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2021, Número 4

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Dermatología Cosmética, Médica y Quirúrgica 2021; 19 (4)


Alopecia androgenética: revisión de tratamientos y nuevas opciones terapéuticas

Idioma: Español
Referencias bibliográficas: 38
Paginas: 369-375
Archivo PDF: 151.30 Kb.


RESUMEN

La alopecia androgenética (AGA) se caracteriza por una miniaturización progresiva sin cicatrices del folículo piloso, con una distribución de patrón en hombres y mujeres predispuestos. Es una de las causas más habituales de consulta en tricología. La etiopatogenia se basa en una miniaturización progresiva del folículo piloso que conduce a la transformación vellosa del cabello terminal, y es mediada genéticamente y por estímulo androgénico. Existen datos tricoscópicos específicos para facilitar su diagnóstico. El objetivo del tratamiento es evitar el proceso de miniaturización y, si es posible, revertirlo; debe ser individualizado en cada paciente y depende de varios factores, incluida la eficacia, la viabilidad, los riesgos y los costos, ya que son tratamientos a largo plazo debido a que se trata de una enfermedad progresiva y crónica. Se analizan las terapias que ya existen y algunas nuevas, como el minoxidil oral, dutasterida, PRP, cortexolona 17 α-propionato, espironolactona, acetato de ciproterona, flutamida, bicalutamida, activadores de la vía Wnt/β-catenina y microneedling


REFERENCIAS (EN ESTE ARTÍCULO)

  1. Kelly Y, Blanco A y Tosti A, Androgenetic alopecia: an update of treatment options, Drugs 2016; 76:1349–64. doi:10.1007/s40265-016-0629-5.

  2. Pierard-Franchimont C y Pierard G, Teloptosis, a turning point in hair shedding biorhythms, Dermatology 2001; 203:115-7. doi: 10.1159/000051723.

  3. Katzer T, Leite A, Beck R y Silva C, Physiopathology and current treatments of androgenetic alopecia: going beyond androgens and antiandrogens Dermatologic Therapy 2019; 32: e13059. doi: 10.1111/dth.13059.

  4. Lolli F et al., Androgenetic alopecia: a review, Endocrine 2017; 57:9-17. doi: 10.1007/s12020-017-1280-y.

  5. Premanand A y Reena B, Androgen modulation of Wnt/β-catenin signaling in androgenetic alopecia, Arch Dermatol Res 2018; 310:391-9. doi: 10.1007/s00403-018-1826-8.

  6. Goren A y Naccarato T, Minoxidil in the treatment of androgenetic alopecia, Dermatologic Therapy 2018; 31:e12686. doi:10.1111/dth.12686.

  7. Roberts J, Desai N, McCoy J y Goren A, Sulfotransferase activity in plucked hair follicles predicts response to topical minoxidil in the treatment of female androgenetic alopecia, Dermatologic Therapy 2014; 27:252-4. doi: 10.1111/dth.12130.

  8. McCoy J, Goren A, Kovacevic M y Shapiro J, Minoxidil dose response study in female pattern hair loss patients determined to be nonresponders to 5% topical minoxidil, Journal of Biological Regulators and Homeostatic Agents 2016; 30:1153-5.

  9. Jiménez J et al., Effectiveness and safety of low-dose oral minoxidil in male androgenetic alopecia, Journal of the American Academy of Dermatology 2019; 81:648-9. doi: 10.1016/j.jaad.2019.04.054.

  10. Mella J, Perret M, Manzotti M, Catalano H y Guyatt G, Efficacy and safety of finasteride therapy for androgenetic alopecia: a systematic review, Arch Dermatol 2010; 146:1141-50. doi: 10.1001/archdermatol.2010.256.

  11. Rossi A et al., Finasteride, 1 mg daily administration on male androgenetic alopecia in different age groups: 10-year follow-up, Dermatol Therapy 2011; 24:455-61. doi: 10.1111/j.1529-8019.2011.01441.x.

  12. Mysore V y Shashikumar B, Guidelines on the use of finasteride in androgenetic alopecia, Indian J Dermatol Venereol Leprol 2016; 82:128-134. doi: 10.4103/0378-6323.177432.

  13. Caserini M et al., Effects of a novel finasteride 0.25% topical solution on scalp and serum dihydrotestosterone in healthy men with androgenetic alopecia, Int J Clin Pharmacol Ther 2016; 54:19-27. doi: 10.5414/CP202467.

  14. Lee, S et al., Adverse sexual effects of treatment with finasteride or dutasteride for male androgenetic alopecia: a systematic review and metaanalysis, Acta Derm Venereol 2019; 99:12-17. doi: 10.2340/00015555-3035.

  15. Gur S, Kadowitz P y Hellstrom W, Effects of 5-alpha reductase inhibitors on erectile function, sexual desire and ejaculation, Expert Opin Drug Saf 2013; 12:81-90. doi: 10.1517/14740338.2013.742885.

  16. Gray S y Semla T, Post-finasteride syndrome, bmj 2019; 366:l5047. doi: 10.1136/bmj.l5047.

  17. Clark R et al., Marked suppression of dihydrotestosterone in men with benign prostatic hyperplasia by dutasteride, a dual 5alpha-reductase inhibitor, J Clin Endocrinol Metab 2004; 89:2179-84. doi: 10.1210/ jc.2003-030330.

  18. Jung J et al., Effect of dutasteride 0.5 mg/d in men with androgenetic alopecia recalcitrant to finasteride, Int J Dermatol 2014; 53:1351-7. doi: 10.1111/ijd.12060.

  19. Shanshanwal S y Dhurat R, Superiority of dutasteride over finasteride in hair regrowth and reversal of miniaturization in men with androgenetic alopecia: a randomized controlled open-label, evaluatorblinded study, Indian J Dermatol Venereol Leprol 2017; 83:47-54. doi: 10.4103/0378-6323.188652.

  20. Saceda D et al., Mesotherapy with dutasteride in the treatment of androgenetic alopecia, Int J Trichology 2017; 9:143-5. doi:10.4103/ijt.ijt_73_16.

  21. Vañó S y Camacho F, New treatments for hair loss, Actas Dermosifiliogr 2017; 108:221-228. doi: 10.1016/j.ad.2016.11.010.

  22. Giordano S, Romeo M y Lankinen P, Plated-rich plasma for androgenetic alopecia: does it work? Evidence from meta-analysis, J Cosmet Dermatol 2017; 16:374-381. doi: 10.1111/jocd.12331.

  23. Mao G, Zhang G y Fan W, Platelet-rich plasma for treating androgenic alopecia: a systematic review, Aesthetic Plastic Surgery 2019. doi:10.1007/ s00266-019-01391-9.

  24. Sharma V, Bhari N, Patra V y Singh A, Platelet-rich plasma therapy for androgenetic alopecia, Indian J Dermatol 2019; 64:417-9. doi: 10.4103/ ijd.ijd_363_17.

  25. Andrasfay A, A phase 2 study to evaluate the safety and efficacy of cb-03-01 solution, a comparator solution and vehicle solution in males with androgenetic alopecia, ClinicalTrials 2016; nct02279823.

  26. Rathnayake D y Sinclair R, Innovative use of spironolactone as an antiandrogen in the treatment of female pattern hair loss, Dermatol Clin 2010; 28:611-8. doi: 10.1016/j.det.2010.03.011.

  27. Sinclair R, Wewerinke M y Jolley D, Treatment of female pattern hair loss with oral antiandrogens, Br J Dermatol 2005; 152:466-73. doi: 10.1111/j.1365-2133.2005.06218.x.

  28. Vexiau P et al., Effects of minoxidil 2% vs. cyproterone acetate treatment on female androgenetic alopecia: a controlled, 12-month randomized trial, Br J Dermatol 2002; 146:992-9. doi: 10.1046/j.1365-2133.2002.04798.x.

  29. Acetato de ciproterona a dosis altas (Androcur®) y riesgo de meningioma: nuevas restricciones de uso, Agencia Española de Medicamentos y Productos Sanitarios, febrero de 2020.

  30. Ezeh U, Huang A, Landay M y Azziz R, Long-term response of hirsutism and other hyperandrogenic symptoms to combination therapy in polycystic ovary syndrome, J Womens Health (Larchmt) 2018; 27:892.

  31. Paradisi R et al., Prospective cohort study on the effects and tolerability of flutamide in patients with female pattern hair loss, Ann Pharmacother 2011; 45;469-75. doi: 10.1345/aph.1P600.

  32. Ismail F et al., Safety of oral bicalutamide in female pattern hair loss: a retrospective review of 316 patients, J Am Acad Dermatol 2020; 83:1478-9. doi: 10.1016/j.jaad.2020.03.034.

  33. Tosti A et al., Topical application of the Wnt/β-catenin activator methyl vanillate increases hair count and hair mass index in women with androgenetic alopecia, J Cosmet Dermatol 2016; 15:469-74. doi: 10.1111/jocd.12225.

  34. Lee S et al., Valproic acid induces hair regeneration in murine model and activates alkaline phosphatase activity in human dermal papilla cells, plos One 2012; 7:e34152. doi:10.1371/journal.pone.0034152.

  35. Yazici Y et al., Safety and efficacy of a topical treatment (sm04554) for androgenetic alopecia (aga): results from a phase 1 trial, Journal of the American Academy of Dermatology 2016; 74:ab138. doi:10.1016/j. jaad.2016.02.544.

  36. Won CH et al., Hair growth-promoting effects of adiponectin in vitro, J Invest Dermatol 2012; 132:2849-51. doi: 10.1038/jid.2012.217.

  37. Dhurat R y Mathapati S, Response to microneedling treatment in men with androgenetic alopecia who failed to respond to conventional therapy, Indian J Dermatol 2015; 60:260-3. doi: 10.4103/0019-5154.156361.

  38. Leavitt M, Charles G, Heyman E y Michaels D, HairMax LaserComb laser phototherapy device in the treatment of male androgenetic alopecia: a randomized, double-blind, sham device-controlled, multicentre trial, Clin Drug Investig 2009; 29:283-92. doi: 10.2165/00044011-200929050-00001




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