Year 2021, Volume 47 , Issue 1, Pages 141 - 149 2021-04-01

Androgenetik Alopesi
Androgenetic Alopecia

Gökhan ŞAHİN [1] , Hilal ÖZDEMİR [2] , Fatma AYDIN [3]


Androgenetik alopesi genetik yatkınlığı olan kişilerde farklı patolojik mekanizmalarla ortaya çıkabilen, erkek ve kadınlarda kliniği değişiklik gösterebilen bir saç dökülme şeklidir. Androgenetik alopesi her ne kadar sık görülüyor ve tanısı genellikle kolay koyuluyor olsa da hasta yönetimi için standart bir tedavi rehberi yoktur. Androgenetik alopesi yönetiminde amaç foliküler minyatürizasyonu durdurmak ve saç dansitesini arttırmaktır. Androgenetik alopesi yönetiminde kullanılan tedaviler potasyum iyon kanalı düzenleyicileri (topikal minoksidil ve oral minoksidil), 5α redüktaz inhibitörleri (oral finasterid, topikal finasterid ve oral dutasterid), androjen reseptör antagonistleri (spironolak-ton, siproteron asetat, flutamid, korteksolon 17 alfa propionat ve topikal fluridil), diğer medikal tedaviler (topikal prostoglandin analogları, topikal ketokonazol, topikal melatonin, Wnt/β katenin sinyal yolağı aktivatörleri ve JAK-STAT yolağı inhibitörleri), fiziksel tedaviler (düşük dereceli lazer ışık tedavisi, lazer tedavileri, mikroiğneleme, mezoterapi, PRP ve kök hücre tedavileri), tamamlayıcı tedaviler (saç transplantasyonu, besin takviyeleri ve kamuflaj yöntemleri) ve kombinasyon tedavileridir. Bu derlemede erkek ve kadında androgenetik alopesi yönetiminde güncel tedavi yöntemleri hakkında bilgi verilmesi amaçlanmıştır.
Androgenetic alopecia is a form of hair loss that can occur with different pathological mechanisms in people with genetic predisposition, and the clinic may vary in men and women. Although androgenetic alopecia is common and its diagnosis is usually easy, there is no standard treatment guideline for patient management. The purpose of the management of androgenetic alopecia is to stop follicular miniaturization and to increase hair density. Therapies used in the management of androgenetic alopecia are potassium ion channel modifiers (topical minoxidil and oral minoxidil), 5α reductase inhibitors (oral finasteride, topical finasteride and oral dutasteride), androgen receptor antagonists (spironolactone, cyproterone acetate, flutamide, cortexolone 17 alpha propionate solution and topical minoxidil) , other medical treatments (topical prostaglandin analogues, topical ketoconazole, topical melatonin, Wnt / β catenin signaling pathway activators and JAK-STAT pathway inhibitors), physical treatments (low-grade laser light therapy, laser treatments, microneedling, mesotherapy, PRP and stem cell treatments), complementary therapies (hair transplantation, nutritional supplements and camouflage methods) and combination therapies. In this review, it is aimed to provide information about current treatment methods in the management of androgenetic alopecia in men and women.
  • Referans1 Rhodes T, Girman CJ, Savin RC, et al. Prevalence of male pattern hair loss in 18-49 year old men. Dermatol Surg 1998;24(12):1330-2.
  • Referans2 Norwood OT. Incidence of female androgenetic alopecia (female pattern alopecia). Dermatol Surg 2001;27(1):53-4.
  • Referans3 Paik JH, Yoon JB, Sim WY, Kim BS, Kim NI. The prevalence and types of androgenetic alopecia in Korean men and women. Br J Dermatol 2001;145(1):95-9.
  • Referans4 Heilmann-Heimbach S, Hochfeld LM, Paus R, Nöthen MM. Hunting the genes in male-pattern alopecia: how important are they, how close are we and what will they tell us? Exp Dermatol 2016;25(4):251-7.
  • Referans5 Tosti A, Iorizzo M, Piraccini BM. Androgenetic alopecia in children: report of 20 cases. Br J Dermatol 2005;152(3):556-9.
  • Referans6 Sperling LC, Sinclair RD, Shabrawi-Caelen LE: Alopecias. In Bolognia JL, Schaffer JV, Cerroni L (eds): Dermatology. Forth Edition. Elsevier, 2018. pp. 1162-87.
  • Referans7 Imperato-McGinley J, Zhu YS. Androgens and male physiology the syndrome of 5alpha-reductase-2 deficiency. Mol Cell Endocrinol 2002;198(1-2):51-9.
  • Referans8 Sawaya ME, Price VH. Different levels of 5alpha-reductase type I and II, aromatase, and androgen receptor in hair follicles of women and men with androgenetic alopecia. J Invest Dermatol 1997;109(3):296-300.
  • Referans9 Sawaya ME. Purification of androgen receptors in human sebocytes and hair. J Invest Dermatol 1992;98(6 Suppl):92S-96S.
  • Referans10 Garza LA, Liu Y, Yang Z, et al. Prostaglandin D2 inhibits hair growth and is elevated in bald skalpof men with androgenetic alopecia . Sci Transl Med 2012;4:126ra34
  • Referans11 Schmidt JB, Lindmaier A, Trenz A, Schurz B, Spona J. Hormone studies in females with androgenic hairloss. Gynecol Obstet Invest 1991;31(4):235-9.
  • Referans12 Yip L, Rufaut N, Sinclair R. Role of genetics and sex steroid hormones in male androgenetic alopecia and female pattern hair loss: an update of what we now know. Australas J Dermatol. 2011;52(2):81-8.
  • Referans13 Norwood OT. Male pattern baldness: classification and incidence. South Med J 1975;68(11):1359-65.
  • Referans14 Olsen EA. Female pattern hair loss. J Am Acad Dermatol 2001;45(3 Suppl):S70-80.
  • Referans15 Ludwig E. Classification of the types of androgenetic alopecia (common baldness) occurring in the female sex. Br J Dermatol 1977;97(3):247-54.
  • Referans16 Cash TF. The psychosocial consequences of androgenetic alopecia: a review of the research literature. Br J Dermatol 1999;141(3):398-405.
  • Referans17 Arias-Santiago S, Gutiérrez-Salmerón MT, Castellote-Caballero L, Buendía-Eisman A, Naranjo-Sintes R. Androgenetic alopecia and cardiovascular risk factors in men and women: a comparative study. J Am Acad Dermatol 2010;63(3):420-9.
  • Referans18 Amoretti A, Laydner H, Bergfeld W. Androgenetic alopecia and risk of prostate cancer: a systematic review and meta-analysis. J Am Acad Dermatol 2013;68(6):937-43.
  • Referans19 Keum N, Cao Y, Lee DH, et al. Male pattern baldness and risk of colorectal neoplasia. Br J Cancer 2016;114(1):110-7.
  • Referans20 Hirsso P, Rajala U, Laakso M, et al. Health-related quality of life and physical well-being among a 63-year-old cohort of women with androgenetic alopecia; a Finnish population-based study. Health Qual Life Outcomes 2005;3:49.
  • Referans21 Inui S. Trichoscopy for common hair loss diseases: algorithmic method for diagnosis. J Dermatol 2011;38(1):71-5.
  • Referans22 Olsen EA, Messenger AG, Shapiro J, et al. Evaluation and treatment of male and female pattern hair loss. J Am Acad Dermatol 2005;52(2):301-11.
  • Referans23 Horenstein MG, Jacob JS. Follicular streamers (stelae) in scarring and non-scarring alopecia. J Cutan Pathol 2008;35(12):1115-20.
  • Referans24 Whiting DA. Diagnostic and predictive value of horizontal sections of scalp biopsy specimens in male pattern androgenetic alopecia. J Am Acad Dermatol 1993;28:755-63.
  • Referans25 Chitalia J, Dhurat R, Goren A, et al. Characterization of follicular minoxidil sulfotransferase activity in a cohort of pattern hair loss patients from the Indian Subcontinent. Dermatol Ther 2018;31(6):e12688.
  • Referans26 Lachgar S, Charveron M, Gall Y, Bonafe JL. Minoxidil upregulates the expression of vascular endothelial growth factor in human hair dermal papilla cells. Br J Dermatol 1998;138(3):407-11.
  • Referans27 Olsen EA, Whiting D, Bergfeld W, et al. A multicenter, randomized, placebo-controlled, double-blind clinical trial of a novel formulation of 5% minoxidil topical foam versus placebo in the treatment of androgenetic alopecia in men. J Am Acad Dermatol 2007;57(5):767-74.
  • Referans28 Olsen EA, Dunlap FE, Funicella T, et al. A randomized clinical trial of 5% topical minoxidil versus 2% topical minoxidil and placebo in the treatment of androgenetic alopecia in men. J Am Acad Dermatol 2002;47(3):377-85.
  • Referans29 Van Zuuren EJ, Fedorowicz Z, Schoones J. Interventions for female pattern hair loss. Cochrane Database Syst Rev 2016;2016(5):CD007628.
  • Referans30 Bergfeld W, Washenik K, Callender V, et al. A Phase III, Multicenter, Parallel-Design Clinical Trial to Compare the Efficacy and Safety of 5% Minoxidil Foam Versus Vehicle in Women With Female Pattern Hair Loss. J Drugs Dermatol 2016;15(7):874-81.
  • Referans31 Ramos PM, Sinclair RD, Kasprzak M, Miot HA. Minoxidil 1 mg oral versus minoxidil 5% topical solution for the treatment of female-pattern hair loss: A randomized clinical trial. J Am Acad Dermatol 2020;82(1):252-253.
  • Referans32 Kaufman KD, Olsen EA, Whiting D, et al. Finasteride in the treatment of men with androgenetic alopecia. Finasteride Male Pattern Hair Loss Study Group. J Am Acad Dermatol 1998;39:578-89.
  • Referans33 Price VH, Roberts JL, Hordinsky M, et al. Lack of efficacy of finasteride in postmenopausal women with androgenetic alopecia. J Am Acad Dermatol 2000;43:768-76.
  • Referans34 Yeon JH, Jung JY, Choi JW, et al. 5 mg/day finasteride treatment for normoandrogenic Asian women with female pattern hair loss. J Eur Acad Dermatol Venereol 2011;25(2):211-4.
  • Referans35 Trüeb RM; Swiss Trichology Study Group. Finasteride treatment of patterned hair loss in normoandrogenic postmenopausal women. Dermatology 2004;209(3):202-7.
  • Referans36 Mella JM, Perret MC, Manzotti M, Catalano HN, Guyatt G. Efficacy and safety of finasteride therapy for androgenetic alopecia: a systematic review. Arch Dermatol 2010;146(10):1141-50.
  • Referans37 Irwig MS, Kolukula S. Persistent sexual side effects of finasteride for male pattern hair loss. J Sex Med 2011;8(6):1747-53.
  • Referans38 Rahimi-Ardabili B, Pourandarjani R, Habibollahi P, Mualeki A. Finasteride induced depression: a prospective study. BMC Clin Pharmacol 2006;6:7.
  • Referans39 Klein EA, Tangen CM, Goodman PJ, Lippman SM, Thompson IM. Assessing benefit and risk in the prevention of prostate cancer: the prostate cancer prevention trial revisited. J Clin Oncol 2005;23(30):7460-6.
  • Referans40 Kjærulff TM, Ersbøll AK, Green A, et al. Finasteride Use and Risk of Male Breast Cancer: A Case-Control Study Using Individual-Level Registry Data from Denmark, Finland, and Sweden. Cancer Epidemiol Biomarkers Prev 2019;28(5):980-986.
  • Referans41 Lehrer S. Finasteride for postmenopausal breast cancer prevention. Eur J Cancer Prev 2015;24(5):456-7.
  • Referans42 Hajheydari Z, Akbari J, Saeedi M, Shokoohi L. Comparing the therapeutic effects of finasteride gel and tablet in treatment of the androgenetic alopecia. Indian J Dermatol Venereol Leprol 2009;75(1):47-51.
  • Referans43 Olsen EA, Hordinsky M, Whiting D, et al; Dutasteride Alopecia Research Team. The importance of dual 5alpha-reductase inhibition in the treatment of male pattern hair loss: results of a randomized placebo-controlled study of dutasteride versus finasteride. J Am Acad Dermatol 2006;55(6):1014-23.
  • Referans44 Eun HC, Kwon OS, Yeon JH, et al. Efficacy, safety, and tolerability of dutasteride 0.5 mg once daily in male patients with male pattern hair loss: a randomized, double-blind, placebo-controlled, phase III study. J Am Acad Dermatol 2010;63(2):252-8.
  • Referans45 Olszewska M, Rudnicka L. Effective treatment of female androgenic alopecia with dutasteride. J Drugs Dermatol 2005;4(5):637-40.
  • Referans46 Rathnayake D, Sinclair R. Innovative use of spironolactone as an antiandrogen in the treatment of female pattern hair loss. Dermatol Clin 2010;28(3):611-8.
  • Referans47 Famenini S, Slaught C, Duan L, Goh C. Demographics of women with female pattern hair loss and the effectiveness of spironolactone therapy. J Am Acad Dermatol 2015;73(4):705-6.
  • Referans48 Yazdabadi A, Green J, Sinclair R. Successful treatment of female-pattern hair loss with spironolactone in a 9-year-old girl. Australas J Dermatol 2009;50(2):113-4.
  • Referans49 Camacho-Martínez FM. Hair loss in women. Semin Cutan Med Surg 2009;28(1):19-32.
  • Referans50 Vexiau P, Chaspoux C, Boudou P, et al. Effects of minoxidil 2% vs. cyproterone acetate treatment on female androgenetic alopecia: a controlled, 12-month randomized trial. Br J Dermatol 2002;146(6):992-9.
  • Referans51 Fabbrocini G, Cantelli M, Masarà A, et al. Female pattern hair loss: A clinical, pathophysiologic, and therapeutic review. Int J Womens Dermatol 2018;4(4):203-211.
  • Referans52 Paradisi R, Porcu E, Fabbri R, et al. Prospective cohort study on the effects and tolerability of flutamide in patients with female pattern hair loss. Ann Pharmacother 2011;45(4):469-75.
  • Referans53 Ocampo-Garza J, Griggs J, Tosti A. New drugs under investigation for the treatment of alopecias. Expert Opin Investig Drugs 2019;28(3):275-284.
  • Referans54 Sovak M, Seligson AL, Kucerova R, et al. Fluridil, a rationally designed topical agent for androgenetic alopecia: first clinical experience. Dermatol Surg 2002;28(8):678-85.
  • Referans55 Valente Duarte de Sousa IC, Tosti A. New investigational drugs for androgenetic alopecia. Expert Opin Investig Drugs 2013;22(5):573-89.
  • Referans 56 Blume-Peytavi U, Lönnfors S, Hillmann K, Garcia Bartels N. A randomized double-blind placebo-controlled pilot study to assess the efficacy of a 24-week topical treatment by latanoprost 0.1% on hair growth and pigmentation in healthy volunteers with androgenetic alopecia. J Am Acad Dermatol 2012;66(5):794-800.
  • Referans57 Emer JJ, Stevenson ML, Markowitz O. Novel treatment of female-pattern androgenetic alopecia with injected bimatoprost 0.03% solution. J Drugs Dermatol 2011;10(7):795-8.
  • Referans58 Piérard-Franchimont C, De Doncker P, Cauwenbergh G, Piérard GE. Ketoconazole shampoo: effect of long-term use in androgenic alopecia. Dermatology 1998;196(4):474-7.
  • Referans59 Fischer TW, Trüeb RM, Hänggi G, Innocenti M, Elsner P. Topical melatonin for treatment of androgenetic alopecia. Int J Trichology 2012;4(4):236-45.
  • Referans60 Jo SJ, Shin H, Park YW, et al. Topical valproic acid increases the hair count in male patients with androgenetic alopecia: a randomized, comparative, clinical feasibility study using phototrichogram analysis. J Dermatol 2014;41(4):285-91.
  • Referans61 Zimber MP, Ziering C, Zeigler F, et al. Hair regrowth following a Wnt- and follistatin containing treatment: safety and efficacy in a first-in-man phase 1 clinical trial. J Drugs Dermatol 2011;10(11):1308-12.
  • Referans62 Harel S, Higgins CA, Cerise JE, et al. Pharmacologic inhibition of JAK-STAT signaling promotes hair growth. Sci Adv 2015;1(9):e1500973.
  • Referans63 Jimenez JJ, Wikramanayake TC, Bergfeld W, et al. 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 2014;15(2):115-27.
  • Referans64 Kelly Y, Blanco A, Tosti A. Androgenetic Alopecia: An Update of Treatment Options. Drugs 2016;76(14):1349-64.
  • Referans65 Lee GY, Lee SJ, Kim WS. The effect of a 1550 nm fractional erbium-glass laser in female pattern hair loss. J Eur Acad Dermatol Venereol 2011 Dec;25(12):1450-4.
  • Referans66 Fertig RM, Gamret AC, Cervantes J, Tosti A. Microneedling for the treatment of hair loss? J Eur Acad Dermatol Venereol 2018;32(4):564-569.
  • Referans67 Mysore V. Mesotherapy in management of hairloss - Is it of any use? Int J Trichology 2010;2(1):45-6.
  • Referans68 Alves R, Grimalt R. Randomized placebo-controlled, double-blind, half-head study to assess the efficacy of platelet-rich plasma on the treatment of androgenetic alopecia. Dermatol Surg 2016;42(4):491-7.
  • Referans69 Mapar MA, Shahriari S, Haghighizadeh MH. Efficacy of platelet-rich plasma in the treatment of androgenetic (male-patterned) alopecia: A pilot randomized controlled trial. J Cosmet Laser Ther 2016;18(8):452-455.
  • Referans70 Rose PT. The latest innovations in hair transplantation. Facial Plast Surg 2011;27(4):366-77.
  • Referans71 Harel S, Higgins CA, Cerise JE, et al. Pharmacologic inhibition of JAK-STAT signaling promotes hair growth. Sci Adv 2015;1(9):e1500973.
  • Referans72 Shin H, Ryu HH, Kwon O, Park BS, Jo SJ. Clinical use of conditioned media of adipose tissue-derived stem cells in female pattern hair loss: a retrospective case series study. Int J Dermatol 2015;54(6):730-5.
  • Referans73 Leavitt M, Perez-Meza D, Rao NA, et al. Effects of finasteride (1 mg) on hair transplant. Dermatol Surg 2005;31(10):1268-76, discussion 1276.
  • Referans74 Epstein JS. The treatment of female pattern hair loss and other applications of surgical hair restoration in women. Facial Plast Surg Clin North Am 2004;12(2):241-7.
  • Referans75 Khandpur S, Suman M, Reddy BS. Comparative efficacy of various treatment regimens for androgenetic alopecia in men. J Dermatol 2002;29(8):489-98.
Primary Language tr
Subjects Dermatology
Journal Section Collection
Authors

Orcid: 0000-0002-7129-4339
Author: Gökhan ŞAHİN (Primary Author)
Institution: Ondokuz Mayıs Üniversitesi Tıp Fakültesi, Dermatoloji Anabilim Dalı, Samsun.
Country: Turkey


Orcid: 0000-0003-0958-2767
Author: Hilal ÖZDEMİR
Institution: Ondokuz Mayıs Üniversitesi Tıp Fakültesi, Dermatoloji Anabilim Dalı, Samsun.
Country: Turkey


Orcid: 0000-0002-5176-249X
Author: Fatma AYDIN
Institution: Ondokuz Mayıs Üniversitesi Tıp Fakültesi, Dermatoloji Anabilim Dalı, Samsun.
Country: Turkey


Dates

Publication Date : April 1, 2021

Bibtex @review { uutfd857676, journal = {Uludağ Üniversitesi Tıp Fakültesi Dergisi}, issn = {1300-414X}, eissn = {2645-9027}, address = {Uludağ Üniversitesi Tıp Fakültesi Dekanlığı, Görükle Kampüsü 16059, Nilüfer, BURSA}, publisher = {Bursa Uludağ University}, year = {2021}, volume = {47}, pages = {141 - 149}, doi = {10.32708/uutfd.857676}, title = {Androgenetik Alopesi}, key = {cite}, author = {Şahin, Gökhan and Özdemir, Hilal and Aydın, Fatma} }
APA Şahin, G , Özdemir, H , Aydın, F . (2021). Androgenetik Alopesi . Uludağ Üniversitesi Tıp Fakültesi Dergisi , 47 (1) , 141-149 . DOI: 10.32708/uutfd.857676
MLA Şahin, G , Özdemir, H , Aydın, F . "Androgenetik Alopesi" . Uludağ Üniversitesi Tıp Fakültesi Dergisi 47 (2021 ): 141-149 <https://dergipark.org.tr/en/pub/uutfd/issue/61997/857676>
Chicago Şahin, G , Özdemir, H , Aydın, F . "Androgenetik Alopesi". Uludağ Üniversitesi Tıp Fakültesi Dergisi 47 (2021 ): 141-149
RIS TY - JOUR T1 - Androgenetik Alopesi AU - Gökhan Şahin , Hilal Özdemir , Fatma Aydın Y1 - 2021 PY - 2021 N1 - doi: 10.32708/uutfd.857676 DO - 10.32708/uutfd.857676 T2 - Uludağ Üniversitesi Tıp Fakültesi Dergisi JF - Journal JO - JOR SP - 141 EP - 149 VL - 47 IS - 1 SN - 1300-414X-2645-9027 M3 - doi: 10.32708/uutfd.857676 UR - https://doi.org/10.32708/uutfd.857676 Y2 - 2021 ER -
EndNote %0 Uludağ Üniversitesi Tıp Fakültesi Dergisi Androgenetik Alopesi %A Gökhan Şahin , Hilal Özdemir , Fatma Aydın %T Androgenetik Alopesi %D 2021 %J Uludağ Üniversitesi Tıp Fakültesi Dergisi %P 1300-414X-2645-9027 %V 47 %N 1 %R doi: 10.32708/uutfd.857676 %U 10.32708/uutfd.857676
ISNAD Şahin, Gökhan , Özdemir, Hilal , Aydın, Fatma . "Androgenetik Alopesi". Uludağ Üniversitesi Tıp Fakültesi Dergisi 47 / 1 (April 2021): 141-149 . https://doi.org/10.32708/uutfd.857676
AMA Şahin G , Özdemir H , Aydın F . Androgenetik Alopesi. Uludağ Tıp Derg. 2021; 47(1): 141-149.
Vancouver Şahin G , Özdemir H , Aydın F . Androgenetik Alopesi. Uludağ Üniversitesi Tıp Fakültesi Dergisi. 2021; 47(1): 141-149.
IEEE G. Şahin , H. Özdemir and F. Aydın , "Androgenetik Alopesi", Uludağ Üniversitesi Tıp Fakültesi Dergisi, vol. 47, no. 1, pp. 141-149, Apr. 2021, doi:10.32708/uutfd.857676