TITLE:
Pathophysiology of Androgenetic Alopecia and Implications for Treatment: An Overview of Current Literature
AUTHORS:
Neha Iska, Esther Nwozo, Hafsa Hassan, Navya Peddireddy, Alejandra Sataray-Rodriguez, Kelly Frasier
KEYWORDS:
Androgenetic Alopecia, Hair Follicle Miniaturization, Dihydrotestosterone, Androgen Receptor, Sebaceous Glands, Inflammation, Platelet-Rich Plasma, Stem Cell Therapy
JOURNAL NAME:
Journal of Biosciences and Medicines,
Vol.14 No.3,
March
27,
2026
ABSTRACT: Androgenetic alopecia (AGA) is the most common form of hair loss, affecting both men and women through a progressive follicular miniaturization. While historically considered a non-inflammatory and cosmetic condition, growing evidence reveals a multifactorial pathogenesis involving genetic predisposition, hormonal dysregulation, sebaceous gland alterations, lipidomic changes, and localized inflammation. Androgens, particularly dihydrotestosterone (DHT), play a central role in AGA by inducing follicular miniaturization, promoting perifollicular fibrosis, and altering sebaceous gland structure and function. Genetic variants, including polymorphisms in the androgen receptor (AR) gene, influence individual susceptibility and therapeutic response. Additionally, disruptions in lipid metabolism and immune privilege contribute to the inflammatory microenvironment and follicular degeneration observed in AGA-affected scalps. Current management strategies include topical minoxidil, 5α-reductase inhibitors like finasteride and dutasteride, and adjunctive therapies targeting inflammation and seborrheic conditions. Emerging treatments, however, offer regenerative potential by restoring follicular cycling, improving vascularization, and modulating inflammatory pathways. This review synthesizes current understanding of AGA pathophysiology and explores evolving treatment modalities aimed at halting disease progression, improving hair density, and restoring scalp homeostasis. By addressing the condition as both a dermatologic and systemic phenomenon, future therapies may expand beyond cosmetic outcomes to more holistic and personalized care approaches.