Expert Reviews in Molecular Medicine

 



Review Article

Androgenetic alopecia: pathogenesis and potential for therapy


Justine A.  Ellis a1c1, Rodney Sinclair a2 and Stephen B. Harrap a1
a1 Department of Physiology, The University of Melbourne, Victoria 3010, Australia.
a2 University of Melbourne Department of Dermatology, St Vincent's Hospital, Victoria Parade, Melbourne, Victoria 3065, Australia.

Abstract

Androgenetic alopecia occurs in men and women, and is characterised by the loss of hair from the scalp in a defined pattern. Determining factors appear to be genetic predisposition coupled with the presence of sufficient circulating androgens. The prevalence of this condition is high (up to 50% of white males are affected by 50 years of age) and, although there are no serious direct health consequences, the loss of scalp hair can be distressing. Knowledge of the pathogenesis of androgenetic alopecia has increased markedly in recent years. Pre-programmed follicles on the scalp undergo a transformation from long growth (anagen) and short rest (telogen) cycles, to long rest and short growth cycles. This process is coupled with progressive miniaturisation of the follicle. These changes are androgen dependent, and require the inheritance of several genes. To date, only one of these genes, which encodes the androgen receptor (AR), has been identified. Of the many treatments available for androgenetic alopecia, only two (finasteride and minoxidil) have been scientifically shown to be useful in the treatment of hair loss. However, these therapies are variable in their effectiveness. Discovery of the involvement of the AR gene, and the identification of other genes contributing to the condition, might lead to the development of new and more effective therapies that target the condition at a more fundamental level.


Key Words: Male pattern baldness; hair loss; genetic studies; androgenetic alopecia; androgen receptor.

Correspondence:
c1 Department of Physiology, The University of Melbourne, Victoria 3010, Australia. Tel: +61 3 8344 0243; Fax: +61 3 9349 4519; E-mail: justine@unimelb.edu.au