Understanding Pattern Hair Loss—Hair Biology Impacted by Genes, Androgens, Prostaglandins and Epigenetic Factors

Pattern hair loss (PHL) is the most frequent cause of hair loss in men and women, accounting for 65% of consultations in a hair referral center. PHL is understood to represent a hereditary, age-dependent progressive thinning of the scalp hair, which follows distinct clinical patterns with notable di...

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Main Author: Ralph M. Trüeb
Format: Article
Language:English
Published: Thieme Medical Publishers, Inc. 2021-10-01
Series:Indian Journal of Plastic Surgery
Subjects:
Online Access:http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1739252
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author_facet Ralph M. Trüeb
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description Pattern hair loss (PHL) is the most frequent cause of hair loss in men and women, accounting for 65% of consultations in a hair referral center. PHL is understood to represent a hereditary, age-dependent progressive thinning of the scalp hair, which follows distinct clinical patterns with notable differences depending on sex and age of onset. Clinical and investigative advances have helped us to understand some of the pathogenic steps, leading to PHL. Besides genetic factors and peculiarities of androgen metabolism, additional pathogenic factors that are suspected include microbiomata, oxidative stress, and microinflammation. While further suspects are likely to be exposed, individual diversity of causal agents, as well as of the sequence of events, or combined factors, must be kept in mind. A large number of therapeutic molecules claimed to be active and patented in this field, and their limited efficacy in offering a definitive cure of PHL confirm the complexity of PHL. The aim of therapy is to retard progression of hair thinning and increase hair coverage of the scalp. As yet, two FDA-approved drugs are available for this purpose, oral finasteride, and topical solution of minoxidil. Variations in posology and formulation allow for an enhancement of patient comfort and treatment efficacy. Antiandrogen treatments in women with normal androgen levels have questionable efficacy while having health risks.
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spelling doaj.art-728a176c61d848ed90ed97b189e267e92022-12-21T18:45:26ZengThieme Medical Publishers, Inc.Indian Journal of Plastic Surgery0970-03581998-376X2021-10-01540438539210.1055/s-0041-1739252Understanding Pattern Hair Loss—Hair Biology Impacted by Genes, Androgens, Prostaglandins and Epigenetic FactorsRalph M. Trüeb0Center for Dermatology and Hair Diseases Professor Trüeb, SwitzerlandPattern hair loss (PHL) is the most frequent cause of hair loss in men and women, accounting for 65% of consultations in a hair referral center. PHL is understood to represent a hereditary, age-dependent progressive thinning of the scalp hair, which follows distinct clinical patterns with notable differences depending on sex and age of onset. Clinical and investigative advances have helped us to understand some of the pathogenic steps, leading to PHL. Besides genetic factors and peculiarities of androgen metabolism, additional pathogenic factors that are suspected include microbiomata, oxidative stress, and microinflammation. While further suspects are likely to be exposed, individual diversity of causal agents, as well as of the sequence of events, or combined factors, must be kept in mind. A large number of therapeutic molecules claimed to be active and patented in this field, and their limited efficacy in offering a definitive cure of PHL confirm the complexity of PHL. The aim of therapy is to retard progression of hair thinning and increase hair coverage of the scalp. As yet, two FDA-approved drugs are available for this purpose, oral finasteride, and topical solution of minoxidil. Variations in posology and formulation allow for an enhancement of patient comfort and treatment efficacy. Antiandrogen treatments in women with normal androgen levels have questionable efficacy while having health risks.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1739252pattern hair lossoral finasteridetopical minoxidilminoxidil sulfatetopical finasterideoral minoxidiloxidative stressmicroinflammation
spellingShingle Ralph M. Trüeb
Understanding Pattern Hair Loss—Hair Biology Impacted by Genes, Androgens, Prostaglandins and Epigenetic Factors
Indian Journal of Plastic Surgery
pattern hair loss
oral finasteride
topical minoxidil
minoxidil sulfate
topical finasteride
oral minoxidil
oxidative stress
microinflammation
title Understanding Pattern Hair Loss—Hair Biology Impacted by Genes, Androgens, Prostaglandins and Epigenetic Factors
title_full Understanding Pattern Hair Loss—Hair Biology Impacted by Genes, Androgens, Prostaglandins and Epigenetic Factors
title_fullStr Understanding Pattern Hair Loss—Hair Biology Impacted by Genes, Androgens, Prostaglandins and Epigenetic Factors
title_full_unstemmed Understanding Pattern Hair Loss—Hair Biology Impacted by Genes, Androgens, Prostaglandins and Epigenetic Factors
title_short Understanding Pattern Hair Loss—Hair Biology Impacted by Genes, Androgens, Prostaglandins and Epigenetic Factors
title_sort understanding pattern hair loss hair biology impacted by genes androgens prostaglandins and epigenetic factors
topic pattern hair loss
oral finasteride
topical minoxidil
minoxidil sulfate
topical finasteride
oral minoxidil
oxidative stress
microinflammation
url http://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1739252
work_keys_str_mv AT ralphmtrueb understandingpatternhairlosshairbiologyimpactedbygenesandrogensprostaglandinsandepigeneticfactors