Using the Mechanisms of Action Involved in the Pathogenesis of Androgenetic Alopecia to Treat Hair Loss

Androgenetic alopecia (AGA) is the most common type of baldness, characterized by progressive miniaturization of the hair follicle and eventually atrophy. Both genetic and androgenic factors play definite roles in the pathophysiology of the disease, including androgens and growth factors, which induce a crosstalk between the dermal papilla and the hair follicle cells. The goal of AGA treatments is to prevent the hair miniaturization process; however, currently there are only two FDA-approved medications to treat AGA: topical Minoxidil (5% and 2%) for men and women, and oral Finasteride (1 mg tablets-Proscar and Propecia) for men. Nevertheless, these are costly, require lifelong treatment, and may have side effects. Thus, there have been many attempts to develop drugs that can harness the mechanisms controlling the pathogenesis of AGA. These pharmacological therapies might achieve more targeted and effective treatment for the disease. In this review, we present various treatments that have demonstrated their ability to induce hair growth by controlling the pathophysiological mechanisms involved in the development of AGA. Interestingly, treatment by a combination of some drugs has resulted in better outcomes than each of the drugs alone, hence demonstrating the advantage of activating different molecular mechanisms simultaneously.