Search Results (130)

Androgenetic alopecia (AGA) is the most prevalent form of alopecia areata. Traditional treatment options, including minoxidil, finasteride, and hair transplantation, have their limitations, such as skin irritation, systemic side effects, invasiveness, and high costs. The transdermal drug delivery system (TDDS) offers an innovative approach for treating AGA by administering medications through the skin to achieve localized and efficient delivery while overcoming the skin barrier. This review systematically explores the application of TDDS in AGA treatment, highlighting emerging technologies such as microneedles (MNs), liposomes, ionic liquids (ILs), nanostructured lipid carriers (NLCs), and transporters (TFs). It analyzes the underlying mechanisms that enhance drug penetration through hair follicles. Finally, this review presents a forward-looking perspective on the future use of TDDS in the management of AGA, aiming to provide insights and references for designing effective transdermal drug delivery systems for this condition. Full article

Background: Alopecia areata (AA), an autoimmune condition causing non-scarring hair loss, often coexists with atopic dermatitis (AD) due to shared T-helper cell type 2 (Th2)-mediated pathways. Dupilumab, a monoclonal antibody inhibiting IL-4 and IL-13 signaling, is a cornerstone treatment for AD but has conflicting reports regarding its impact on AA, with some suggesting therapeutic benefits and others indicating AA induction. Methods: This retrospective study, utilizing the TriNetX Research Network’s de-identified data from over 300 million patient records, investigates the association between dupilumab use and AA risk in AD patients. Results: After propensity score matching, 23,782 dupilumab users were compared with an equal number of controls. Results revealed a statistically significant increased AA risk in dupilumab users (odds ratio: 1.436, 95% CI: 1.066–1.935, p = 0.0167) after 16 weeks. Cases occurring within 16 weeks were excluded. Conclusions: Potential mechanisms include immune rebalancing, with Th2 suppression possibly upregulating Th1/Th17 pathways or unmasking latent AA in predisposed individuals. These findings challenge dupilumab’s potential as an AA treatment and highlight the need for vigilant monitoring, including routine scalp examinations and patient education. Future research should focus on mechanistic pathways, risk stratification, and comparative studies with other biologics to optimize personalized treatment strategies for AD and AA. Full article

Alopecia areata (AA) is a complex autoimmune disorder with multifactorial pathogenesis. Recent research highlights the gut microbiota as a possible key player in AA pathogenesis through the gut–skin axis: gut dysbiosis may disrupt intestinal barrier integrity and immune tolerance by affecting T regulatory cells, potentially contributing to disease onset and progression. The purpose of this review is to analyze the current evidence on the correlation between gut microbiota and AA, dissecting both the pathogenetic role of its alterations in the onset and progression of disease and its potential role as a therapeutic target. Full article

Alopecia areata (AA) and atopic dermatitis (AD) are complex immune-mediated conditions that frequently coexist in pediatric patients, complicating treatment approaches. Upadacitinib, a selective JAK1 inhibitor, modulates both Th1 and Th2 pathways and is approved for AD in adolescents and adults. This study presents a case series of three adolescent patients with refractory AA and AD treated with upadacitinib 15 mg/day for 12 months, alongside a comprehensive literature review. All patients demonstrated rapid remission of AD symptoms within the first month and progressive hair regrowth, with SALT scores significantly improving at six and twelve months. No severe adverse events were reported. Notably, one patient achieved complete regrowth despite the presence of ophiasis, a pattern typically associated with poor prognosis. Our literature review identified only four previous pediatric cases successfully treated with upadacitinib, highlighting the novelty of our findings. These cases, together with our experience, suggest that upadacitinib offers a safe and effective therapeutic option for pediatric patients with concomitant AA and AD, including those who failed conventional or biologic therapies such as dupilumab. Larger, controlled studies are needed to confirm long-term efficacy and safety. Our results also support the potential role of upadacitinib in managing multiple Th1/Th2-mediated comorbidities in pediatric populations. Full article

Background/Objectives: Serum diagnostic tests for alopecia areata may be used to monitor response to treatment, aiding in the objective assessment of disease activity and helping to change treatment at an earlier point. Attenuated total reflection Fourier transform infrared (ATR-FTIR) spectroscopy offers a nondestructive and user-friendly approach for analyzing a wide range of samples. In this study, we evaluated whether ATR-FTIR spectroscopy combined with machine learning can detect alopecia areata and quantify disease activity. We also established whether patient-specific spectral differences correlate with response to therapy, offering molecular insight into treatment response. Methods: Serum samples from 42 patients with alopecia areata and 41 healthy donors were compared. Logistic regression models were developed to separate alopecia areata patients from controls and to monitor treatment response based on clinical scoring. Results: Significant spectral variations were found in the 3000–2800 cm⁻¹ and 1800–1000 cm⁻¹ regions corresponding to the principal biochemical constituents such as proteins, lipids, carbohydrates, and nucleic acids. The AUC of the logistic regression model for distinguishing alopecia areata patients from healthy controls was 0.85 (95% CI: 0.75–0.94) with a sensitivity of 0.89 and a specificity of 0.71. In terms of prediction of treatment response, the model showed discriminative potential (AUC = 0.86, 95% CI: 0.71–0.98), with distinct alterations in the spectrum, particularly in the Amide I band, associated with improvement in the patient’s condition. Conclusions: ATR-FTIR spectroscopy assisted by machine learning offers a serum-based solution for treatment monitoring in alopecia areata patients with clinical applicability. This technique has highly promising potential for the development of rapid, non-invasive, and objective biomarkers in autoimmune dermatology. Additional multi-center trials are required to validate and incorporate these spectral biomarkers into individual treatment regimens. Full article

Androgenetic alopecia (AGA) is a prevalent form of non-scarring hair loss, affecting approximately 32.13% of the population. Seborrheic alopecia is the most frequently observed among its various types, contributing to over 25% of hair loss cases in men. Identifying effective natural compounds or therapeutic agents that stimulate hair growth remains a key research focus. Platycladus orientalis L., known for its medicinal properties, shows potential in promoting hair darkening and regeneration, although its mechanisms remain unclear. In this study, Fr2 of Platycladus orientalis L. was found to significantly enhance hair growth in mice. Similarly, (7E)-7,8-Dehydroheliobuphthalmin (DHHB) was successfully isolated and purified for the first time through a combination of medium-pressure liquid chromatography and two-dimensional high-performance liquid chromatography. In an alopecia areata (AGA) model using dermal papilla cells (DPCs), DHHB was found to significantly promote cell proliferation and differentiation by down-regulating the expression of androgen receptor (AR) proteins, and activating the Wnt/β-catenin signaling pathway, as compared with the dihydrotestosterone-induced model group. These results indicate that DHHB is a major bioactive compound in Platycladus orientalis L. and represents a promising candidate for promoting hair growth. Full article

With alopecia affecting millions globally, recent advancements in the understanding of hair follicle biology have driven the development of novel therapies focused on hair regrowth. This review discusses two emerging therapeutic strategies: hair follicle neogenesis and the modulation of the Wnt/B-catenin signaling pathway. Hair follicle neogenesis, a frontier once considered impossible to achieve in adult humans, has recently gained traction due to advancements in stem cell biology and further understanding of the epithelial–mesenchymal interactions that are critical to hair follicle development. Such an approach shows significant potential for addressing conditions leading to hair loss, such as androgenetic and scarring alopecias. The Wnt/B-catenin signaling pathway, a critical intracellular pathway responsible for hair follicle cycles, has gained traction as a target for therapeutic interventions. Studies show that stimulating this pathway leads to hair follicle growth, while its inhibition prompts hair follicle regression. Investigations demonstrate clinical efficacy of small molecule inhibitors and peptides, such as PTD-DBM, which activates the Wnt/β-catenin pathway by interfering with CXXC5, a negative regulator that inhibits pathway activation. Such therapies show potential as more effective treatment options than existing solutions such as finasteride and minoxidil. Adjunctive therapies, such as low-level laser therapy, have also shown clinical efficacy, further highlighting how modulation of this pathway stimulates follicular regrowth. While these novel therapies require further research to validate their efficacy and to gain additional insight into their risk profile, it is clear that alopecia treatment is approaching a new frontier beyond traditional pharmacologic interviews, with regenerative medicine and pathway modulation paving the way forward. Full article

This article profiles 27 innovative advancements in small-molecule drugs approved by the U.S. Food and Drug Administration (FDA) in 2024. These drugs target various therapeutic areas including non-small cell lung cancer, advanced or metastatic breast cancer, glioma, relapsed or refractory acute leukemia, urinary tract infection, Staphylococcus aureus bloodstream infections, nonalcoholic steatohepatitis, primary biliary cholangitis, Duchenne muscular dystrophy, hypertension, anemia due to chronic kidney disease, extravascular hemolysis, primary axillary hyperhidrosis, chronic obstructive pulmonary disease, severe alopecia areata, WHIM syndrome, Niemann–Pick disease type C, schizophrenia, supraventricular tachycardia, congenital adrenal hyperplasia, and cystic fibrosis. Among these approved small-molecule drugs, those with unique mechanisms of action and designated as breakthrough therapies by the FDA represent a significant proportion, highlighting ongoing innovation. Notably, eight of these drugs (including Rezdiffra^®, Voydeya^®, Iqirvo^®, Voranigo^®, Livdelzi^®, Miplyffa^®, Revuforj^®, and Crenessity^®) are classified as “first-in-class” and have received breakthrough therapy designation. These agents not only exhibit distinct mechanisms of action but also offer substantial improvements in efficacy for patients compared to prior therapeutic options. This article offers a comprehensive analysis of the mechanisms of action, clinical trials, drug design, and synthetic methodologies related to representative drugs, aiming to provide crucial insights for future pharmaceutical development. Full article

Background: Alopecia areata is regarded as a T cell-mediated autoimmune disorder, but the exact etiopathogenesis of the disease has not been completely elucidated. The aim of the study was to assess vascular circulation using Flow-Mediated Skin Fluorescence (FMSF) in alopecia patients compared to healthy volunteers, which could explain disease pathogenesis. Methods: FMSF is a new non-invasive method for assessing vascular circulation. The study recruited thirty women and four men. In our group, the most common clinical pattern of hair loss was alopecia with circular patches (AA), recognizable in 26 patients: twenty-two women and four men. Alopecia universalis (AU) was diagnosed in eight patients: all women. Results: The most pronounced differences between experimental group participants and controls are seen in the flowmotion (FM), neurogenic oscillation (NEURO), and normoxia oscillatory index (NOI) parameters characterizing microcirculation oscillations. In alopecia, microcirculation oscillations characterized by the FM and NEURO parameters are significantly decreased. Conclusions: This observation may suggest that neuroinflammation is an important factor responsible for alopecia pathogenesis. The women with alopecia areata have dysfunctional microcirculatory function. FMSF could serve as a useful tool for monitoring patients with alopecia. Full article

Alopecia areata (AA) is an autoimmune disorder causing non-scarring hair loss, which is often triggered by psychological stress. Conventional treatments, such as corticosteroids and immunotherapy, show variable efficacy and can cause side effects like hair discoloration. Exosome therapy, utilizing extracellular vesicles, presents a promising alternative, though its use in stress-related AA remains underexplored. A 39-year-old male with unifocal AA on the right parietal scalp developed hair loss following emotional distress after his fiancée’s death. Methotrexate and prednisolone were ineffective, prompting a bioregenerative approach using rose stem cell-derived exosomes (RSCEs) combined with thulium laser therapy. Six monthly sessions of RSCEs (20 mg/vial, 10 billion exosomes) were administered, with laser pre-treatment enhancing absorption. Within one month, vellus hair regrowth appeared, progressing to an increased density and pigmentation at three months. By six months, complete regrowth and natural pigmentation were achieved, with reduced inflammation confirmed by trichoscopy. The therapy was well-tolerated, with no adverse effects. This case highlights RSCE therapy as a promising treatment for stress-induced AA, achieving significant regrowth without corticosteroid-related side effects. Further studies are needed to validate its efficacy and refine protocols for broader clinical applications. Full article

Background: Alopecia areata (AA) contributes to clinically significant suffering, and impaired social functioning. Among AA patients, there is a clear impact of the disease on their sense of attractiveness and desirability as sexual partners. This review explores the development of sexual disorders among AA patients, highlighting their importance in the clinical diagnosis of comorbid health disorders with hair loss. Methods: A systematic review was conducted by searching electronic databases, including MEDLINE and Google Scholar, without date limitations, according to the PRISMA guidelines. Key search terms included “sexuality” or “sexual health” or “sexual dysfunction” or “sexual disorder” AND “alopecia areata”. Data synthesis included findings from eight relevant studies. Results: Hair loss in the course of AA has a negative impact on the sexual sphere, significantly reducing the quality of life of patients and their partners. Proper sexual functioning is an integral part of every person, so special attention should be paid to the possibility of developing sexual dysfunction in the course of AA. Conclusions: Small sample sizes and heterogeneous populations make it difficult to draw firm conclusions. Continued research with standardized criteria for SD diagnosis and appropriately large cohorts will be essential to fully establish psychosexual disorders among AA patients. Full article

Background: Alopecia areata (AA) is an autoimmune disease affecting 2% of the global population, often causing localized scalp hair loss that can progress to alopecia totalis or universalis. While corticosteroids and JAK inhibitors are effective, their significant side effects highlight the need for safer, more targeted treatments. Recently, biologics have gained attention as potential treatments for AA. Methods: A review of clinical trials, case series, and case reports published on PubMed was conducted to assess the efficacy of cytokine-targeting biologics for the treatment of AA. Data on the mechanism of action, treatment outcomes, and safety were extracted and analyzed. Results: Cytokine-targeting biologics identified included Dupilumab, Secukinumab, Tralokinumab, Etanercept, Ustekinumab, Infliximab, Adalimumab, and Tildrakizumab. Dupilumab and ustekinumab demonstrated strong efficacy, with dupilumab showing significant regrowth in 89% of cases and ustekinumab in all patients. Tralokinumab demonstrated a 33.75% improvement, with no patients achieving SALT₅₀. Limited efficacy was observed with secukinumab, tildrakizumab, and adalimumab, with 71.4%, 77.8%, and 50% of patients, respectively, showing no response. Disease worsening was observed in patients who received etanercept (29%) and infliximab (50%). Conclusions: Further research is necessary to optimize treatment protocols, identify predictive biomarkers, and, crucially, discover novel and more effective cytokine targets to advance biologics as a cornerstone therapy for AA. Full article

Background: Alopecia areata is an autoimmune disorder that causes hair loss in clumps about the size and shape of a quarter. The estimated prevalence of the disorder is approximately 1 in 1000 people, with a lifetime risk of approximately 2 percent. One of the systemic therapies for alopecia areata consists of the use of glucocorticoids or immunosuppressants. Methods: Baricitinib (BCT) is a Janus kinase (JAK) 1 and 2 selective inhibitor used as an immunosuppressant drug. In this study, three olive oil BCT formulations (Oil A, Oil B, and Oil C, which differ in their content in squalene, tocopherol, tyrosol, and hydroxytyrosol) have been developed for topical delivery. The formulations were physicochemically characterized and the in vitro drug release and ex vivo permeation through human skin tissues were assessed. Results: The results showed nearly identical viscosity across all three formulations, exhibiting Newtonian behavior. The mathematical modeling used to describe the drug release profiles was the one-site binding hyperbola for all formulations. Oil-based formulations showed a slow BCT penetration into human skin. Skin integrity remained intact during the experiments, with no signs of irritation or alterations observed. In addition, all the formulations proved their efficacy in vivo. Conclusions: Among the formulations, Oil A demonstrated the highest ability retention capacity (Q_r = 1875 ± 124.32 ng/cm²) in the skin, making it an excellent candidate for further investigation in the treatment of alopecia areata. Full article

Autoimmune-induced alopecia, such as alopecia areata, involves immune-mediated damage to hair follicles, leading to significant hair loss. Emerging therapies that stabilize hypoxia-inducible factor 1-alpha (HIF-1α) show promise in counteracting follicular degradation and supporting hair regrowth. This communication highlights the potential of iron chelators, specifically deferoxamine (DFO) and deferiprone (DFP), to stabilize HIF-1α by reducing iron availability, thereby promoting vascularization, cellular proliferation, and a regenerative environment in the hair follicle niche. Clinical trials with iron chelators demonstrated improvements in hair density, thickness, and elasticity, as well as a reduction in hair loss by up to 66.8% over six months. These findings underscore the therapeutic potential of iron chelators in autoimmune alopecia management. Future research should explore the synergistic use of iron chelators with immune-modulating therapies, positioning them as viable options in the evolving field of alopecia treatment. Full article

Background: Frontal fibrosing alopecia (FFA) is a primary cicatricial alopecia, initially described in postmenopausal women but increasingly reported in men. The male form remains under-recognized, often misdiagnosed as androgenetic alopecia (AGA) or alopecia areata (AA), particularly in the beard. Objective: This review aims to summarize the current literature on the epidemiology, clinical presentation, etiopathogenesis, diagnosis, and treatment of FFA in men. Epidemiology and Clinical Features: FFA in men typically presents at a younger age compared to women. Key features include frontal and temporal hairline recession, early involvement of the beard and sideburns, and a high prevalence of eyebrow alopecia (43–94.9%). Facial papules and body hair loss are more common in men than women. Occipital involvement varies widely across studies (8–45%). Clinical features like beard alopecia, often presenting as plaque or diffuse patterns, are highly suggestive of FFA in men but are not part of current diagnostic criteria. Etiopathogenesis: FFA is postulated to have an autoimmune basis influenced by genetic, hormonal, and environmental factors. Genetic studies have identified associations with HLA-B*07:02 and CYP1B1 loci. Environmental triggers include prolonged use of facial sunscreens and moisturizers, as demonstrated in case-control studies and meta-analyses. Diagnosis: Diagnosis is predominantly clinical, supported by trichoscopy and biopsy when needed, particularly in cases overlapping with AGA or AA. Unique presentations, such as beard alopecia and the “watch sign”, highlight the importance of considering FFA in atypical male cases. Treatment: Current treatment protocols in men mirror those for women and focus on disease stabilization. Oral 5-ARi (dutasteride) combined with topical corticosteroids and calcineurin inhibitors form the first line. Additional treatments include intralesional corticosteroids, oral isotretinoin for facial papules, and minoxidil for associated AGA. Surgical hair transplantation remains controversial, requiring disease control and careful patient counselling. Conclusions: FFA in men presents with distinct clinical features and challenges in diagnosis, often overlapping with other alopecia. Further studies are needed to validate diagnostic criteria and evaluate treatment efficacy in this underrepresented population. Full article