Tom 1, Nr 4 (2023)
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Opublikowany online: 2024-03-14
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Eksport do Mediów Społecznościowych

Eksport do Mediów Społecznościowych

Diagnostyka i leczenie łysienia androgenowego — przegląd najnowszych metod postępowania

Karol Śliwa1, Daria Synia1, Waldemar Placek2, Agnieszka Owczarczyk-Saczonek2
Dermatologia w Praktyce Klinicznej 2023;1(4):123-137.

Streszczenie

Łysienie androgenowe jest powszechnym problemem we współczesnej dermatologii. Dotyczy ono także wielu młodych pacjentów, zwłaszcza mężczyzn, wywołując u nich większą skłonność do stanów lękowych i depresji, których przyczyną może być zaburzony obraz własnego ciała. Te problemy behawioralne mogą występować również u osób starszych. Dlatego istnieje oczywista potrzeba dalszego rozwoju w dziedzinie dermatologii, który powinien uwzględniać także poszukiwanie nowych sposobów leczenia. U mężczyzn rozpoznanie łysienia androgenowego jest dość proste, a leczenie zwykle polega na zastosowaniu minoksydylu i/lub finasterydu. U niektórych pacjentów lepsze wyniki może dać zmiana leczenia z minoksydylu stosowanego miejscowo na postać podawaną ogólnoustrojowo, a także z finasterydu na dutasteryd. Ogólnie rzecz biorąc, łysienie typu męskiego (MPHL, male pattern hair loss) jest chorobą przewlekłą, która może wymagać długotrwałego leczenia farmakologicznego, często o nieograniczonym czasie trwania. Dlatego też, biorąc pod uwagę obawy pacjentów związane z ogólnoustrojowym stosowaniem inhibitorów 5α-reduktazy, a także ograniczenia obecnego leczenia, niektórzy specjaliści stosują miejscowo finasteryd, dutasteryd z użyciem mezoterapii i wiele innych dodatkowych metod. Łysienie androgenowe kobiet (FPHL, female pattern hair loss) to w większości przypadków także choroba przewlekła, co szczególnie u młodszych kobiet wymaga wykonywania wielu badań laboratoryjnych w poszukiwaniu potencjalnego hiperandrogenizmu. Należy pamiętać, że szczególnie u kobiet schorzenie może być wywołane wieloma bodźcami środowiskowymi i innymi dodatkowymi czynnikami, dlatego w przypadku niektórych pacjentów uwzględnienie tego może być pomocne.

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Referencje

  1. Gupta AK, Talukder M, Venkataraman M, et al. Minoxidil: a comprehensive review. J Dermatolog Treat. 2022; 33(4): 1896–1906.
  2. Nestor MS, Ablon G, Gade A, et al. Treatment options for androgenetic alopecia: Efficacy, side effects, compliance, financial considerations, and ethics. J Cosmet Dermatol. 2021; 20(12): 3759–3781.
  3. Rudnicka L, Kaczorowska A, Waśkiel-Burnat A, et al. Treatment of diseases associated with cicatricial alopecia. Dermatology Review. 2022; 109(1): 32–42.
  4. Bhat YJ, Saqib NU, Latif I, et al. Female pattern hair loss-an update. Indian Dermatol Online J. 2020; 11(4): 493–501.
  5. Starace M, Orlando G, Alessandrini A, et al. Female androgenetic alopecia: an update on diagnosis and management. Am J Clin Dermatol. 2020; 21(1): 69–84.
  6. Liu Q, Tang Y, Huang Y, et al. Insights into male androgenetic alopecia using comparative transcriptome profiling: hypoxia-inducible factor-1 and Wnt/β-catenin signalling pathways. Br J Dermatol. 2022; 187(6): 936–947.
  7. Guarrera M, Rebora A. Kenogen in female androgenetic alopecia. A longitudinal study. Dermatology. 2005; 210(1): 18–20.
  8. Nirmal B, Somiah S, Sacchidanand SA, et al. Evaluation of perifollicular inflammation of donor area during hair transplantation in androgenetic alopecia and its comparison with controls. Int J Trichology. 2013; 5(2): 73–76.
  9. Katzer T, Leite Junior A, Beck R, et al. Physiopathology and current treatments of androgenetic alopecia: Going beyond androgens and anti-androgens. Dermatol Ther. 2019; 32(5): e13059.
  10. Asfour L, Cranwell W, Sinclair R, et al. Male androgenetic alopecia. MBBS(Hons), BMedSc(Hons), and Rodney Sinclair, MBBS, MD, FACD, Male Androgenetic Alopecia; 2016. https://www.ncbi.nlm.nih.gov/books/ NBK278957/ (1.05.2023).
  11. Brzezińska-Wcisło L, Rakowska A, Rudnicka L, et al. Androgenetic alopecia. Diagnostic and therapeutic recommendations of the Polish dermatological society. Dermatology Review. 2018; 105(1): 1–18.
  12. Pietrauszka K, Bergler-Czop B. Sulfotransferase SULT1A1 activity in hair follicle, a prognostic marker of response to the minoxidil treatment in patients with androgenetic alopecia: a review. Postepy Dermatol Alergol. 2022; 39(3): 472–478.
  13. Goren A, Shapiro J, Roberts J, et al. Clinical utility and validity of minoxidil response testing in androgenetic alopecia. Dermatol Ther. 2015; 28(1): 13–16.
  14. Dhurat R, Daruwalla S, Pai S, et al. SULT1A1 (Minoxidil Sulfotransferase) enzyme booster significantly improves response to topical minoxidil for hair regrowth. J Cosmet Dermatol. 2022; 21(1): 343–346.
  15. Sharma A, Goren A, Dhurat R, et al. Tretinoin enhances minoxidil response in androgenetic alopecia patients by upregulating follicular sulfotransferase enzymes. Dermatol Ther. 2019; 32(3): e12915.
  16. Goldman BE, Fisher DM, Ringler SL. Transcutaneous PO2 of the scalp in male pattern baldness: a new piece to the puzzle. Plast Reconstr Surg. 1996; 97(6): 1109–16; discussion 1117.
  17. Panchaprateep R, Lueangarun S. Efficacy and Safety of Oral Minoxidil 5 mg Once Daily in the Treatment of Male Patients with Androgenetic Alopecia: An Open-Label and Global Photographic Assessment. Dermatol Ther (Heidelb). 2020; 10(6): 1345–1357.
  18. Ramos PM, Gohad P, McCoy J, et al. Minoxidil sulfotransferase enzyme (SULT1A1) genetic variants predicts response to oral minoxidil treatment for female pattern hair loss. J Eur Acad Dermatol Venereol. 2021; 35(1): e24–e26.
  19. Nestor MS, Ablon G, Gade A, et al. Treatment options for androgenetic alopecia: Efficacy, side effects, compliance, financial considerations, and ethics. J Cosmet Dermatol. 2021; 20(12): 3759–3781.
  20. Blume-Peytavi U, Hillmann K, Dietz E, et al. A randomized, single-blind trial of 5% minoxidil foam once daily versus 2% minoxidil solution twice daily in the treatment of androgenetic alopecia in women. J Am Acad Dermatol. 2011; 65(6): 1126–1134.e2.
  21. Ramírez-Marín HA, Tosti A. Role of oral minoxidil in patterned hair loss. Indian Dermatol Online J. 2022; 13(6): 729–733.
  22. Ramos PM, Sinclair RD, Kasprzak M, et al. 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.
  23. Sinclair RD. Female pattern hair loss: a pilot study investigating combination therapy with low-dose oral minoxidil and spironolactone. Int J Dermatol. 2018; 57(1): 104–109.
  24. Kaufman K, Olsen E, Whiting D, et al. Finasteride in the treatment of men with androgenetic alopecia. J Am Acad Dermatol. 1998; 39(4): 578–589.
  25. Trueb RD, Rezende H, Dias MR, et al. A comment on the post-finasteride syndrome. Int J Trichology. 2018; 10(6): 255–261.
  26. Caserini M, Radicioni M, Leuratti C, et al. A novel finasteride 0.25% topical solution for androgenetic alopecia: pharmacokinetics and effects on plasma androgen levels in healthy male volunteers. Int J Clin Pharmacol Ther. 2014; 52(10): 842–849.
  27. Piraccini BM, Blume-Peytavi U, Scarci F, et al. Topical Finasteride Study Group. 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(2): 286–294.
  28. Mysore V, Shashikumar BM. Guidelines on the use of finasteride in androgenetic alopecia. Indian J Dermatol Venereol Leprol. 2016; 82(2): 128–134.
  29. Romero Pérez P. Post-Finasteride syndrome. Literature review. Arch Esp Urol. 2022; 75(5): 382–399.
  30. Haber RS, Gupta AK, Epstein E, et al. Finasteride for androgenetic alopecia is not associated with sexual dysfunction: a survey-based, single-centre, controlled study. J Eur Acad Dermatol Venereol. 2019; 33(7): 1393–1397.
  31. Arca E, Açikgöz G, Taştan HB, et al. An open, randomized, comparative study of oral finasteride and 5% topical minoxidil in male androgenetic alopecia. Dermatology. 2004; 209(2): 117–125.
  32. Hu R, Xu F, Sheng Y, et al. Combined treatment with oral finasteride and topical minoxidil in male androgenetic alopecia: a randomized and comparative study in Chinese patients. Dermatol Ther. 2015; 28(5): 303–308.
  33. Suchonwanit P, Iamsumang W, Leerunyakul K. Topical finasteride for the treatment of male androgenetic alopecia and female pattern hair loss: a review of the current literature. J Dermatolog Treat. 2022; 33(2): 643–648.
  34. Gupta AK, Talukder M, Williams G. Comparison of oral minoxidil, finasteride, and dutasteride for treating androgenetic alopecia. J Dermatolog Treat. 2022; 33(7): 2946–2962.
  35. Gupta AK, Charrette A. The efficacy and safety of 5α-reductase inhibitors in androgenetic alopecia: a network meta-analysis and benefit-risk assessment of finasteride and dutasteride. J Dermatolog Treat. 2014; 25(2): 156–161.
  36. Jung JY, Yeon JeHo, Choi JW, et al. Effect of dutasteride 0.5 mg/d in men with androgenetic alopecia recalcitrant to finasteride. Int J Dermatol. 2014; 53(11): 1351–1357.
  37. Shanshanwal SJS, Dhurat RS. Superiority of dutasteride over finasteride in hair regrowth and reversal of miniaturization in men with androgenetic alopecia: A randomized controlled open-label, evaluator-blinded study. Indian J Dermatol Venereol Leprol. 2017; 83(1): 47–54.
  38. Reguero-Del Cura L, Durán-Vian C, de Quintana-Sancho A. RF-Mesotherapy with dutasteride: a future alternative treatment for androgenetic alopecia. Actas Dermosifiliogr (Engl Ed). 2020; 111(5): 419–420.
  39. Saceda-Corralo D, Moustafa F, Moreno-Arrones Ó, et al. Mesotherapy with dutasteride for androgenetic alopecia: a retrospective study in real clinical practice. J Drugs Dermatol. 2022; 21(7): 742–747.
  40. Saceda-Corralo D, Rodrigues-Barata AR, Vañó-Galván S, et al. Mesotherapy with dutasteride in the treatment of androgenetic alopecia. Int J Trichology. 2017; 9(3): 143–145.
  41. Hu AC, Chapman LW, Mesinkovska NA. The efficacy and use of finasteride in women: a systematic review. Int J Dermatol. 2019; 58(7): 759–776.
  42. Saceda-Corralo D, Domínguez-Santas M, Vañó-Galván S, et al. What's new in therapy for male androgenetic alopecia? Am J Clin Dermatol. 2023; 24(1): 15–24.
  43. Abdin R, Zhang Y, Jimenez JJ. Treatment of androgenetic alopecia using PRP to target dysregulated mechanisms and pathways. Front Med (Lausanne). 2022; 9: 843127.
  44. Sharma A, Chouhan K, Bhatia S, et al. Platelet-Rich plasma in androgenetic alopecia. Indian Dermatol Online J. 2021; 12(Suppl 1): S31–S40.
  45. de Oliveira AF, Arcanjo FP, Rodrigues MR, et al. Use of autologous platelet-rich plasma in androgenetic alopecia in women: a systematic review and meta-analysis. J Dermatolog Treat. 2023; 34(1): 2138692.
  46. Shashank B, Bhushan M. Injectable Platelet-Rich Fibrin (PRF): The newest biomaterial and its use in various dermatological conditions in our practice: A case series. J Cosmet Dermatol. 2021; 20(5): 1421–1426.
  47. Pillai JK, Mysore V. Role of low-level light therapy (LLLT) in androgenetic alopecia. J Cutan Aesthet Surg. 2021; 14(4): 385–391.
  48. Guo Y, Qu Q, Chen J, et al. Proposed mechanisms of low-level light therapy in the treatment of androgenetic alopecia. Lasers Med Sci. 2021; 36(4): 703–713.
  49. Afifi L, Maranda EL, Zarei M, et al. Low-level laser therapy as a treatment for androgenetic alopecia. Lasers Surg Med. 2017; 49(1): 27–39.
  50. Barikbin B, Khodamrdi Z, Kholoosi L, et al. Comparison of the effects of 665 nm low level diode Laser Hat versus and a combination of 665 nm and 808nm low level diode Laser Scanner of hair growth in androgenic alopecia. J Cosmet Laser Ther. 2017 [Epub ahead of print].
  51. 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): 115–127.
  52. Suchonwanit P, Rojhirunsakool S, Khunkhet S. A randomized, investigator-blinded, controlled, split-scalp study of the efficacy and safety of a 1550-nm fractional erbium-glass laser, used in combination with topical 5% minoxidil versus 5% minoxidil alone, for the treatment of androgenetic alopecia. Lasers Med Sci. 2019; 34(9): 1857–1864.
  53. Starace M, Orlando G, Alessandrini A, et al. Female androgenetic alopecia: an update on diagnosis and management. Am J Clin Dermatol. 2020; 21(1): 69–84.
  54. Faghihi G, Nabavinejad S, Mokhtari F, et al. Microneedling in androgenetic alopecia; comparing two different depths of microneedles. J Cosmet Dermatol. 2021; 20(4): 1241–1247.
  55. English RS, Ruiz S, DoAmaral P. Microneedling and its use in hair loss disorders: a systematic review. Dermatol Ther (Heidelb). 2022; 12(1): 41–60.
  56. Gupta AK, Quinlan EM, Venkataraman M, et al. Microneedling for hair loss. J Cosmet Dermatol. 2022; 21(1): 108–117.
  57. Dhurat R, Sukesh Ms, Avhad G, et al. A randomized evaluator blinded study of effect of microneedling in androgenetic alopecia: a pilot study. Int J Trichology. 2013; 5(1): 6–11.
  58. Vargas-Mora P, Morgado-Carrasco D. Spironolactone in dermatology: uses in acne, hidradenitis suppurativa, female pattern baldness, and hirsutism. Actas Dermosifiliogr (Engl Ed). 2020; 111(8): 639–649.
  59. Searle TN, Al-Niaimi F, Ali FR. Spironolactone in dermatology: uses in acne and beyond. Clin Exp Dermatol. 2020; 45(8): 986–993.
  60. Olamiju B, Craiglow BG. Combination oral minoxidil and spironolactone for the treatment of androgenetic alopecia in adolescent girls. J Am Acad Dermatol. 2021; 84(6): 1689–1691.
  61. Abdel-Raouf H, Aly UF, Medhat W, et al. A novel topical combination of minoxidil and spironolactone for androgenetic alopecia: Clinical, histopathological, and physicochemical study. Dermatol Ther. 2021; 34(1): e14678.
  62. Faghihi G, Iraji F, Siadat AH, et al. Comparison between "5% minoxidil plus 2% flutamide" solution vs. "5% minoxidil" solution in the treatment of androgenetic alopecia. J Cosmet Dermatol. 2022; 21(10): 4447–4453.
  63. Goodman NF, Cobin RH, Futterweit W, et al. American Association of Clinical Endocrinologists, American College of Endocrinology, and Androgen Excess and PCOS Society Disease State clinical review: guide to the best practices in the evaluation and treatment of polycystic ovary syndrome — part 1. Endocr Pract. 2015; 21(11): 1291–1300.
  64. Rogers NE. Hair transplantation update. Semin Cutan Med Surg. 2015; 34(2): 89–94.
  65. Rassman W, Pak J. Follicular unit extraction: evolution of a technology. J Transplant Technol Res. 2016; 06(02).
  66. Collins K, Avram MR. Hair transplantation and follicular unit extraction. Dermatol Clin. 2021; 39(3): 463–478.
  67. Gupta AK, Talukder M, Bamimore MA. Natural products for male androgenetic alopecia. Dermatol Ther. 2022; 35(4): e15323.
  68. Zhou Y, Yu S, Zhao J, et al. Effectiveness and safety of botulinum toxin type a in the treatment of androgenetic alopecia. Biomed Res Int. 2020; 2020: 1501893.
  69. Asfour L, Cranwell W, Sinclair R, et al. Male androgenetic alopecia. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc. 2000, indexed in Pubmed: 25905192.
  70. Mao Y, Liu P, Wei J, et al. Cell therapy for androgenetic alopecia: elixir or trick? Stem Cell Rev Rep. 2023; 19(6): 1785–1799.
  71. Gan Y, Du L, Wang H, et al. A clinical trial of treating androgenic alopecia with mesenchymal stem cell suspension derived from autologous hair follicle. Plast Reconstr Surg. 2023 [Epub ahead of print].
  72. Gupta AK, Wang T, Rapaport JA. Systematic review of exosome treatment in hair restoration: Preliminary evidence, safety, and future directions. J Cosmet Dermatol. 2023; 22(9): 2424–2433.
  73. Chen X, Xiang H, Yang M. Topical cetirizine for treating androgenetic alopecia: A systematic review. J Cosmet Dermatol. 2022; 21(11): 5519–5526.
  74. Fu H, Li W, Weng Z, et al. Water extract of cacumen platycladi promotes hair growth through the Akt/GSK3β/β-catenin signaling pathway. Front Pharmacol. 2023; 14: 1038039.