Molecular Mechanisms and Therapeutic Advances in Androgenetic Alopecia

Abstract

Androgenetic alopecia (AGA), also known as seborrheic alopecia, is the most common type of hair loss in clinical practice, accounting for about 80% of all types of hair loss. In China, the prevalence among men and women is approximately 21.3% and 6%, respectively, affecting a wide population. Although it does not threaten physical health, it seriously impacts patients' mental health and quality of life and has shown a trend toward younger onset in recent years. This article provides a systematic review of the clinical features of AGA, influencing factors, molecular mechanisms, and mainstream drug treatment strategies, with a focus on the core roles of 5α-reductase and androgen receptor (AR) in disease pathogenesis. It explores the mechanisms of action, clinical efficacy, and safety of various drugs such as minoxidil and finasteride, and summarizes research advances in new drug delivery methods and combination therapy strategies. Studies have found that the pathogenesis of AGA is the result of multiple factors, including abnormal androgen metabolism, polygenic inheritance, and microinflammation, with the collaborative regulation of type II 5α-reductase and AR being a key link in disease development. Existing therapeutic drugs still have limitations, while new delivery methods and combination therapies can effectively improve efficacy. Personalized treatment and the exploration of new targets are future research directions. This article reviews recent research findings in the field of AGA, identifies current research shortcomings, and provides references for optimizing clinical diagnosis and treatment as well as for subsequent related studies.