Acquired Progressive Kinking of the Hair: A Narrative Review of the Androgen-Dependent Phenotype

Acquired progressive kinking of the hair (APKH) is an underrecognized hair disorder characterized by a gradual change in hair texture, often manifesting as increased curliness, frizziness, and darkening of the shafts. While various systemic triggers and congenital conditions can induce similar phenotypes, a subset of cases-particularly those involving the frontal and temporal scalp in young males-appears to be linked to androgen-mediated mechanisms. This narrative review focuses on the androgen-dependent phenotype of APKH, integrating clinical, trichoscopic, and histopathological findings and presenting a representative case. We also propose a conceptual framework for distinguishing between androgen-dependent and non-androgen-dependent subtypes. A detailed analysis of all published cases meeting criteria for androgen-sensitive APKH is provided, highlighting patterns of progression, diagnostic clues, and therapeutic implications. Recognizing this presentation as a potential early manifestation of androgenetic alopecia may inform clinical decisions and prompt timely intervention.