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Dermatol Ther. 2019 Sep;32(5):e13059. doi: 10.1111/dth.13059. Epub 2019 Aug 26.

Physiopathology and current treatments of androgenetic alopecia: Going beyond androgens and anti-androgens.

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Pharmaceutical Nanotechnology Post Graduate Program, Federal University of Santa Maria, Santa Maria, Brazil.
Clinical Psychology Post Graduate Program, Pontifícia Universidade Católica, São Paulo, Brazil.
Pharmaceutical Science Post Graduate Program, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.


Androgenetic alopecia (AGA) is the most diagnosed hair loss dysfunction. Its physiopathology comprises a genetic predisposition affording an exacerbated response of the hair follicles cells to androgens aggravated by scalp inflammation and extrinsic factors. This paper presents a review of the mechanisms and extrinsic factors involved in the AGA physiopathology as well as its conventional and emerging treatments. The research focused on reports regarding AGA physiopathology and treatments published between January 2001 and July 2019 in medical and related journals. The most used medical treatments for AGA-minoxidil and finasteride-present non satisfactory results in some cases. Currently, the low-level laser therapy is recognized as a safe and effective treatment for AGA. Some minimally invasive techniques-mesotherapy, microneedling, carboxytherapy, and platelet-rich plasma-are also used to stimulate hair growth. Pharmaceutical substances with mechanisms differing from the anti-androgen activity are under current investigation and many of them have botanical origins; however, formulations with higher performance are required, and the hair follicles ability of being a drug and nanoparticle reservoir has been researched. The association of different strategies, that is, substances with synergic mechanisms and the use of advantageous technologies associated with lifestyle changes could improve the treatment outcomes.


baldness; low-level laser therapy; nanotechnology


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