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Acupuncture is the practice of applying needles to target specific pressures points in the body. Since originating in China, acupuncture has been practiced for thousands of years to treat numerous conditions including chronic pain and mood disorders. Alopecia is a common dermatologic condition associated with psychological distress and decreased quality of life. Although it remains underexplored in western medicine, recent evidence suggests that acupuncture may be efficacious in the treatment of alopecia. In this review, we discuss the available evidence describing the efficacy of acupuncture or moxibustion alone (ACU) and in combination with other traditional and alternative interventions (ACU + TRAD) for hair loss. Additionally, the proposed physiologic mechanisms, targeted acupuncture points, and the benefits and barriers to treatment will be further described. An exploratory search using PubMed, EMBASE and Scopus databases was performed for studies that evaluated the effect of acupuncture and moxibustion on alopecia. In these studies, both ACU and ACU + TRAD were efficacious for numerous etiologies of hair loss including alopecia areata, androgenetic alopecia, and seborrheic alopecia. Given their ability to modulate the immune system, as well as neuronal networks associated with emotional cognition, the most frequently targeted acupoints were ST 36, GV 20, and LR 3. The proposed mechanistic effect is dependent upon disease etiology and is theorized to be twofold: reduction of inflammation and decrease in testosterone levels. The limited side effect profile of acupuncture makes it an advantageous treatment option, however, factors including cost, time, limited access, and aversion to needles may serve as barriers to treatment.

This article presents a short summary of our current knowledge of cicatricial alopecia disease pathogenesis and the hypothetical disease mechanisms that may be involved in scarring alopecia development. Several forms of scarring alopecia likely involve targeted cytotoxic action against hair follicle cells mediated by a folliculocentric inflammation. However, the specific nature of the inflammatory interference in hair follicle growth is open to question. A popular hypothesis of lymphocyte-mediated scarring alopecia development involves autoimmune targeting of hair follicle–specific self-antigens, although there is no direct evidence in support of such a view. Alternative hypotheses focus on defects in sebaceous gland function, destruction of hair follicle stem cells, and interference in the communication between hair follicle mesenchyme and epithelium. Many questions arise from these hypotheses, and addressing them with a systematic research approach may enable significant advances in understanding cicatricial alopecia etiology. [ABSTRACT FROM AUTHOR]

Introduction. The understanding of the etiology and pathogenesis of androgenetic alopecia (AGA) has formed modern therapeutic strategies for the treatment of this trichopathy. However, the significant prevalence of this pathology, limited therapeutic success, and differences in the response to standard therapy in male and female patients determine the interest in a more in-depth study and search for new links in the etiopathogenesis of AGA. Goal. Using a review of scientific publications in recent years on AGA in male and female patients, analyze and formulate the modern concept of the etiology and pathogenesis of this disease in order to further search for new treatment methods. Materials and methods. We searched and analyzed publications for the query «androgenetic alopecia, etiology, pathogenesis», the search was carried out using Google Scholar, considered articles that have been published since 2016. Results. The effect of androgens on hair follicles in androgen-dependent areas of the scalp under conditions of genetic predisposition is considered as the most studied and proven concept of AGA etiopathogenesis. However, recent studies have also revealed nonandrogenic cofactors, among which the pathological cascade of events «oxidative stress-microinflammation-fibrosis», which are determined at different stages of disease progression, is potentially interesting for further study. Knowledge of the phenomenon of apoptosis as an important factor in the disturbance of the dynamics of the hair cycle has been expanded. The management of perifollicular microinflammation and apoptosis can allow the control of the processes of sequential hair miniaturization and give a pronounced clinical result during the treatment of AGA. Thus, the nonandrogenic mechanisms of AGA pathobiology require further study. Conclusions. New data on the causes and mechanism of development of androgenetic alopecia in women and men have expanded our understanding of these processes. The need to supplement knowledge on this topic causes significant scientific interest and is very relevant, since they can be used to improve treatment for use in practical medicine.

Tricho–dento–osseous (TDO) syndrome is a multisystem congenital disorder that is known by bone, skin, and hair abnormalities. Primitive studies show different varieties of manifestations related to this disorder, which involve sclerotic bones, nail involvement, enamel hypoplasia, mandibular prognathism, and taurodontism. Although exploring different TDO cases revealed genetic mutations in all of them, they have many variations in phenotypic view. In this study, we report a case whose primary diagnosis was alopecia and came for extraction of her third molars, but after clinical and radiographic examination, it was found that the cause of her disease was something different. [ABSTRACT FROM AUTHOR]

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Context: Although etiopathogenesis of frontal fibrosing alopecia (FFA) is not fully discovered, it seems that hormonal factors play a role. Aims: The aim of this study was to investigate the serum level of sex hormones in patients with FFA compared to a control group. Settings and Design: This was a case-control study. Subjects and Methods: All patients who referred to the Dermatology Clinic of Faghihi Hospital, Shiraz University of Medical Sciences, between 2013 and 2018 and were pathologically and clinically diagnosed with FFA were considered as the case group. The control group was selected from community people who did not have alopecia, and each was matched with its counterpart in the case group in terms of gender, age, and menstrual status. Both the groups were evaluated for serum level of sex hormones. Statistical Analysis Used: SPSS software version 23 was used in this study. Results: Of 20 patients, who were all female, 8 were postmenopausal and 12 were cyclic. There was no significant difference between sex hormone levels of the case and control groups regardless of their menstrual statuses. Similarly, there was no significant difference between hormonal levels in postmenopausal women of both the groups. However, follicle-stimulating hormone (FSH) was significantly lower in the case group cyclic women. Moreover, postmenopausal patients with premenopausal onset of FFA had lower levels of FSH and luteinizing hormone than those with postmenopausal onset. Free testosterone correlated inversely with duration of FFA. Conclusions: It seems that the pathogenesis of FFA is not associated directly with serum concentrations of sex hormones. Therefore, future studies are recommended to investigate possible tissue mechanisms of hormonal factors involved in its pathogenesis. [ABSTRACT FROM AUTHOR]

Frontal fibrosing alopecia (FFA) is a primary patterned cicatricial alopecia with a complicated pathogenesis yet to be fully understood. FFA appears to be increasing in incidence worldwide, especially in the last decade. In order to consider current treatment options, we reviewed current evidence for its pathogenesis comprising immune‐mediated, genetic, hormonal and environmental factors. Th1‐mediated inflammation with collapse of hair follicle immune privilege and bulge epithelial stem cell destruction, peroxisome proliferator‐activated receptor gamma (PPAR‐γ) depletion and epithelial–mesenchymal transition are key events leading to permanent hair follicle destruction in FFA. Although the vast majority of cases are sporadic, familial reports of FFA implicate genetic or epigenetic mechanisms in its pathogenesis. The frequent onset of FFA in post‐menopausal women, similar patterning and co‐existence with female pattern hair loss, together with a reportedly good response to 5α‐reductase inhibitors suggest a role for sex steroid hormones. The reported increasing incidence invites speculation for, yet unproven, environmental triggers such as sun exposure and topical allergens. More robust research into this unique entity is required to help understand the complexity of the pathogenesis of FFA in order to find satisfactory therapeutic targets for this often distressing condition. [ABSTRACT FROM AUTHOR]

Acupuncture is the practice of applying needles to target specific pressures points in the body. Since originating in China, acupuncture has been practiced for thousands of years to treat numerous conditions including chronic pain and mood disorders. Alopecia is a common dermatologic condition associated with psychological distress and decreased quality of life. Although it remains underexplored in western medicine, recent evidence suggests that acupuncture may be efficacious in the treatment of alopecia. In this review, we discuss the available evidence describing the efficacy of acupuncture or moxibustion alone (ACU) and in combination with other traditional and alternative interventions (ACU + TRAD) for hair loss. Additionally, the proposed physiologic mechanisms, targeted acupuncture points, and the benefits and barriers to treatment will be further described. An exploratory search using PubMed, EMBASE and Scopus databases was performed for studies that evaluated the effect of acupuncture and moxibustion on alopecia. In these studies, both ACU and ACU + TRAD were efficacious for numerous etiologies of hair loss including alopecia areata, androgenetic alopecia, and seborrheic alopecia. Given their ability to modulate the immune system, as well as neuronal networks associated with emotional cognition, the most frequently targeted acupoints were ST 36, GV 20, and LR 3. The proposed mechanistic effect is dependent upon disease etiology and is theorized to be twofold: reduction of inflammation and decrease in testosterone levels. The limited side effect profile of acupuncture makes it an advantageous treatment option, however, factors including cost, time, limited access, and aversion to needles may serve as barriers to treatment., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Li, Andrews, Hilts and Valdebran.)

Androgenetic alopecia is the most common form of progressive hair loss in humans. A genetic predisposition and hormonal status are considered as major risk factors for this condition. Several recent advances in molecular biology and genetics have increased our understanding of the mechanisms of hair loss in androgenetic alopecia. We review these advances and examine the trends in the genetic and molecular aspects of androgenetic alopecia. [ABSTRACT FROM AUTHOR]

Cicatricial alopecia is a rare, clinically diversified set of disorders causing permanent and irreversible hair loss, which often results in serious discomfort and patient’s mental problems.Clinically, this form of irreversible hair loss is characterized by visible loss of hair follicle openings in the bald spots. Histologically, it consists in destroying a hair follicle and replacing it with fibrocartilage. Such disorders are perceived as primary if a hair follicle itself is the target of the disease process and secondary if hair follicles are damaged incidentally in the context of more general tissue damage (e.g. deep skin infections, thermal burns, trauma or ionizing radiation).In this article we tried to summarize the knowledge on possible pathogenic mechanisms of cicatricial alopecia. The presented factors usually overlap and affect prognosis of particular patients. Their profound understanding may enable further research on the treatment methods of this challenging disease unit. [ABSTRACT FROM AUTHOR]

Until recently, there was only circumstantial evidence to support the autoimmune and genetic etiology of alopecia areata. The advent of HLA stereotyping and linkage analysis has revealed an increase in specific HLA alleles in patients with alopecia areata and controls. Even more current is the detection of autoantibodies to the hair follicle in the sera from humans with alopecia areata and laboratory animal models of the disease. Recent experiments suggest that there may even be specific HLA class II alleles that play a protective role against the development of alopecia areata. Herein, the circumstantial data and the confirmed linkage data to support a genetic/autoimmune interplay theory of alopecia areata are discussed. The temporal advancements of research in the area of the HLA typing are reviewed for the disease. [ABSTRACT FROM AUTHOR]

Linked Article:Aldoori et al. Br J Dermatol 2016; 175:762–767. [ABSTRACT FROM AUTHOR]