Response to Javaheri et al., 'Topical Estrogens: Use in Hair Loss and Additional Safety Concerns for Consideration'

The document discusses the use of topical and systemic estrogens for hair loss, particularly in menopausal women. It highlights that while 17α-estradiol is historically used for hair loss, it is not available in the U.S., and the evidence supporting topical estrogen for hair loss is weaker compared to its use for skin aging. There is a lack of data on 17β-estradiol as a topical agent for hair loss, and systemic estrogen's effects on hair are not well understood, with mixed outcomes reported. Some studies suggest an association between systemic menopausal hormone therapy and increased risk of frontal fibrosing alopecia. Overall, current data do not support the use of estrogen for menopausal hair loss, and further research is needed to explore hormonal regimens' benefits and safety in alopecia treatment.