Authors :
Shilpa Gopinath; Swarnagowri BN
Volume/Issue :
Volume 9 - 2024, Issue 12 - December
Google Scholar :
https://tinyurl.com/yeyjbufm
Scribd :
https://tinyurl.com/2vdpkrss
DOI :
https://doi.org/10.5281/zenodo.14651228
Abstract :
Male Pattern Hair Loss (MPHL) is a subset of
androgenetic alopecia and represents the most prevalent
form of hair loss in men, whose prevalence increases
significantly with age worldwide. It is caused mainly by
hormonal changes, especially high levels of
dihydrotestosterone, which causes miniaturization of hair
follicles and progressive thinning of hair. This
longitudinal study investigates the complex relationship
between hormonal changes and MPHL development over
a period of three years, offering an extensive examination
of androgen activity, stress-related hormones, and their
influence on hair follicle biology. A total of 120
participants with a diagnosis of early-stage MPHL were
assigned to one of three groups: finasteride treatment,
placebo, and control. Serum levels of DHT, testosterone,
and cortisol were measured biannually, while hair density
and follicular changes were monitored using advanced
scalp imaging techniques. Participants also self-reported
their experiences related to treatment efficacy and
psychosocial impacts. The findings revealed a significant
reduction in DHT levels among finasteride-treated
participants, correlating with improved hair density and
partial reversal of follicular miniaturization. In contrast,
placebo and control groups showed a steady progression
of hair loss, confirming the critical role of DHT in MPHL.
While finasteride was effective, its side effects, such as
reduced libido and fatigue, emphasized the need for safer,
long-term therapies. The study also pointed out the
interplay between stress-induced cortisol elevations and
hair loss, therefore suggesting potential benefits from
combined therapeutic approaches targeting both
androgens and systemic stress. This study contributes to
the knowledge on MPHL pathophysiology, with a focus
on the role of hormonal profiling in clinical management.
It also presents future research on alternative therapies
and individualized treatment approaches by pointing out
both the benefits and limitations of current treatments.
These findings are important in emphasizing the need for
a multidisciplinary approach in managing MPHL in
terms of genetic, hormonal, and environmental factors in
order to improve the quality and outcomes of life.
Keywords :
Male Pattern Hair Loss (MPHL), Androgenetic Alopecia, Hormonal Alterations, Dihydrotestosterone (DHT), Finasteride, Hair Follicle Miniaturization, Longitudinal Study, Androgen Receptors, Cortisol Levels, Hair Density.
References :
- Olsen, E. A., Messenger, A. G., Shapiro, J., Bergfeld, W. F., Hordinsky, M. K., Roberts, J. L., ... & Whiting, D. A. (2005). Evaluation and treatment of male and female pattern hair loss. Journal of the American Academy of Dermatology, 52(2), 301-311. https://doi.org/10.1016/j.jaad.2004.04.008
- Grymowicz, M., Rudnicka, E., Podfigurna, A., Napierala, P., Smolarczyk, R., Smolarczyk, K., & Meczekalski, B. (2020). Hormonal effects on hair follicles. International Journal of Molecular Sciences, 21(15), 5342. https://doi.org/10.3390/ijms21155342
- Mirmirani, P. (2015). Age-related hair changes in men: Mechanisms and management of alopecia and graying. Maturitas, 80(1), 58-62. https://doi.org/10.1016/j.maturitas.2014.10.001
- Irwig, M. S., & Kolukula, S. (2011). Persistent sexual side effects of finasteride for male pattern hair loss. The Journal of Sexual Medicine, 8(6), 1747-1753. https://doi.org/10.1111/j.1743-6109.2011.02255.x
- Sinclair, R. (1998). Male pattern androgenetic alopecia. BMJ, 317(7162), 865-869. https://doi.org/10.1136/bmj.317.7162.865
- Caruso, D., Abbiati, F., Giatti, S., Romano, S., Fusco, L., Cavaletti, G., & Melcangi, R. C. (2015). Patients treated for male pattern hair with finasteride show, after discontinuation of the drug, altered levels of neuroactive steroids in cerebrospinal fluid and plasma. The Journal of Steroid Biochemistry and Molecular Biology, 146, 74-79. https://doi.org/10.1016/j.jsbmb.2014.06.007
- Trüeb, R. M. (2002). Molecular mechanisms of androgenetic alopecia. Experimental Gerontology, 37(8-9), 981-990. https://doi.org/10.1016/S0531-5565(02)00094-8
- Kaufman, K. D. (2002). Androgens and alopecia. Molecular and Cellular Endocrinology, 198(1-2), 89-95. https://doi.org/10.1016/S0303-7207(02)00367-2
- Sawaya, M. E., & Price, V. H. (1997). Different levels of 5α-reductase type I and II, aromatase, and androgen receptor in hair follicles of women and men with androgenetic alopecia. Journal of Investigative Dermatology, 109(3), 296-300. https://doi.org/10.1111/1523-1747.ep12335719
- Ellis, J. A., & Sinclair, R. (2008). Male pattern baldness: Current treatments, future prospects. Drug Discovery Today: Therapeutic Strategies, 5(2), 159-165. https://doi.org/10.1016/j.ddstr.2008.09.001
- Whiting, D. A. (2001). Possible mechanisms of miniaturization during androgenetic alopecia or pattern hair loss. Journal of the American Academy of Dermatology, 45(3), S81-S86. https://doi.org/10.1067/mjd.2001.117432
- Inui, S., & Itami, S. (2013). Androgen actions on the human hair follicle: Perspectives. Experimental Dermatology, 22(3), 168-171. https://doi.org/10.1111/exd.12034
- Kaliyadan, F., & Nambiar, A. (2013). Androgenetic alopecia: An update. Indian Journal of Dermatology, Venereology, and Leprology, 79(5), 613-625. https://doi.org/10.4103/0378-6323.116733
- Rossi, A., Cantisani, C., Melis, L., Iorio, A., Scali, E., & Calvieri, S. (2012). Minoxidil use in dermatology, side effects and recent patents. Recent Patents on Inflammation & Allergy Drug Discovery, 6(2), 130-136. https://doi.org/10.2174/187221312800166859
- Gupta, M., Mysore, V., & Shetty, N. (2016). Finasteride in androgenetic alopecia: An update. Indian Dermatology Online Journal, 7(4), 255-263. https://doi.org/10.4103/2229-5178.185468
- Mella, J. M., Perret, M. C., Manzotti, M., Catalano, H. N., & Guyatt, G. (2010). Efficacy and safety of finasteride therapy for androgenetic alopecia: A systematic review. Archives of Dermatology, 146(10), 1141-1150. https://doi.org/10.1001/archdermatol. 2010.256
- Tosti, A., & Piraccini, B. M. (1999). Finasteride and the hair cycle. Journal of the American Academy of Dermatology, 41(5), 794-795. https://doi.org/10.1016/S0190-9622(99)70264-0
- Shapiro, J., & Kaufman, K. D. (2003). Use of finasteride in the treatment of men with androgenetic alopecia (male pattern hair loss). Journal of Investigative Dermatology Symposium Proceedings, 8(1), 20-23. https://doi.org/10.1046/j.1523-1747.2003.12167.x
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Male Pattern Hair Loss (MPHL) is a subset of
androgenetic alopecia and represents the most prevalent
form of hair loss in men, whose prevalence increases
significantly with age worldwide. It is caused mainly by
hormonal changes, especially high levels of
dihydrotestosterone, which causes miniaturization of hair
follicles and progressive thinning of hair. This
longitudinal study investigates the complex relationship
between hormonal changes and MPHL development over
a period of three years, offering an extensive examination
of androgen activity, stress-related hormones, and their
influence on hair follicle biology. A total of 120
participants with a diagnosis of early-stage MPHL were
assigned to one of three groups: finasteride treatment,
placebo, and control. Serum levels of DHT, testosterone,
and cortisol were measured biannually, while hair density
and follicular changes were monitored using advanced
scalp imaging techniques. Participants also self-reported
their experiences related to treatment efficacy and
psychosocial impacts. The findings revealed a significant
reduction in DHT levels among finasteride-treated
participants, correlating with improved hair density and
partial reversal of follicular miniaturization. In contrast,
placebo and control groups showed a steady progression
of hair loss, confirming the critical role of DHT in MPHL.
While finasteride was effective, its side effects, such as
reduced libido and fatigue, emphasized the need for safer,
long-term therapies. The study also pointed out the
interplay between stress-induced cortisol elevations and
hair loss, therefore suggesting potential benefits from
combined therapeutic approaches targeting both
androgens and systemic stress. This study contributes to
the knowledge on MPHL pathophysiology, with a focus
on the role of hormonal profiling in clinical management.
It also presents future research on alternative therapies
and individualized treatment approaches by pointing out
both the benefits and limitations of current treatments.
These findings are important in emphasizing the need for
a multidisciplinary approach in managing MPHL in
terms of genetic, hormonal, and environmental factors in
order to improve the quality and outcomes of life.
Keywords :
Male Pattern Hair Loss (MPHL), Androgenetic Alopecia, Hormonal Alterations, Dihydrotestosterone (DHT), Finasteride, Hair Follicle Miniaturization, Longitudinal Study, Androgen Receptors, Cortisol Levels, Hair Density.