Androgen-Associated and Androgen-Independent Causes of Alopecia and Acne in Women: Literature Review

The document from May 2020 reviewed the causes of alopecia and acne in women, particularly the role of androgens. It categorized alopecia into scarring and non-scarring types, with the latter including alopecia areata, telogen effluvium, and female pattern hair loss/androgenetic alopecia (FPHL/AGA). FPHL/AGA, the most common form, often coexisted with telogen effluvium and was a multifactorial condition involving genetic factors, androgen receptor gene expression, dihydrotestosterone synthesis, and local inflammation. It could occur with or without hyperandrogenism, and was associated with an increased risk of metabolic syndrome in both cases. Successful treatment of FPHL/AGA with hyperandrogenism required collaboration between gynecologists/endocrinologists and dermatologists/trichologists. The document also discussed acne pathogenesis, emphasizing its complexity and the need for stepwise therapy. It recommended assessing androgen status in acne patients, identifying the source of hyperandrogenism, and evaluating tissue androgens.