Alterations in the Hair Follicle Bacteriome and Mycobiome in Androgenetic Alopecia: A Cross-Sectional Study of 72 Patients and 24 Healthy Controls

This study investigated the bacterial and fungal microbiome in the hair follicles of 72 androgenetic alopecia (AGA) patients compared to 24 healthy controls. While bacterial communities remained stable, significant fungal dysbiosis was observed in AGA patients, characterized by a depletion of the commensal yeast Malassezia and an increase in opportunistic taxa like Thermomyces and Bifidobacterium, particularly in advanced disease stages. The study found that microbial diversity increased with disease severity and age, suggesting a disruption of the follicular niche. Male patients showed distinct fungal shifts compared to females, and geographical location influenced the microbiome in patients. These findings suggest that AGA involves an ecological imbalance, highlighting potential for microbiome-targeted therapies.