The Role of Fibrosis in Androgenetic Alopecia: Mechanisms and Implications
Year: 2025
Type: article
Abstract: Background: Androgenetic alopecia (AGA) is a common pattern hair loss in which perifollicular fibrosis drives hair follicle miniaturization. Inflammatory-fibrotic cross talk centered on TGF-β/Smad, with input from Wnt/β-catenin and Notch, disrupts epithelial-mesenchymal communication and impairs regeneration. Summary: We summarize evidence linking chronic inflammation to fibroblast/myofibroblast activation and excessive extracellular matrix deposition around hair follicles, highlight dermoscopic features that may reflect fibrotic burden, and outline a continuum between AGA and fibrosing patterned alopecias. We review anti-fibrotic strategies directed at TGF-β, Wnt/β-catenin, and Notch signaling, and how combining antiandrogenic, anti-inflammatory, and anti-fibrotic approaches could address both hormonal and structural drivers. Key Messages: Perifollicular fibrosis is integral to AGA progression and may underlie incomplete treatment responses. Dermoscopic signs such as perifollicular hyperpigmentation and whitish perifollicular structures may correlate with histologic fibrosis and merit validation. Pathway-directed anti-fibrotic agents targeting TGF-β and Wnt/Notch show anti-fibrotic activity in other organs but require AGA-specific testing.
Source: Skin Appendage Disorders
DOI: 10.1159/000549748
Authors: Lubing Li, Yuqi Chen, Minmin Lin, Tongyao Chen, Youxia Xi, Yibin Fan, Xiaoxia Ding
Language: English
Topic: Hair Growth and Disorders
Subfield: Urology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4416704583