Post Hoc Analysis.

Patients with alopecia areata (AA) may have received several therapies for management of AA during their lives. In the ALLEGRO phase 2b/3 (NCT03732807) study, the oral JAK3/TEC family kinase inhibitor ritlecitinib demonstrated efficacy and an acceptable safety profile in patients aged ≥ 12years with AA and ≥ 50% scalp hair loss. This post hoc analysis investigated associations between prior use of AA therapies and Severity of Alopecia Tool (SALT) responses in patients receiving ritlecitinib for AA. Patients receiving ritlecitinib 30mg or 50mg once daily with or without an initial 4-week 200-mg daily loading dose were grouped by previous exposure to AA treatments, including topicals, intralesional corticosteroids (ILCS), topical immunotherapy, and systemic immunosuppressants or any prior AA treatment. Multivariable logistic regression analyses evaluated the association between response based on a SALT score of ≤ 20 and any prior treatment for AA at weeks 24 and 48. Of 522 patients, 360 (69.0%) had previous exposure to any AA treatment. At Week 24, SALT ≤ 20 response was positively associated with prior use of ILCS (odds ratio [OR], 2.12; 95% confidence interval [CI], 1.23-3.65; P < 0.05) and negatively associated with prior use of systemic immunosuppressants (OR 0.50; 95% CI 0.28-0.88; P < 0.05). Prior use of topicals or topical immunotherapy was not associated with SALT ≤ 20 response at Week 24. By Week 48, no association was identified between SALT ≤ 20 response and prior use of topicals, ILCS, topical immunosuppressants, or systemic immunosuppressants (all P > 0.05). Previous exposure to any AA therapy was not associated with SALT ≤ 20 response at weeks 24 or 48 (all P > 0.05). Prior AA treatment history had no effect on longer-term treatment response to ritlecitinib. NCT03732807.

ThP2.15 - Investigating the use of autologous stem cell therapy in the treatment of Androgenetic Alopecia

Abstract Background and Introduction Androgenetic alopecia (AGA) is the commonest form of alopecia and is characterised by progressive degeneration of hair follicles and programmed cell death, impacting individuals of both genders. This affects 80% of individuals in the Caucasian population and causes impairment of quality of life. The cause of AGA is complex and involves androgens, genetics, and hormonal miniaturisation. Dihydrotestosterone (DHT) is the primary androgen responsible for activating pathogenic pathways, resulting in the shortening of terminal follicles. Existing treatment methods are currently limited, and the development of a therapeutic approach that overcomes these limits might be of importance in plastic surgery. Method A comprehensive search is conducted on databases including Pubmed, Medline, Ovid, and Embase. Research studies are extracted and analysed using the PRISMA table. Results The bulge region serves as a vital reservoir of epidermal and melanocytic stem cells. The use of Rigenera® and autologous stem cell therapy has the capability to collect and separate these stem cells (SCs), leading to a 29% ± 5% augmentation in hair density over a span of 6 months. Additional types of multipotent stem cells, such as those found in adipose tissue, bone marrow, and human umbilical cord blood, might potentially be suitable for the purpose of hair regeneration. Possible advantages include a reduced number of biopsies, a shorter treatment duration, and not being limited by the number of donor follicles compared to surgical intervention. Conclusion Autologous stem cell therapy demonstrates potential effectiveness and warrants additional investigation to enhance the therapeutic efficacy of AGA.

Comparative Study Between Follicular Unit Extraction Technique with or without Platelet Rich Plasma in Non Androgenic Alopecia

Comparative Study Between Follicular Unit Extraction Technique with or without Platelet Rich Plasma in Non Androgenic Alopecia

Terminalia bellirica (Gaertn.) Roxb. Extracts reshape the perifollicular microenvironment and regulate the MAPK pathway for androgenetic alopecia treatment

Ethnopharmacological relevanceTerminalia bellirica (Gaertn.) Roxb. (TBR), a popular herbal remedy in India and Southeast Asia, has been demonstrated to possess multiple pharmacological activities. However, systematic studies on the medicinal effects and mechanism of TBR for the androgenetic alopecia (AGA) treatment are deficient. Materials and methodsHuman Umbilical Vein Endothelial Cells (HUVECs) and testosterone-induced AGA mice were used to evaluate the hair regrowth activity of TBR extracts. Chemical constituents and potential active components of TBR extracts were analyed by UPLC-Q-TOF-MS in vitro/vivo. The hair regrowth mechanisms of TBR were elucidated through network pharmacology and experimental validation. ResultsTotally 28 chemical constituents in TBR were identified, of which 15 were predicted as potential active components for AGA therapy. TBR could significantly scavenge ROS, promote VEGF level/cell migration of HUVECs, and inhibiting type II 5α-reductase activity (the inhibit rate: 82.35 ± 1.02 %). Pharmacodynamic evaluation suggested that TBR effectively led to hair regrowth in C57BL6 mice compared to minoxidil. TBR promoted the hair follicle (HF) transition from the telogen phase to anagen phase by decreasing MDA levels, increasing VEFG expression and up-regulating phosphorylated P38/ERK protein levels in the MAPK signalling pathway. ConclusionsTBR reversed AGA via inhibiting SRD5A2 activity and stimulating the MAPK pathway. Meantime, TBR could remodel the follicle microenvironment by reducing oxidative stress and increasing angiogenesis.

Evaluating treatments for male androgenetic alopecia: clinical profile and comparative efficacy of platelet rich plasma and minoxidil with finasteride

Background: Androgenetic alopecia (AGA) is a common, hereditary, and androgen-dependent disorder characterized by progressive hair thinning on the scalp, affecting both men and women. It arises from follicular miniaturization, leading to the conversion of terminal hair into vellus hair. Methods: This study is a single-center, prospective, open-label, randomized, placebo-controlled trial with four parallel arms designed to evaluate treatments for male pattern baldness. Eighty patients were randomized into four groups: Group 1 received topical minoxidil and finasteride solution, group 2 received PRP alone, group 3 received PRP with minoxidil and finasteride solution, and group 4 received normal saline (NS). Interventions were administered monthly over three months, followed by a three-month follow-up period. Treatment effects were assessed using measures such as patient self-assessment, global photography, and the hair pull test. Results: Group 3 (Combined treatment) showed the most significant improvement in the hair pull test after six months (73.33% negative tests), followed by group 2 (PRP treatment) with 60% improvement. Patient satisfaction scores were highest in group 3 across all follow-ups (F1 to F5), demonstrating superior treatment response compared to other groups (p&lt;0.001). Global photography assessments indicated varying results among groups, with group 4 recording the highest proportion of fair improvements (58.5%). Group 3 exhibited the highest percentage of patients with above-average improvement. Conclusions: Our study provides valuable insights into managing AGA, emphasizing the effectiveness of combining PRP with topical treatments compared to individual therapies and placebo.

Does low-energy fractional carbon dioxide laser therapy improve hair regrowth in female-pattern hair loss?

Background Female-pattern hair loss (FPHL) has the potential to impact the quality of life, physical attractiveness, and interpersonal relationships of many patients. In recent years, lasers and light therapy have been used as alternatives or supplementary therapy for hair loss. Objective To evaluate the efficacy of ablative fractional carbon dioxide (CO2) laser therapy alone in improving hair growth in FPHL. Patients and methods Thirty patients presenting with FPHL were included in a split-scalp prospective interventional study. Two areas of the scalp were studied. One area was treated with fractional CO2 laser and the second was injected with intradermal saline as control. The sessions were scheduled every 2 weeks for four sessions then monthly for 2 months. Patients were evaluated after each session and 2 months after the last session. Results were evaluated by clinical photography, trichoscopic, and folliscopic examination regarding the count of terminal and vellus hair, the thickness and density of hair shafts, and the patient’s satisfaction score. Results Fractional CO2 laser therapy alone was found to be effective in improving hair growth in FPHL. Conclusion Fractional CO2 laser therapy would have potential mechanisms in inducing hair regrowth in FPHL. However, the detailed mechanisms underlying hair regrowth and injury induced by the laser need further clarification.

Androgenic Alopecia Is Associated With More Severe Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia.

To evaluate the possible association between androgenic alopecia (AGA) and lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH). A total of 148 patients aged over 45 with LUTS secondary to BPH were prospectively enrolled in this study. According to the Norwood-Hamilton classification, the patients were divided into two groups: AGA (n = 69) and non-AGA (n = 79). In addition, the cases of AGA were categorized as vertex (n = 39) and frontal baldness (n = 30). The International Prostate Symptom Score (IPSS), uroflowmetry parameters, prostate volume, serum total testosterone (TT), and free and total prostate-specific antigen concentrations of all patients were assessed and compared between the groups. Correlations between the AGA grade and other variables were also investigated. The serum TT level (354 ± 97.1 vs. 308.6 ± 73.1 ng/dL, p = 0.01), total IPSS (16.1 ± 8.1 vs. 13.4 ± 7.7, p = 0.04), IPSS storage subscore (IPSS-S) (7.1 ± 3.5 vs. 5.8 ± 3.6, p = 0.03), and number of nocturia episodes (2.5 ± 1.4 vs. 1.8 ± 1.4, p < 0.01) were significantly higher in the AGA group than in the non-AGA group. There were no significant differences in any of the parameters between the patients with vertex and frontal baldness. The AGA grade showed a significant positive correlation with the TT level (r = 0.407, p = 0.003), IPSS-S (r = 0.164, p = 0.04), and number of nocturia episodes (r = 0.203, p = 0.015). This study demonstrated that among patients with LUTS, those with AGA had worse symptoms and higher TT levels compared with those without AGA of similar age. Furthermore, the AGA grade was positively correlated with the TT level and storage symptoms.