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RETROSPECTIVE OF TREATMENT FORMS AGAINST ANDROGENIC
ALOPECIA
Thayz Regina Portes Abrahão1
Raquel Pires Bispo Andrade2
Danilo Portes Abrahão3
Carolina Cristina Ribas4
Luciana Caroline Ferreira Passos da Silva5
Mariana Moura Tomitan6
Daniela Barbosa de Assis7
Ingrid Silva Brito8
Sara Mendes de Oliveira9
Oliveira Barbosa10
Andrea Gisell Velázquez Gómez11
Abstract: Androgenic Alopecia is a pathology that affects a signicant percentage of the population.
The search for forms of treatment arises from the need for acceptance or to achieve the beauty standards
required in society, whether as a denitive or temporary treatment. This is a retrospective through
the analysis of digitally collected data on the development of forms of treatment against androgenic
1 Medical students from the Central University of Paraguay
2 Medical students from the Central University of Paraguay
3 Medical students from the Central University of Paraguay
4 Medical students from the Central University of Paraguay
5 Medical students from the Central University of Paraguay
6 Medical students from the Central University of Paraguay
7 Medical students from the Central University of Paraguay
8 Medical students from the Central University of Paraguay
9 Medical students from the Central University of Paraguay
10 Medical students from the Central University of Paraguay
11 Teacher of Medicine at the Central University of Paraguay
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alopecia. Using a basic, descriptive research, carried out using bibliographic and documentary data.
The longitudinal research on the development of techniques and the use of published methods, aims
at delineating the treatment against AGA.
Keyword: treatment, androgenic alopecia
INTRODUCTION
Over the centuries, shape, body and silhouette have always been the target of human desire,
such as a slender shape, light eyes and long, shiny hair. Such a cliché grew and became something
intangible.
Man over the decades, uses products that within empiricism believed to be the elixir of
youth, but what has been proven that many of these principles are toxic and unhealthy and the desire
for perfect beauty becomes a utopia, but the initiation of scientic research of products that are really
effective in the desire for this ideation is the path that must be followed.
Hair throughout history comes with specic morphological characteristics and mainly
culturally as in ancient Egypt where Cleopatra already used essential oils, hairstyles and adornments
in her long hair as a symbolism of power, cultural acceptance and point of seduction to her various
partners.
Hair care has been growing exponentially as the most effective treatment to combat alopecia,
white hair and hair growth as quickly as possible
Androgenetic Alopecia is a chronic dermatological disorder, which occurs in genetically
predisposed people due to the hypersensitivity of testosterone in the hair follicles of the scalp. The
androgenic action gradually reduces the hair follicle and causes early alternation between phases of
the hair cycle
The object of study is a bibliographic research of a simple nature with the purpose of outlining
the different techniques over the last few years against alopecia
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Hair anatomy
A review of the capillary anatomy is presented so that the understanding of the formation and
structure of the capillary is the focus of the search for success in the domain from germinal formation
to nitude, from the anatomical understanding it is possible to understand the forms of treatment.
Hair development: a histological look
The skin (complexion, integument) and its derivatives make up the integumentary system.
The skin forms the outer covering of the body and is its largest organ, constituting 15% to 20% of its
total mass. The skin consists of two main layers:
• Epidermis, composed of a attened and cornied stratied epithelium that grows
continuously, but maintains its normal thickness due to the desquamation process. The
epidermis derives from the ectoderm.
• Dermis, composed of a dense connective tissue that provides mechanical support,
strength and thickness to the skin. The dermis derives from the mesoderm.
The hypodermis contains varying amounts of adipose tissue organized into lobules
separated by connective tissue septa. It lies deeper than the dermis and is equivalent to the anatomist’s
subcutaneous fascia.
In people who are well-nourished and live in cold climates, fat tissue can be quite thick.
The epidermal derivatives of the skin (cutaneous appendages) comprise the following integumentary
structures and products:
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• Hair follicles and hair;
• Sweat glands;
• Sebaceous glands
• Mammary glands
The integumentary system fullls essential functions related to its location on the external
surface. The skin and its appendages are a complex organ made up of many different cell types. The
diversity of these cells and their ability to work together provide many functions that allow a person
to cope with the external environment. The main functions of the skin are as follows:
It acts as a barrier that protects against physical, chemical, and biological agents from the
external environment (i.e., mechanical barrier, permeability barrier, ultraviolet barrier).
Provides immunological information obtained during the processing of antigens for cells
appropriate effectors in the lymphatic tissue.
It participates in homeostasis by regulating body temperature and water loss. (HARRIS,
2009; ALEXANDER et al., 2012).
METHODOLOGICAL PROCEDURES
This article is a basic descriptive research, carried out through bibliographic and documentary
data.
Lakatos and Marconi (1990) dene research in stages using a method of reective thinking,
which requires a scientic treatment. Gil (2010) follows this same line of thought, stating that research
is carried out through accessible knowledge with the use of investigation methods and techniques,
involving several stages. Therefore, a documentary research has the need for a systematization of
data collection in order to provide a concise content in its investigation, which can be a historical
retrospective, or even the ling of related subjects.
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The proposed theme reviewed 85 scientic articles published digitally in a database where
data collection was systematically carried out using keywords “treatment”, “alopecia”, “androgenic”
between the years 2016 and 2020, with the objective of outlining the most discussed forms of treatment
in the last 5 years.
Discussion of data
In an analysis of the years researched, several forms of treatment were observed, such as
Minoxidil, either 2 or 5%, in intradermal or topical form, use of platelet-rich plasma, microneedling,
nasteride, dutasteride, among other items found
After listing the 85 articles annually, it was later ordered by forms of treatment, to carry out
a historical analysis.
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Data analysis
The Table above shows the forms of treatment found between the years 2016-2020 in a
database where the main forms published in those years were classied, including Minoxidil, platelet-
rich plasma, low-level laser, and others.
The rst item of greatest relevance in the articles investigated was the use of Minoxidil,
where it was initially developed to act as an antihypertensive drug.
In this function, its form of action is well known, occurring through vasodilation and the
opening of potassium channels. Hypertensive patients treated with Minoxidil developed hypertrichosis
(increased hair volume). From this data, it was found that it promotes hair growth.
Its mechanism of action at the capillary level is not yet fully known, and vasodilation is not
the main stimulus factor. What is already known is that Minoxidil affects the hair cycle. It promotes
an increase in the duration of the anagen phase, stimulates cell proliferation in the dermal papilla,
generates an increase in the diameter of hair shafts and an increase in the size of follicles, stimulates
vascular growth factor (VEGF) and prostaglandin synthesis, inhibits collagen synthesis, consequently
increasing the number of hairs per cm2. (ABCRC, 2021)
The second item was platelet-rich plasma where PRP is a biological product produced from
an autologous blood centrifugation process, allowing the extraction of a plasma with a concentration
of three to ve times higher of platelets in relation to their quantity in basal blood. Many researches
developed in the most diverse areas of Medicine, especially in dentistry, orthopedics and reconstructive
surgery, have suggested that the product enhances the tissue healing process at the site where it is
applied, through the release of biological mediators called growth factors (Aleixo et al, 2017)
PRP is an inexpensive and efcient method of preparing platelet- and growth-factor-rich
plasma.
Borzini and Mazzucco (2007) argue in their literature review article that, among hundreds of
published studies on the clinical use of platelet derivatives, very few belong to the class of prospective
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randomized clinical trials or to the category of retrospective clinical trials. The vast majority of
published works belong to the category of case reports or pilot studies. Despite this lack of randomized
controlled trial studies, the authors cite that, by carefully analyzing the published papers, there is
strong evidence that platelet gel (PRP) is clinically effective.
The third nd in this timeline was the low-level laser.
Low-level lasers promote benecial biological effects, of an analgesic, anti-inammatory
and healing nature, through a phenomenon of biostimulation (Lins, RDAU et al, 2010)
The incorporation of the laser as a therapeutic instrument has been followed in the biomedical
eld since 1960, through Theodore Maiman, and one of the rst published experiments on the effects
of low-level laser dates back to 1983, through the irradiation of HeNe (Helium-Neon) laser, on rat
wounds for 14 consecutive days. The effects of low-level laser can be observed in the behavior of
lymphocytes, increasing their proliferation and activation; on macrophages, increasing phagocytosis;
increasing the secretion of broblast growth factors and intensifying the reabsorption of both brin
and collagen. (Andrade, et al, 2014)
The effects of low-level laser can be observed in the behavior of lymphocytes, increasing
their proliferation and activation; on macrophages, increasing phagocytosis; increasing the secretion
of broblast growth factors and intensifying the reabsorption of both brin and collagen. In addition,
they contribute to increase the motility of epithelial cells, the amount of granulation tissue, and can
decrease the synthesis of inammatory mediators. (Andrade FSSD et al, 2012)
Finasteride, a synthetic steroid, systemic hormone blocker, has been used for the treatment
of AGA in men since 1997 (Mulinari-Brenne, Soares, 2009)
Dutasteride is a type 1 and 2 5α-Reductase inhibitor, and also acts to reduce the amount of
DHT more effectively than nasteride, decreasing DHT levels by up to 90%. In addition, dutasteride
is a good alternative for cases in which nasteride has proven to be ineffective and is capable of
generating a greater increase in the number of hairs than nasteride. (Chaves et al, 2021)
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Final Considerations
This research can offer the academic community and health professionals subsidies to achieve
practical success in the development of the treatment against androgenic alopecia.
In view of the proposed objective, it is possible to draw a timeline of the main forms of
treatment against AGA,
The bibliographic retrospective presented in this study makes us reect on how important
hair is, not only in the pathological sphere, but in the well-being of the individual.
The study shows that from 2016 onwards there was a growth in techniques in the ght
against AGA, whether they were innovative or simply improved
Many of the techniques analyzed were used in conjunction with other manipulations to
combat alopecia.
As it has also been shown that PRP (platelet-rich plasma) is an instrument of use that has its
potential against baldness, either through its regeneration factor and growth in the hair bulb.
Just as Minoxidil in its various concentrations, even in initial studies being developed in the
ght against hypertension, has been demonstrating effective results against alopecia, as well as the
low-frequency laser, even though it is a line of less investigation, proves its effectiveness.
The look at the human being must be in its entirety as a Bio-Psychic-Social being and when
dealing with androgenic alopecia, these aspects cannot be forgotten since it is a pathology that is
directly related to the general well-being of the individual. The treatment of AGA is not only aesthetic,
but also intrinsic factors such as self-esteem and acceptance.
The concreteness of the theme addressed makes the next researchers broaden their prism of
scientic knowledge against androgenic alopecia and promoting greater scientic technical knowledge
in the forms of treatment against androgenic alopecia.
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