Androgenetic alopecia

Yingzi Liu^{1

2

3}, Antonella Tosti⁴, Etienne C E Wang^{5

6}, Stefanie Heilmann-Heimbach⁷, Crystal Aguh⁸, Francisco Jimenez^{9

10

11}, Sung-Jan Lin^{12

13

14

15

16}, Ohsang Kwon^{17

18

19

20}, Maksim V Plikus^{21

22

23}

Affiliations

¹ Department of Developmental and Cell Biology, University of California, Irvine, Irvine, CA, USA.
² Sue and Bill Gross Stem Cell Research Center, University of California, Irvine, Irvine, CA, USA.
³ Center for Complex Biological Systems, University of California, Irvine, Irvine, CA, USA.
⁴ Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA.
⁵ National Skin Centre, Singapore, Singapore.
⁶ Skin Research Institute of Singapore, Singapore, Singapore.
⁷ Institute of Human Genetics, School of Medicine & University Hospital Bonn, University of Bonn, Bonn, Germany.
⁸ Department of Dermatology, Johns Hopkins School of Medicine, Baltimore, MD, USA.
⁹ Mediteknia Skin & Hair Laboratory, Las Palmas de Gran Canaria, Spain.
¹⁰ Facultad de Ciencias de La Salud, Universidad Fernando Pessoa Canarias, Las Palmas de Gran Canaria, Spain.
¹¹ Clinica CDI/Ruber Internacional, Madrid, Spain.
¹² Department of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan.
¹³ Department of Medical Research and Department of Dermatology, National Taiwan University Hospital, Taipei, Taiwan.
¹⁴ Department of Dermatology, College of Medicine, National Taiwan University, Taipei, Taiwan.
¹⁵ Research Center for Developmental Biology and Regenerative Medicine, National Taiwan University, Taipei, Taiwan.
¹⁶ Genomics Research Center, Academia Sinica, Taipei, Taiwan.
¹⁷ Department of Dermatology, College of Medicine, Seoul National University, Seoul, Korea.
¹⁸ Genomic Medicine Institute, Seoul National University, Seoul, Korea.
¹⁹ Laboratory of Cutaneous Aging and Hair Research, Clinical Research Institute, Seoul National University Hospital, Seoul, Korea.
²⁰ Institute of Human Environment Interface Biology, College of Medicine, Seoul National University, Seoul, Korea.
²¹ Department of Developmental and Cell Biology, University of California, Irvine, Irvine, CA, USA. plikus@uci.edu.
²² Sue and Bill Gross Stem Cell Research Center, University of California, Irvine, Irvine, CA, USA. plikus@uci.edu.
²³ Center for Complex Biological Systems, University of California, Irvine, Irvine, CA, USA. plikus@uci.edu.

PMID: 41068174
DOI: 10.1038/s41572-025-00656-9

Review

Androgenetic alopecia

Yingzi Liu et al. Nat Rev Dis Primers. 2025.

. 2025 Oct 9;11(1):73.

doi: 10.1038/s41572-025-00656-9.

Authors

Affiliations

¹ Department of Developmental and Cell Biology, University of California, Irvine, Irvine, CA, USA.
² Sue and Bill Gross Stem Cell Research Center, University of California, Irvine, Irvine, CA, USA.
³ Center for Complex Biological Systems, University of California, Irvine, Irvine, CA, USA.
⁴ Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA.
⁵ National Skin Centre, Singapore, Singapore.
⁶ Skin Research Institute of Singapore, Singapore, Singapore.
⁷ Institute of Human Genetics, School of Medicine & University Hospital Bonn, University of Bonn, Bonn, Germany.
⁸ Department of Dermatology, Johns Hopkins School of Medicine, Baltimore, MD, USA.
⁹ Mediteknia Skin & Hair Laboratory, Las Palmas de Gran Canaria, Spain.
¹⁰ Facultad de Ciencias de La Salud, Universidad Fernando Pessoa Canarias, Las Palmas de Gran Canaria, Spain.
¹¹ Clinica CDI/Ruber Internacional, Madrid, Spain.
¹² Department of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan.
¹³ Department of Medical Research and Department of Dermatology, National Taiwan University Hospital, Taipei, Taiwan.
¹⁴ Department of Dermatology, College of Medicine, National Taiwan University, Taipei, Taiwan.
¹⁵ Research Center for Developmental Biology and Regenerative Medicine, National Taiwan University, Taipei, Taiwan.
¹⁶ Genomics Research Center, Academia Sinica, Taipei, Taiwan.
¹⁷ Department of Dermatology, College of Medicine, Seoul National University, Seoul, Korea.
¹⁸ Genomic Medicine Institute, Seoul National University, Seoul, Korea.
¹⁹ Laboratory of Cutaneous Aging and Hair Research, Clinical Research Institute, Seoul National University Hospital, Seoul, Korea.
²⁰ Institute of Human Environment Interface Biology, College of Medicine, Seoul National University, Seoul, Korea.
²¹ Department of Developmental and Cell Biology, University of California, Irvine, Irvine, CA, USA. plikus@uci.edu.
²² Sue and Bill Gross Stem Cell Research Center, University of California, Irvine, Irvine, CA, USA. plikus@uci.edu.
²³ Center for Complex Biological Systems, University of California, Irvine, Irvine, CA, USA. plikus@uci.edu.

PMID: 41068174
DOI: 10.1038/s41572-025-00656-9

Abstract

Androgenetic alopecia (AGA) is a condition of scalp hair growth characterized by progressive miniaturization of hair follicles and a reduction in the number of active follicles. In general, frontal, mid-scalp and crown hair follicles in postpubescent men and in postmenopausal women are susceptible to AGA. In rare cases, premenopausal women and prepubescent individuals are affected. In men, AGA is hypothesized to be caused by increased androgen signalling within susceptible hair follicles, altering the levels of locally produced signalling factors that sustain hair growth, whereas the molecular basis of AGA in women remains undetermined. AGA displays variability in its time of onset, severity and distribution patterns, and genome-wide association studies have uncovered more than 380 genomic loci associated with AGA, including genes involved in androgen and WNT pathways. Furthermore, epidemiological studies support substantial ancestral variation in AGA. Effective therapies for AGA include autologous transplantation of androgen-resistant occipital hair follicles, oral finasteride and topical minoxidil. Not all individuals with AGA respond to these therapies or comply with daily use of medicines, creating a need for new approaches. Emerging therapies for AGA include hair follicle-activating peptides, mRNA-containing liposomes, as well as bioengineering of new hair follicles. AGA has a negative socioemotional effect on affected individuals, and its prompt diagnosis and treatment can improve self-reported quality of life.

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Conflict of interest statement

Competing interests: M.V.P. and Y.L. are inventors on patent applications related to hair loss treatment filed by the University of California, Irvine. M.V.P. is co-founder and Chief Scientific Officer at the Amplifica Holdings Group, Inc., and has received consultation fees from Oddity Labs and L’Oréal. A.T. has received consultation fees from DS Laboratories, Almirall, Thirty Madison, Eli Lilly and Company, Pfizer, Myovant Sciences, Bristol Myers Squibb, Ortho Dermatologics and Sun Pharmaceutical. C.A. has received consultation fees from Eli Lilly and Company, Pfizer, Olaplex and Myovant Sciences; has authored an UpToDate section on central centrifugal cicatricial alopecia; and directs the Ethnic Skin Program at Johns Hopkins University, funded by an educational grant from Janssen. S.H.-H. has received salary payments from Life & Brain GmbH. S.-J.L. has received clinical trial funds from Eli Lilly and Company. O.K. has received consultation fees from Eli Lilly and Company and has received clinical study funds from Eli Lilly and Company, Pfizer and AbbVie. E.C.E.W. and F.J. declare no competing interests.

References

1. Otberg, N., Finner, A. M. & Shapiro, J. Androgenetic alopecia. Endocrinol. Metab. Clin. North. Am. 36, 379–398 (2007). - PubMed - DOI
1. Pratt, C. H., King, L. E. Jr., Messenger, A. G., Christiano, A. M. & Sundberg, J. P. Alopecia areata. Nat. Rev. Dis. Primers 3, 17011 (2017). - PubMed - PMC - DOI
1. Peyravian, N., Deo, S., Daunert, S. & Jimenez, J. J. The inflammatory aspect of male and female pattern hair loss. J. Inflamm. Res. 13, 879–881 (2020). - PubMed - PMC - DOI
1. McElwee, K. J. & Sundberg, J. P. Innovative strategies for the discovery of new drugs against androgenetic alopecia. Expert. Opin. Drug. Discov. 20, 517–536 (2025). - PubMed - DOI
1. Chaikittisilpa, S. et al. Prevalence of female pattern hair loss in postmenopausal women: a cross-sectional study. Menopause 29, 415–420 (2022). - PubMed - DOI

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Androgenetic alopecia

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Androgenetic alopecia

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Conflict of interest statement

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