Do androgens really play a major role in the pathophysiology of androgenetic alopecia?

Abstract

Introduction: Androgens have always been known to play a major role in the pathophysiology of androgenetic alopecia. They are responsible for the AGA development and progression along with other triggers such as the Wnt/B-catenin pathway, PGD2, perifollicular inflammation, tension in the galea aponeurotica, epigenetic factors, psychogenic factors and oxidative stress. The great importance given to androgens role in AGA is reinforced by studies of antiandrogen drugs for the treatment of the disease, which are very effective to patients who take them properly. However, studies show that in the last decades the serum androgens levels are decreasing in the general population.

Perspective: Researches have also shown that the severity of androgenetic alopecia has gotten worse over the years, reaching more important levels at times in life when androgens are no longer present in concentrations as significant as they were before the age of 30. The purpose of this study is to discuss the true role of androgens in the pathophysiology of AGA, as well as to suggest a more careful approach to the already known causes and pathways that participate in the disease including the therapeutic management of patient´s problems.