Updates on Therapeutic Approaches for Management of Androgenetic Alopecia: A Review

This review discusses the current and emerging treatments for androgenetic alopecia (AGA), a common form of hair loss affecting both men and women. The condition is primarily driven by elevated dihydrotestosterone (DHT), leading to follicular miniaturization. Standard FDA-approved treatments include topical minoxidil and oral finasteride, which require long-term use and have limitations such as delayed onset and initial shedding. The review highlights the efficacy of topical minoxidil, which works through mechanisms like vasodilation and activation of the Wnt/β-catenin signaling pathway, with the 5% formulation showing greater efficacy than the 2% version. However, response rates vary, with about 60% of male patients being non-responders, potentially due to differences in scalp sulfotransferase activity. Emerging treatments, including topical antiandrogens like finasteride and flutamide, are also explored for their potential to inhibit androgen activity locally while minimizing systemic side effects.