OBJECTIVE: Androgenetic alopecia (AGA) is the most common cause of hair loss in men and women, and it can affect the psychological and social activities of individuals, thus reducing their quality of life. Photobiomodulation (PBM) is a recent adjuvant treatment for this condition with promising results for hair regrowth. We aimed to assess the health-related quality of life of men and women with AGA before and after PBM sessions.
METHODS: This is a single-center prospective observational study conducted with 42 men and 43 women with AGA. All participants answered a sociodemographic questionnaire in an interview and individually answered the Brazilian version of Skindex-29 (self-application). After 24 PBM sessions, two 20-minute sessions per week, with 48 to 72 hours of interval between sessions, participants answered the Skindex-29 again.
RESULTS: Women had a large reduction in Skindex-29 total score after PBM (p<0.01; d=0.82) and lower scores in the emotions (p<0.01; d=0.89), psychosocial functioning (p<0.01; d=0.60), and symptoms domains (p=0.03; d=0.38). Men presented a moderate reduction in Skindex-29 total score after PBM (p<0.01; d=0.68), largely lower scores in the emotions domain (p<0.01; d=0.82) and a small reduction in the psychosocial functioning domain (p<0.01; d=0.47).
CONCLUSIONS: The use of PBM in AGA is associated with improving the quality of life of men and women. This enhancement was higher regarding emotions, the major domain affected in the AGA population. Women had larger impacts on all domains of Skindex-29 after the use of PBM.

Studies on androgenetic alopecia (AGA or patterned hair loss (PHL)) have suggested different underlying pathological mechanisms between males and females. While many genetic factors for male hair loss have been identified through genome-wide association studies (GWASs), the genetic determinants of female hair loss remain unclear. In this study, we analyzed approximately 1000 individuals (436 males and 568 females) to identify sex-specific genetic factors. We conducted three independent GWASs for the total, male-only, and female-only groups, identifying three novel loci (rs7814359, rs2163085, and rs4793158 of the TSNARE1, FZD1, and GJC1 genes, respectively). rs7814359 showed a significant genome-wide association with AGA in the combined sex group and a weak association in both the male-only and female-only groups. The single nucleotide polymorphism (SNP) rs2163085 showed a significant genome-wide association with AGA in the combined group and notable significance in females. The rs4793158 SNP showed a suggestive association with AGA in both the combined and female-only groups. TSNARE1, related to rs7814359, is involved in vesicle transport. FZD1 is a key regulator of the Wnt signaling pathway. GJC1 is a gap junction protein. The associations of FZD1 and GJC1 with female-specific AGA suggest that sex hormones, such as estrogen, may influence FPHL through these genes. These findings will contribute to our understanding of the sex-specific pathophysiology of AGA.

BACKGROUND: Zinc is an essential element for hair growth and may act as a strong inhibitor in accelerating follicle regression, besides being an accelerator for the recovery of the hair follicle. This study investigated the status of zinc in Kurdish adults with hair loss and its relation with each of the four types of hair loss.
METHODS: We investigated the zinc status of a sample of Kurdish adults with hair loss who attended the Dermatology Outpatient Clinics at Azadi Teaching Hospital in Duhok, Kurdistan Region, Iraq. We included a total of 200 subjects in this study, of which 125 had hair loss with a diagnosis of alopecia areata, female pattern hair loss, male pattern hair loss, and telogen effluvium, and 75 were sex- and age-matched apparently healthy subjects without hair fall as a control group. Serum samples were used to measure zinc by colorimetric technique.
RESULTS: In participants with hair loss, we found significantly lower serum zinc levels (p=0.002) compared with the control group. The telogen effluvium group had the lowest mean serum zinc level (p=0.006) and higher odds ratio compared with other hair loss groups (4.61). Overall, severe zinc deficiency was found in 12 (9.6%) subjects with hair loss, whereas none of the controls had severe zinc deficiency. Mild-to-moderate zinc deficiency was observed in 43 (34.4%) subjects with hair loss compared to one (1.3%) in the control group.  Conclusions: Our results showed that lower zinc status is linked to hair loss, especially alopecia areata and telogen effluvium in the Kurdish population.

BACKGROUND: Female pattern hair loss (FPHL) is the most prevalent type of alopecia among adult women. Presently, topical minoxidil stands as the sole treatment endorsed by the FDA. Addressing cases of FPHL in individuals who develop contact dermatitis in response to minoxidil can pose a challenge for dermatologists.
OBJECTIVE: To assess the efficacy and safety of subcutaneous injections of Botulinum Toxin Type A (BTA) in treating FPHL.
METHODS: Enrolled outpatients with FPHL who exhibited an allergic reaction to minoxidil solution. Diagnosis of FPHL was established through clinical examination and trichoscopy. Inclusion criteria involved patients with no prior treatment within the last year and without any comorbidities. BTA, specifically 100 units, was mixed with 2 mL of 0.9% normal saline. Twenty injection target sites, spaced 2-3 cm apart, were symmetrically marked on the hairless area of the scalp. A dosage of five units was intradermally injected at each target site. Representative photographs and dermoscopic images of the scalp were captured before and after 3 months of treatment.
RESULTS: A total of 10 FPHL, aged between 26 and 40 years, were included. The average age was 30.3 ± 4.64 years, and all patients had a positive family history of Androgenetic Alopecia. The average duration of the disease was 3.70 ± 1.42 years. According to patients\' self-assessment, after 1 month of treatment, 10 FPHL patients reported experiencing moderate to marked improvement in symptoms related to scalp oil secretion. Three months later, dermatological assessments showed that three had mild improvement, six had no change, and one had a worsening condition. No adverse effects were observed.
CONCLUSIONS: Our study suggests that the effectiveness of BTA for FPHL is limited to 3 months. However, it can be considered for tentative use after effective communication with patients. The long-term efficacy and safety of BTA in treating FPHL require further observation and study.

UNASSIGNED: Many studies have associated male androgenetic alopecia with the risk of cardiovascular disorders but very few studies have addressed this association in women with FPHL.
UNASSIGNED: This was a cross-sectional hospital-based study in which a total of 50 women (18-45 years) were recruited. The objective was to measure carotid intima-media thickness (CIMT) by doppler ultrasound, Body mass index (BMI), waist circumference, lipid profile, fasting blood sugar (FBS), insulin, testosterone, Sex hormone binding globulin (SHBG), hs-CRP, ESR and fibrinogen, in pre-menopausal women having FPHL and to correlate these parameters with severity of FPHL. The prevalence of Metabolic syndrome (MetS) and Insulin resistance were evaluated.
UNASSIGNED: Metabolic syndrome and insulin resistance were found in 12 (24%) and 17 (34%) cases respectively. Hypercholesterolemia, elevated LDL levels and hypertriglyceridemia, low HDL levels and hyperinsulinemia were found in 11 (22%), 31 (62%), 9 (18%), 17 (34%) and 7 (14%) cases respectively. 8 (16%) cases were diabetics. Elevated ESR, increased fibrinogen levels and elevated hs-CRP were found in 43 (86%), 10 (20%) and 21 (42%) cases respectively. CIMT was found to be within its normal range. Correlation of CIMT, anthropometric indices (BMI and WC), biochemical markers (serum cholesterol, triglycerides, FBS, and fibrinogen), and presence of metabolic syndrome with severity of FPHL in terms of Ludwig grade was found to be statistically significant.
UNASSIGNED: The determination of metabolic syndrome, insulin resistance and acute phase reactants such as hs-CRP and fibrinogen may be useful screening methods to detect increased cardiovascular risk in women with FPHL.

BACKGROUND: Androgenetic alopecia (AGA) is a prevalent, multifactorial form of hair loss involving complex aetiological factors, such as altered androgen regulation and energy metabolism. Existing treatments offer limited success, thus highlighting the need for advanced, personalised therapeutic strategies. This study focuses on correlating the genetic mechanisms of AGA with molecular targets involved in the response to current treatment modalities.
METHODS: An anonymised database including 26,607 patients was subjected to analysis. The dataset included information on patients\' genotypes in 26 single nucleotide polymorphisms (SNPs), specifically, and diagnosed AGA grades, representing a broad range of ethnic backgrounds.
RESULTS: In our sample, 64.6% of males and 35.4% of females were diagnosed with female pattern hair loss. This distribution aligns well with prior studies, thus validating the representativeness of our dataset. AGA grading was classified using the Hamilton-Norwood and Ludwig scales, although no association was found to the grade of the disease. SNP association analysis revealed eight SNPs, namely rs13283456 (PTGES2), rs523349 (SRD5A2), rs1800012 (COL1A1), rs4343 (ACE), rs10782665 (PTGFR), rs533116 (PTGDR2), rs12724719 (CRABP2) and rs545659 (PTGDR2), to be statistically significant with a p-value below 0.05.
CONCLUSIONS: The study establishes a preliminary association between eight specific SNPs and AGA. These genetic markers offer insights into the variability of therapeutic responses, thus underlining the importance of personalised treatment approaches. Our findings show the potential for more targeted research to understand these SNPs\' and further roles in AGA pathophysiology and in modulating treatment response.

Alopecia is a highly prevalent condition worldwide including in India. There are different types of alopecia with differing etiology, presentation, and hence treatment. Androgenetic alopecia represents the most common form of hair loss affecting male as well as female population termed as male and female pattern hair loss, respectively. Several treatment options are available for the treatment of alopecia with often unsatisfactory results resulting in psychological distress among such patients. Topical minoxidil is known to be effective in the treatment of alopecia. However, oral minoxidil is not currently approved for the treatment of alopecia. This expert consensus is prepared to provide guidance to the clinicians regarding the use of oral minoxidil in the treatment of alopecia. Extensive literature review was performed to prepare the draft consensus which was then revised based on the suggestions and comments from the experts. The final draft was circulated to the experts for review and approval. This consensus document provides overview of evidence related to oral minoxidil and consensus from the experts for its use in the treatment of minoxidil.

UNASSIGNED: Female pattern hair loss (FPHL) is known to present with characteristic pathological conditions, including reduced overall hair density. Female hormones affect hair condition; however, the detailed mechanism is unknown. Furthermore, research on the topic is complicated by the fact that senescent alopecia often occurs concurrently with FPHL. Therefore, we investigated the effect of estradiol, a female hormone, on hair growth by eliminating aging factors and objectively evaluating hair changes caused by female hormone replacement therapy (HRT).
UNASSIGNED: This study was conducted to elucidate the mechanism through which female hormones exert their effects on hair.
UNASSIGNED: The study included 11 female patients undergoing HRT who were evaluated before initiating HRT, 3 months after initiating HRT, and 6 months after initiating HRT. The thinning hair score, hair density, telogen hair rate, telogen plucking strength, hair growth rate, and hair thickness were measured and evaluated. Furthermore, hematological tests were performed to assess the general physical condition of the participants.
UNASSIGNED: HRT increased the telogen hair rate (P = .010, paired t test) at 3 months, improved frontal hairline thinning score (P = .008, Wilcoxon test), and increased the plucking strength (P = .013, paired t test) at 6 months.
UNASSIGNED: The limitation of this study included the relatively small sample size, inability to conduct further long-term tests because of participant burden, and lack of a control group.
UNASSIGNED: The results suggested that HRT improved the appearance of the frontal hairline. As few studies have analyzed the effects of female hormones on human hair, a novel finding of this study was the effects of estradiol on the plucking strength after excluding age as a factor. We believe that these findings will contribute to understanding FPHL and developing female hormone-related treatments.

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Pattern hair loss can occur in both men and women, and the underlying molecular mechanisms have been continuously studied in recent years. Male androgenetic alopecia (M-AGA), also termed male pattern hair loss, is the most common type of hair loss in men. M-AGA is considered an androgen-dependent trait with a background of genetic predisposition. The interplay between genetic and non-genetic factors leads to the phenotype of follicular miniaturization. Although this similar pattern of phenotypic miniaturization can also be found in female pattern hair loss (FPHL), the corresponding genetic factors in M-AGA do not account for the phenotype in FPHL, indicating that there are different genes contributing to FPHL. Therefore, the role of genetic factors in FPHL is still uncertain. Understanding the genetic mechanism that causes FPHL is crucial for the future development of personalized treatment strategies. This review aims to highlight the differences in the ethnic prevalence and genetic background of FPHL, as well as the current genetic research progress in nutrition, Wnt signaling, and sex hormones related to FPHL.