Abstract
Androgenetic alopecia (AGA), also termed as androgenic alopecia or common baldness, is a condition where there is androgen mediated conversion of susceptible terminal hair into vellus hair. Although it is reported more commonly in males, it also affects females but the incidence is relatively unknown. AGA tremendously affects the psychology of the patient due to its chronicity of treatment and cosmetic implications. There are numerous treatment options available for AGA but the choice of treatment has to often be tailored according to the patient’s needs, affordability, and compliance. This review focusses on the various treatment options available, with special emphasis on the role of low-level laser therapy (LLLT) in the management of AGA. The literature research considered published journal articles (clinical trials or scientific reviews). Studies were identified by searching electronic databases (MEDLINE and PubMed) and reference lists of respective articles. Only articles available in English were considered for this review.
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References
Hamilton JB (1951) Patterned loss of hair in man; types and incidence. Ann N Y Acad Sci 53(3):708–728
Otberg N, Finner AM, Shapiro J (2007) Androgenetic Alopecia. Endocrinol Metab Clin N Am 36(2):379–398
Paus R, Cotsarelis G. The biology of hair follicles. Epstein FH, editor. N Engl J Med 1999;341(7):491–497
Rousso DE, Kim SW (2014) A review of medical and surgical treatment options for androgenetic alopecia. JAMA Facial Plast Surg 16(6):444
Avci P, Gupta GK, Clark J, Wikonkal N, Hamblin MR (2014) Low-level laser (light) therapy (LLLT) for treatment of hair loss: LLLT for hair regrowth. Lasers Surg Med 46(2):144–151
Faghihi G, Mozafarpoor S, Asilian A, Mokhtari F, Esfahani A, Bafandeh B et al (2018) The effectiveness of adding low-level light therapy to minoxidil 5% solution in the treatment of patients with androgenetic alopecia. Indian J Dermatol Venereol Leprol 84(5):547
Kaufman KD, Olsen EA, Whiting D, Savin R, DeVillez R, Bergfeld W et al (1998) Finasteride in the treatment of men with androgenetic alopecia. J Am Acad Dermatol 39(4):578–589
Van Neste D, Fuh V, Sanchez-Pedreno P, Lopez-Bran E, Wolff H, Whiting D et al (2000) Finasteride increases anagen hair in men with androgenetic alopecia. Br J Dermatol 143(4):804–810
Caserini M, Radicioni M, Leuratti C, Terragni E, Iorizzo M, Palmieri R (2016) Effects of a novel finasteride 0.25% topical solution on scalp and serum dihydrotestosterone in healthy men with androgenetic alopecia. Int J Clin Pharmacol Ther 54(01):19–27
Irwig MS (2012) Persistent sexual side effects of finasteride: could they be permanent? J Sex Med 9(11):2927–2932
Finasteride for androgenetic alopecia and side effects [Internet]. [cited 2019 Sep 16]. Available from: https://www.clinicaldermatology.eu/materiale_cic/719_1_4/6207_finasteride/article.htm
Hajheydari Z, Akbari J, Saeedi M, Shokoohi L (2009) Comparing the therapeutic effects of finasteride gel and tablet in treatment of the androgenetic alopecia. Indian J Dermatol Venereol Leprol 75(1):5
Drobnis EZ, Nangia AK (2017) 5α-reductase inhibitors (5ARIs) and male reproduction. Adv Exp Med Biol 1034:59–61
Tsunemi Y, Irisawa R, Yoshiie H, Brotherton B, Ito H, Tsuboi R et al (2016) Long-term safety and efficacy of dutasteride in the treatment of male patients with androgenetic alopecia. J Dermatol 43(9):1051–1058
Prager N, Bickett K, French N, Marcovici G (2002) A randomized, double-blind, placebo-controlled trial to determine the effectiveness of botanically derived inhibitors of 5-alpha-reductase in the treatment of androgenetic alopecia. J Altern Complement Med 8(2):143–152
Rossi A, Mari E, Scarnò M, Garelli V, Maxia C, Scali E et al (2012) Comparitive effectiveness and finasteride vs Serenoa repens in male androgenetic alopecia: a two-year study. Int J Immunopathol Pharmacol 25(4):1167–1173
Sovak M, Seligson AL, Kucerova R, Bienova M, Hajduch M, Bucek M (2002) Fluridil, a rationally designed topical agent for androgenetic alopecia: first clinical experience. Dermatol Surg 28(8):678–685
Rathnayake D, Sinclair R (2010) Male androgenetic alopecia. Expert Opin Pharmacother 11(8):1295–1304
Goren A, Sharma A, Dhurat R, Shapiro J, Sinclair R, Situm M et al (2018) Low-dose daily aspirin reduces topical minoxidil efficacy in androgenetic alopecia patients. Dermatol Ther 31(6):e12741
Rossi A, Cantisani C, Melis L, Iorio A, Scali E, Calvieri S (2012) Minoxidil use in dermatology, side effects and recent patents. Recent Patents Inflamm Allergy Drug Discov 6(2):130–136
Bienová M, Kuerová R, Fiurá M (2005) Androgenetic alopecia and current methods of treatment. Androg Alopecia 14(1):4
Senel E, Purnak T, Sahin C (2011) Liquid formulation of minoxidil versus its foam formulation. Indian J Dermatol 56(4):462
Blumeyer A, Tosti A, Messenger A, Reygagne P, del Marmol V, Spuls PI et al (2011) Evidence-based (S3) guideline for the treatment of androgenetic alopecia in women and in men. JDDG J Dtsch Dermatol Ges 9:S1–S57
Gupta AK, Charrette A (2015) Topical minoxidil: systematic review and meta-analysis of its efficacy in androgenetic alopecia. Skinmed. 13(3):185–189
Chitalia J, Dhurat R, Goren A, McCoy J, Kovacevic M, Situm M et al (2018) Characterization of follicular minoxidil sulfotransferase activity in a cohort of pattern hair loss patients from the Indian subcontinent. Dermatol Ther 31(6):e12688
Goren A, Shapiro J, Roberts J, McCoy J, Desai N, Zarrab Z et al (2015) Clinical utility and validity of minoxidil response testing in androgenetic alopecia. Dermatol Ther 28(1):13–16
Li ZJ, Choi H-I, Choi D-K, Sohn K-C, Im M, Seo Y-J et al (2012) Autologous platelet-rich plasma: a potential therapeutic tool for promoting hair growth. Dermatol Surg 38(7pt1):1040–1046
Lotti T, Goren A, Verner I, D’Alessio PA, Franca K (2019) Platelet rich plasma in androgenetic alopecia: a systematic review. Dermatol Ther 32(3):e12837
Cervelli V, Garcovich S, Bielli A, Cervelli G, Curcio BC, Scioli MG et al (2014) The effect of autologous activated platelet rich plasma (AA-PRP) injection on pattern hair loss: clinical and histomorphometric evaluation. Biomed Res Int 2014:1–9
Puig CJ, Reese R, Peters M (2016) Double-blind, Placebo-controlled pilot study on the use of platelet-rich plasma in women with female androgenetic alopecia. Dermatol Surg 42(11):1243–1247
Ayatollahi A, Hosseini H, Shahdi M, AhmadNasrollahi S, NassiriKashani M, Yadangi S et al (2017) Platelet-rich plasma by single spin process in male pattern androgenetic alopecia: is it an effective treatment? Indian Dermatol Online J 8(6):460–464
Stevens J, Khetarpal S (2019) Platelet-rich plasma for androgenetic alopecia: a review of the literature and proposed treatment protocol. Int J Womens Dermatol 5(1):46–51
Schmidt B, Horsley V (2012) Unravelling hair follicle-adipocyte communication. Exp Dermatol 21(11):827–830
Rossi A, Anzalone A, Fortuna MC, Caro G, Garelli V, Pranteda G et al (2016) Multi-therapies in androgenetic alopecia: review and clinical experiences: an update and future potential treatments. Dermatol Ther 29(6):424–432
Patwardhan N, Mysore V (2008) Hair transplantation: standard guidelines of care. Indian J Dermatol Venereol Leprol 74(Suppl):S46–53
Kassimir JJ (1987) Use of topical minoxidil as a possible adjunct to hair transplant surgery. J Am Acad Dermatol 16(3):685–687
Leavitt M, David P-M, Rao NA, Barusco M, Kaufman KD, Ziering C (2006) Effects of finasteride (1 mg) on hair transplant. Dermatol Surg 31(10):1268–1276
Dhurat R, Mathapati S (2015) Response to microneedling treatment in men with androgenetic alopecia who failed to respond to conventional therapy. Indian J Dermatol 60(3):260
Verner I, Lotti T (2018) Clinical evaluation of a novel fractional radiofrequency device for hair growth: fractional radiofrequency for hair growth stimulation. Dermatol Ther 31(3):e12590
Maddin WS, Bell PW, James JH (1990) The biological effects of a pulsed electrostatic field with specific reference to hair. Electrotrichogenesis Int J Dermatol 29(6):446–450
Doghaim NN, El-Tatawy RA, Neinaa YME, Abd El-Samd MM (2018) Study of the efficacy of carboxytherapy in alopecia. J Cosmet Dermatol 17(6):1275–1285
Ghanaat M (2010) Types of hair loss and treatment options, including the novel low-level light therapy and its proposed mechanism. South Med J 103(9):917–921
Jimenez JJ, Wikramanayake TC, Bergfeld W, Hordinsky M, Hickman JG, Hamblin MR et al (2014) Efficacy and safety of a low-level laser device in the treatment of male and female pattern hair loss: a multicenter, randomized, sham device-controlled, Double-blind Study. Am J Clin Dermatol 15(2):115–127
Kruglikov IL, Zhang Z, Scherer PE (2019) The role of immature and mature adipocytes in hair cycling. Trends Endocrinol Metab 30(2):93–105
Leavitt M, Charles G, Heyman E, Michaels D (2009) HairMax LaserComb® laser phototherapy device in the treatment of male androgenetic alopecia: a randomized, double-blind, sham device-controlled. Multicentre Trial Clin Drug Investig 29(5):283–292
Kim H, Choi JW, Kim JY, Shin JW, Lee S, Huh C-H (2013) Low-level light therapy for androgenetic alopecia: a 24-week, randomized, double-blind, Sham Device–Controlled Multicenter Trial. Dermatol Surg 39(8):1177–1183
Suchonwanit P, Chalermroj N, Khunkhet S (2019) Low-level laser therapy for the treatment of androgenetic alopecia in Thai men and women: a 24-week, randomized, double-blind, sham device-controlled trial. Lasers Med Sci 34(6):1107–1114
Mai-Yi Fan S, Cheng Y-P, Lee M-Y, Lin S-J, Chiu H-Y (2018) Efficacy and safety of a low-level light therapy for androgenetic alopecia: a 24-week, randomized, double-blind, self-comparison, sham device-controlled trial. Dermatol Surg Off Publ Am Soc Dermatol Surg Al 44(11):1411–1420
Lanzafame RJ, Blanche RR, Bodian AB, Chiacchierini RP, Fernandez-Obregon A, Kazmirek ER (2013) The growth of human scalp hair mediated by visible red light laser and LED sources in males: the growth of human scalp hair. Lasers Surg Med 45(8):487–495
Lanzafame RJ, Blanche RR, Chiacchierini RP, Kazmirek ER, Sklar JA (2014) The growth of human scalp hair in females using visible red light laser and LED sources: growth of scalp hair in women. Lasers Surg Med 46(8):601–607
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Galadari, H., Shivakumar, S., Lotti, T. et al. Low-level laser therapy and narrative review of other treatment modalities in androgenetic alopecia. Lasers Med Sci 35, 1239–1244 (2020). https://doi.org/10.1007/s10103-020-02994-4
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DOI: https://doi.org/10.1007/s10103-020-02994-4