A novel framework for integrative hair longevity management

Hair ageing is a multifactorial process involving progressive deterioration of hair follicle structure and function, leading to reduced density, diameter, and overall hair quality. Inspired by advances in longevity science, the emerging concept of hair longevity shifts focus from reactive treatment of visible hair loss to proactive preservation of follicular health. Androgenetic alopecia (AGA), the most common form of non-scarring alopecia, illustrates hair ageing through mechanisms including follicular miniaturization, microinflammation, oxidative stress, and intrinsic cellular senescence. Despite the prevalence and psychological burden of age-related hair thinning, especially among women, preventive approaches remain underdeveloped. An analysis of 102 articles published between 2003 and October 2025 synthesized by an international expert working group and a comprehensive literature analysis allowed to establish a conceptual framework for hair longevity. The proposed model identifies nine hallmarks of hair ageing, grouped into structural, metabolic, and signalling dysfunctions influenced by genetic, hormonal, environmental, and lifestyle factors. Building on this framework, this work proposes an integrative approach to AGA management that incorporates pharmacological treatments, cosmetic formulations, nutritional supplementation, medical devices, and lifestyle-based strategies. Emphasizing prevention as well as treatment, the concept of hair longevity introduces opportunities for earlier intervention, improved patient education, and development of innovative, multi-targeted formulations to support lifelong scalp and hair health.