Clinical Perspectives on Alopecia: From Hair Follicle Biology to Advanced Therapies

Alopecia, or hair loss, is a common medical condition that can affect anyone, regardless of age and sex. Although it is not a life-threateningcondition, it can strongly affect a person’s confidence, self-image and well-being. Hair loss can occur due to interruption of the natural hair growth cycle due to several factors such as genetics, hormonal changes, autoimmune responses, stress, nutritional deficiencies, medications, infections, or long-term hairstyling practices. Alopecia may be temporary or permanent based on the cause. They can be classified into non-scarring alopecia and scarring alopecia. With proper management, non-scarring alopecia, which includes androgenetic alopecia, alopecia areata, telogen effluvium, traction alopecia, anagen effluvium, and trichotillomania, has a good chance in terms of regrowth of hair follicles. Early diagnosis of scarring alopecia, such as lichen planopilaris and frontal fibrosing alopecia is important since it involves an inflammatory stage with permanent destruction of the hair follicles. Inflammation leads to an imbalance in hair production. Diagnosis can be conducted via laboratory testing, trichoscopy, clinical examination, and sometime a scalp biopsy. The treatment methods have increased consequently over the years. The conventional treatment methods such as minoxidil and finasteride are in common usage, but other developments such as JAK inhibitors, PRP therapy, stem cell therapy, low-level laser therapy, and topical/systemic immunotherapy can provide better results. Hair transplants are considered an efficient treatment for chronic hair loss in cases of androgenetic alopecia. Apart from conventional therapies, aloe vera, amla, bhringaraj, fenugreek, onion juice, garlic, and coconut oil are used in combination for their nutrient-rich properties for hair and improving qualities of hair