Surgical and conservative methods of treatment of androgenic alopecia (literature review)
https://doi.org/10.52581/1814-1471/91/05
Abstract
Objective. Androgenic alopecia is the most common form of baldness in both men and women. This pathology is chronically progressive and is present in millions of people around the world. To date, it is considered proven that alopecia is associated with androgen exposure.
Purpose of the study: to compare the existing methods of treatment of androgenic alopecia according to the literature.
Material and methods. The search for research results by keywords was carried out in open databases. A total of 127 scientific sources have been analyzed, which consider the etiology, surgical approaches and methods of treatment of androgenic alopecia.
The results. The etiology, pathogenesis, diagnosis and conservative methods of treatment of androgenic alopecia according to the world literature are considered. Special attention is paid to the study of sources devoted to various methods of surgical treatment of androgenic alopecia.
Conclusion. Despite the fact that complex treatment of androgenic alopecia is currently used, autotransplantation of hair has been and remains the gold standard of treatment. Surgical hair restoration in alopecia ensures high graft survival and satisfaction from its use. The integration of molecular biology, genetics, pharmacology and clinical research can lead to new discoveries in the understanding and treatment of androgenic alopecia and improve treatment outcomes.
About the Authors
R. A. PakhomovaRussian Federation
Regina A. Pakhomova, Dr. Med. sci., Associate Professor, head of the Department of Plastic Surgery
11, Volokolamskoe highway, Moscow, 125080
L. V. Kochetova
Russian Federation
Lyudmila V. Kochetova, Cand. Med. sci., Associate Professor, Professor of the Department of General Surgery named after Professor M.I. Gulman
1, Partizan Zheleznyak st., Krasnoyarsk, 660022
A. A. Kolesnik
Russian Federation
Anastasia A. Kolesnik, postgraduate student, the Department of Plastic Surgery
11, Volokolamskoe highway, Moscow, 125080
V. Ya. Kolesnik
Russian Federation
Vasiliy Ya. Kolesnik, postgraduate student, the Department of Plastic Surgery
11, Volokolamskoe highway, Moscow, 125080
References
1. Gadzhigoroeva A.G. Klinicheskaya trihologiya [Clinical trichology]. M.: GEOTAR-Media Publ., 2022. 264 p. (In Russ.).
2. Hoover E., Alhajj M., Flores J.L. Physiology, hair. Stat Pearls Publishing, Treasure Island (FL). 2023. Jul 30.
3. Aygner E.A. Vzaimosvyaz' patologiy volos s psihoemotsional'nymi rasstroystvami [Relationship between hair pathologies and psychoemotional disorders]. Nauchnyy aspect. 2023;20(11):2476-2480. (In Russ.).
4. Grymowicz M., Rudnicka E., Podfigurna A., Napierala P., Smolarczyk R., Smolarczyk K., Meczekalski B. Hormonal Effects on Hair Follicles. Int J Mol Sci. 2020 Jul;21(15):5342. DOI: 10.3390/ijms21155342
5. Wambier C.G., Vaño-Galván S., McCoy J., Gomez-Zubiaur A., Herrera S., et al. Androgenetic Alopecia Present in the Majority of Patients Hospitalized With COVID-19: The “Gabrin Sign”. J Am Acad Dermatol. 2020;83(2): 680-682. doi: 10.1016/j.jaad.2020.05.079
6. Kondrakhina I.N. Androgennaya alopetsiya u muzhchin: znacheniye geneticheskih, gormonal'nyh i metabolicheskih faktorov (prospektivnoye kogortnoye sravnitel'noye issledovaniye) [Androgenic alopecia in men: the significance of genetic, hormonal and metabolic factors (prospective cohort comparative study)]. Rossiyskiy zhurnal kozhnykh i venericheskikh bolezney – Russian Journal of Skin and Venereal Diseases. 2022;25(5):349-361. doi: 10.17816/dv112068 (In Russ.).
7. Neofitova E.A., Pushkina K.V., Neofitova N.N. Issledovaniye vliyaniya ekzogennyh faktorov na sostoyaniye i svoystva volos na golove cheloveka s ispol'zovaniyem razlichnyh metodov mikroskopii [Study of exogenous factors on the state and properties of hair on the human head by using various methods of microscopy]. Interaktivnaya nauka – Interactive Science. 2016;10:46-53. doi: 10.21661/r-115105 (In Russ.).
8. Tsimbalenko T.V., Gadzhigoroeva A.G. Trihoskopicheskiye priznaki pri androgeneticheskoy alopetsii [Trichoscopic signs in androgenetic alopecia]. Klinicheskaya dermatologiya i venerologiya – Russian Journal of Clinical Dermatology and Venerology. 2022;21(5):708-714. – doi: 10.17116/klinderma202221051708 (In Russ.).
9. Tamashunas N.L., Bergfeld W.F. Male and female pattern hair loss: treatable and worth treating. Cleve Clin J Med. 2021;88:173-82. doi: 10.3949/ccjm.88a.20014
10. Devjani S., Ezemma O., Kelley K.J., Stratton E., Senna M. Androgenetic alopecia: therapy update. Drugs. 2023;83:701-15. doi: 10.1007/s40265-023-01880-x
11. Shatokhina E.A., Klyushina O.Yu., Mayransaeva S.R. Minoksidil: effektivnost' i perspektivy ispol'zovaniya v lechenii androgennoy alopetsii [Minoxidil: effectiveness and prospects of use in the treatment of androgenic alopecia]. Farmateka. 2023;30(13):77-84. doi: 10.18565/pharmateca.2023.13.77-84 (In Russ.).
12. Tsimbalenko T.V., Gadzhigoroeva A.G., Potekaev N.N., Tereshchenko G.P., Mikhalchik E.V. Prognosticheskiye faktory lecheniya androgennoy alopetsii minoksidilom [Prognostic factors in the treatment of androgenetic alopecia with minoxidil]. Meditsinskiy Sovet – Medical Council. 2023;2:89-96. doi: 10.21518/ms2023-007 (In Russ.).
13. Bao L., Gong L., Guo M., Liu T., Shi A., Zong H., Xu X., Chen H., Gao X., Li Y. Randomized trial of electrodynamic microneedle combined with 5% minoxidil topical solution for the treatment of Chinese male Androgenetic alopecia. J Cosmet Laser Ther. 2020 Jan;22(1):1-7. doi: 10.1080/14764172.2017.1376094
14. Ponomareva M.A., Podolsky M.S., Krylova I.N. Sistemnyye pobochnyye effekty minoksidila pri mestnom primenenii [Systemic side effects of minoxidil with local application]. Eksperimental'naya i klinicheskaya farmakoogiya – Experimental and Clinical Pharmacology. 2023;86(4):44-48. doi: 10.30906/0869-2092-2023-86-4-44-48 (In Russ.).
15. Yu L., Moorthy S., Li X., Peng L., Zhang Z., Shen L., Han Y., Huang X. Assessing the efficacy and quality of Life improvements of botulinum toxin type a with topical minoxidil versus topical minoxidil in male androgenetic alopecia: a randomized controlled trial. Arch Dermatol Res. 2024 Aug 17;316(8):532. doi: 10.1007/s00403-024-03258-9
16. Piraccini B.M., Blume-Peytavi U., Scarci F. et al. Efficacy and safety of topical finasteride spray solution for male androgenetic alopecia: a phase III, randomized, controlled clinical trial. J Eur Acad Dermatol Venereol. 2022;36:286-94. doi: 10.1111/jdv.17738
17. Galushkin A.A., Likhikh D.G., Kogan M.I. Postfinasteridnyy sindrom: nashi predstavleniya segodnya [Postfinasteride syndrome: our current knowledge]. Vestnik urologii – Urology Herald. 2020;8(2):50–54. doi: 10.21886/2308-6424-2020-8-2-50-54 (In Russ.).
18. Morozov A.M., Dadabaev V.K., Kurkova V.V. Effektivnost' primeneniya plazmoterapii pri razlichnyh nozologiyah [Effectiveness of plasmotherapy in various nosologies]. Vrach – The Doctor. 2023;34(7):37-40. doi: 10.29296/25877305-2023-07-07 (In Russ.).
19. Gentile P., Garcovich S. Systematic Review of Platelet-Rich Plasma Use in Androgenetic Alopecia Compared with Minoxidil, Finasteride, and Adult Stem Cell-Based Therapy. Int J Mol Sci. 2020 Apr;21(8):2702. doi: 10.3390/ijms21082702
20. Olisova O.Yu., Kochergin N.G., Vertieva E.Yu. Androgennaya alopetsiya: patogeneticheskiye mehanizmy i podhody k lecheniyu [Androgenetic alopecia: pathogenetic mechanisms and approaches to treatment]. Kosmetologiya – Cosmetology. 2013;3:53-57 (In Russ.).
21. Song D., Pan S., Jin W., Wu R., Zhao T., Jiang J., Zhu M. Minoxidil delivered via a stem cell membrane delivery controlled release system promotes hair growth in C57BL/6J mice. Front Bioeng Biotechnol. 2024 Jan 8; 11:1331754. doi: 10.3389/fbioe.2023.1331754
22. Krefft-Trzciniecka K., Piętowska Z., Nowicka D., Szepietowski J.C. Human stem cell use in androgenetic alopecia: a systematic review. Cells. 2023;12:951. doi: 10.3390/cells12060951
23. Vasiliev-Stupalsky E.A. Kompleksnaya korrektsiya androgeneticheskoy alopetsii [Complex correction of androgenic alopecia]. Farmateka. 2017;s4:36-43 (In Russ.).
24. Liu D., Xu Q., Meng X., Liu X., Liu J. Status of research on the development and regeneration of hair follicles. Int J Med Sci. 2024 Jan 1;21(1):80-94. doi: 10.7150/ijms.88508
25. Bajoria P.S., Dave P., Rohit R., et al. Comparing Current Therapeutic Modalities of Androgenic Alopecia: A Literature Review of Clinical Trials. Cureus. 2023;15(7):e42768. doi: 10.7759/cureus.42768
26. Tsilosani A.T. Sovremennye hirurgicheskiye metody vosstanovleniya volos [Modern surgical methods of hair restoration]. Trikhologiya – Trichology. 2018;3-4:94-102 (In Russ.).
27. Bedretdinova A.A. Transplantatsiya volos kak variant resheniya alopetsii volos [Hair transplantation as a solution to hair alopecia]. Tendentsii razvitiya nauki i obrazovaniya. 2022;85(2):39-42. doi: 10.18411/trnio-05-2022-60 (In Russ.).
28. Rousso D.E., Kim S.W. A review of medical and surgical treatment options for androgenetic alopecia. JAMA Facial Plast Surg. 2014 Nov-Dec; 16(6): 444-50. doi: 10.1001/jamafacial.2014.316
29. Jimenez F., Alam М., Vogel J.E., Avram M. Hair transplantation: Basic overview. J Am Acad Dermatol. 2021;4(85):803-814. doi: 10.1016/j.jaad.2021.03.124
30. Pototskaya L.A. Sovremennye predstavleniya o transplantatsii volosyanyh follikulov. Organizatsiya meditsinskoy pomoshchi i zdorov'ye naseleniya v sovremennyh usloviyah: Sbornik nauchnyh trudov [Current concepts of hair follicle transplantation. Organization of medical care and population health in modern conditions: Collection of scientific papers]. Tver, Association of young scientists of the Tver Region, 2022. P. 62–75. (In Russ.).
31. Avram M.R. Hair Transplantation. Cutis. 2012 Dec; 90(6): 317-20.
32. Kerure A.S., Deshmukh N., Agrawal S. Challenges in hair transplantation practice as a beginner. Indian J Dermatol Venereol Leprol. 2021;2(87):303-305. doi: 10.25259/IJDVL_28120.-Text
33. Kerure A.S., Deshmukh N., Agrawal S., Patwardhan N.G. Follicular Unit Extraction [FUE] – One Procedure, Many Uses. Indian Dermatol Online J. 2021;3(12):381-388. doi: 10.4103/idoj.IDOJ_522_20.-Text
34. Fomina M.S., Radul E.V. Transplantatsiya volos. Iskusstvo FUE [Hair transplantation. The art of FUE]. In: Universitetskaya nauka v reshenii zadach natsional'noy bezopasnosti i tehnologicheskogo suvereniteta: materialy regional'noy (mezhvuzovskoy) studencheskoy nauchno-prakticheskoy konferentsii, posvyashchennoy 100-letiyu so dnya rozhdeniya S.I. Manyakina. Omsk, 2 noyabrya 2023 g. [University science in solving problems of national security and technological sovereignty: Proceedings of the regional (interuniversity) student scientific and practical conference dedicated to the 100th anniversary of the birth of S.I. Manyakin. Omsk, November 2, 2023]. Omsk, Omsk State Agrarian University named after P.A. Stolypin, 2023:380-387. (In Russ.).
35. Gupta A.K., Love R.P., Harris J.A. Old Friend or New Ally: A Comparison of Follicular Unit Transplantation and Follicular Unit Excision Methods in Hair Transplantation. Dermatol Surg. 2020;8(46):1078-1083.
36. Othman S., Glat P. Surgical Management for Hair Restoration: A Review of Contemporary Techniques. Aesthetic Plast Surg. 2023 Dec;47(6):2415-2424. doi: 10.1007/s00266-023-03391-2
37. Stoneburner J., Shauly O., Carey J., Patel K.M., Stevens W.G., Gould D.J. Contemporary Management of Alopecia: A Systematic Review and Meta-analysis for Surgeons. Aesthetic Plast Surg. 2020 Feb;44(1):97-113. doi: 10.1007/s00266-019-01529-9
38. Collins K., Avram M.R. Hair Transplantation and Follicular Unit Extraction. Dermatologic Clinics. 2021;39(3): 463-478. doi: 10.1016/j.det.2021.04.003
39. Memon R., Avram M. The pros and cons of follicular unit extraction (FUE) versus elliptical donor harvesting (FUT). Journal of Cosmetic and Laser Therapy. 2022; 24:6-8
40. Epstein G.K., Epstein J., Nikolic J. Follicular Unit Excision: Current Practice and Future Developments. Facial Plast Surg Clin North Am. 2020 May;28(2):169-176. doi: 10.1016/j.fsc.2020.01
41. Krishnamurthy R., Jaganathan B.K., Rangaswamy R., Jeganathan C. A Novel Method of Intraoperative Calculation in Follicular Unit Transplantation: 'The Sequential Strip and FUE Method'. Aesthetic Plast Surg. 2024 Feb; 48(3): 297-303. doi: 10.1007/s00266-023-03300-7
42. Avram M.R., Watkins S. Robotic Hair Transplantation. Facial Plast Surg Clin North Am. 2020 May;28(2): 189-196. doi: 10.1016/j.fsc.2020.01.011
43. Kim S.J., Kim M.J., Lee Y.J., Lee J.C., Kim J.H., Kim D.H., Do Y.H., Choi J.W., Chung S.I., Do B.R. Innovative method of alopecia treatment by autologous adipose-derived SVF. BMC. 2021 Aug 28;12(1):486. doi: 10.1186/s13287-021-02557-6
44. Garg A.K., Garg S. Complications of Hair Transplant Procedures. Causes and Management. Indian J Plast Surg. 2021 Dec 31;54(4):477-482. doi: 10.1055/s-0041-1739255
45. Nadimi S. Complications with Hair Transplantation. Facial Plast Surg Clin North Am. 2020 May;28(2):225-235. doi: 10.1016/j.fsc.2020.01.003
Review
For citations:
Pakhomova R.A., Kochetova L.V., Kolesnik A.A., Kolesnik V.Ya. Surgical and conservative methods of treatment of androgenic alopecia (literature review). Issues of Reconstructive and Plastic Surgery. 2024;27(4):42-52. (In Russ.) https://doi.org/10.52581/1814-1471/91/05