Parietal and occipital hair loss patterns in initial stages of androgenic alopecia in men

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Abstract

Background. The initial stages of androgenetic alopecia in men are characterized by a variety of clinical manifestation in the parietal or occipital scalp regions. However, the differences in the pathogenesis of hair loss patterns are not well understood, selective treatment has not been developed.

Aims. Trichological characteristics of patients with initial stages of androgenetic alopecia with identification of genetic and non-genetic factors that determine the hair loss in the different scalp regions, and their response to conservative therapy.

Materials and methods: Trichograms were photodocumented using an AramoSG microcamera (Republic of Korea). The genetic factor was analyzed by mini-sequencing of single nucleotide polymorphisms rs929626, rs5919324, rs1998076, rs12565727, rs756853. The non-genetic factors study included hormonal status (total and free testosterone, dihydrotestosterone, 17OH-progesterone, dehydroepiandrostenone, SHBG) and blood content of trace elements (Mg, Ca, Zn, Cu, Se, Fe) and vitamins (B12, D, E, folic acid). Conservative treatment was topical application of a minoxidil 5% (twice-a-day, 4 months) and a micronutrient deficiencies personalized correction.

Results. The study included 47 man with initial stages of androgenetic alopecia. Their trichological examination showed two patterns, consisting a predominant decrease in the hair density and diameter in the parietal and occipital scalp regions, which were subgroups formation criteria. An intergroup comparison revealed similar genetic risk, while hormonal parameters (increased dihydrotestosterone levels, a decrease in free testosterone) characterized the subgroup with parietal hair loss pattern. Also, a multiple deficiency of Zn, Cu, Se and vitamins B12, D, folic acid was detected in all patients. Subsequent conservative treatment had a positive effect in patients with parietal hair loss pattern, while in patients with occipital pattern no significant response was observed.

Conclusions. The study develops ideas about differences between androgen-dependent parietal and androgen-independent occipital hair loss patterns in the initial stages of androgenetic alopecia, which requires different approaches to their conservative therapy.

About the authors

Irina N. Kondrakhina

State Research Center of Dermatovenereology and Cosmetology

Author for correspondence.
Email: kondrakhina77@gmail.com
ORCID iD: 0000-0003-3662-9954
SPIN-code: 8721-9424

MD, Dr. Sci. (Med.)

Russian Federation, Moscow

Dmitry A. Verbenko

State Research Center of Dermatovenereology and Cosmetology

Email: verbenko@cnikvi.ru
ORCID iD: 0000-0002-1104-7694
SPIN-code: 8261-6561

Cand. Sci. (Biol.)

Russian Federation, Moscow

Alexander M. Zatevalov

G. N. Gabrichevsky Research Institute for Epidemiology and Microbiology

Email: zatevalov@gabrich.ru
ORCID iD: 0000-0002-1460-4361
SPIN-code: 3718-6127

Chief Researcher

Russian Federation, Moscow

Dmitry G. Deryabin

State Research Center of Dermatovenereology and Cosmetology

Email: dgderyabin@yandex.ru
ORCID iD: 0000-0002-9578-7947
SPIN-code: 8243-2537

MD, Dr. Sci. (Med.), Professor

Russian Federation, Moscow

References

  1. Аравийская Е. Р., Михеев Г. Н., Мошкалова И. А., Соколовский Е. В. Облысение. Дифференциальный диагноз. Методы терапии. СПб.: СОТИС; 2003. с. 91–94 [Aravijskaja ER, Miheev GN, Moshkalova IA, Sokolovskij EV. Oblysenie. Differencial'nyj diagnoz. Metody terapii. (Alopecia. Differential diagnosis. Therapy methods.) Saint-Petersburg: SOTIS; 2003. p. 91–94. (In Russ)]
  2. Norwood OT. Male pattern baldness: classification and incidence. South Med J. 1975;68(11):1359–1365. doi: 10.1097/00007611-197511000-00009
  3. Lee WS, Ro BI, Hong SP, Bak H, Sim WY, Kim DW, et al. A new classification of pattern hair loss that is universal for men and women: basic and specific (BASP) classification. J Am Acad Dermatol. 2007;57(1):37–46. doi: 10.1016/j.jaad.2006.12.029
  4. Chanprapaph K, Sutharaphan T, Suchonwanit P. Scalp Biophysical Characteristics in Males with Androgenetic Alopecia: A Comparative Study with Healthy Controls. Clin Interv Aging. 2021;16:781–787. doi: 10.2147/CIA.S310178
  5. Олисова О. Ю., Кочергин Н. Г., Вертиева Е. Ю. Андрогенная алопеция: патогенетические механизмы и подходы к лечению. Российский журнал кожных и венерических болезней. 2013;(3):53–57 [Olisova OJu, Kochergin NG, Vertieva EJu. Androgenetic alopecia: pathogenetic mechanisms and approaches to treatment. Rossijskij zhurnal kozhnyh i venericheskih boleznej. 2013;(3):53–57. (In Russ.)]
  6. Marcińska M, Pośpiech E, Abidi S, Andersen JD, van den Berge M, Carracedo Á, et al. Evaluation of DNA variants associated with androgenetic alopecia and their potential to predict male pattern baldness. PLoS One. 2015;10(5):e0127852. doi: 10.1371/journal.pone.012785
  7. Lolli F, Pallotti F, Rossi A, Fortuna MC, Caro G, Lenzi A, et al. Androgenetic alopecia: a review. Endocrine. 2017;57(1):9–17. doi: 10.1007/s12020-017-1280-y
  8. Almohanna HM, Ahmed AA, Tsatalis JP, Tosti A. The Role of Vitamins and Minerals in Hair Loss: A Review. Dermatol Ther (Heidelb). 2019;9(1):51–70. doi: 10.1007/s13555-018-0278-6
  9. Кондрахина И. Н., Вербенко Д. А., Затевалов А. М., Кубанов А. А., Дерябин Д. Г. Значение генетических и негенетических факторов в возникновении и развитии андрогенной алопеции у мужчин: многопараметрический анализ. Вестник Российской академии медицинских наук. 2019;74(3):167–175 [Kondrahina IN, Verbenko DA, Zatevalov AM, Kubanov AA, Derjabin DG. Meaning genetic and non-genetic factors in the occurrence and development of androgenic alopecia in men: a multivariate analysis. Vestnik Rossijskoj akademii medicinskih nauk. 2019;74(3):167–175. (In Russ.)] doi: 10.15690/vramn1141
  10. Varothai S, Bergfeld WF. Androgenetic alopecia: an evidence-based treatment update. Am J Clin Dermatol. 2014;15(3):217–230. doi: 10.1007/s40257-014-0077-5
  11. Rondanelli M, Perna S, Peroni G, Guido D. A bibliometric study of scientific literature in Scopus on botanicals for treatment of androgenetic alopecia. J Cosmet Dermatol. 2016;15(2):120–130. doi: 10.1111/jocd.12198
  12. Ho CH, Sood T, Zito PM. Androgenetic Alopecia. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023.
  13. Vecchio F, Guarrera M, Rebora A. Parietal/occipital ratio of the hair diameter as a measure of baldness severity in men. Acta Derm Venereol. 2003;83(6):466-467. doi: 10.1080/00015550310005870
  14. Vecchio F, Guarrera M, Rebora A. Perception of baldness and hair density. Dermatology. 2002;204(1):33–36. doi: 10.1159/000051807
  15. Kaufman KD. Androgen metabolism as it affects hair growth in androgenetic alopecia. Dermatol Clin. 1996;14(4):697–711. doi: 10.1016/s0733-8635(05)70396-x
  16. Kondrakhina IN, Verbenko DA, Zatevalov AM, Gatiatulina ER, Nikonorov AA, Deryabin DG, et al. A Cross-sectional Study of Plasma Trace Elements and Vitamins Content in Androgenetic Alopecia in Men. Biol Trace Elem Res. 2021;199(9):3232–3241. doi: 10.1007/s12011-020-02468-2
  17. Кондрахина И. Н., Затевалов A. М., Гатиатулина Е. Р., Никоноров А. А., Дерябин Д. Г., Кубанов А. А. Оценка эффективности персонализированной коррекции микроэлементного и витаминного статуса при консервативной терапии начальных стадий андрогенной алопеции у мужчин. Вестник Российской академии медицинских наук. 2021;76(6):604–611 [Kondrahina IN, Zatevalov AM, Gatiatulina ER, Nikonorov AA, Derjabin DG, Kubanov AA. Evaluation of the effectiveness of personalized treatment of trace element and vitamin status in men with initial stages of androgenic alopecia treated with conservative therapy. Vestnik Rossijskoj akademii medicinskih nauk. 2021;76(6):604–611. (In Russ.)] doi: 10.15690/vramn1617
  18. Khunkhet S, Chanprapaph K, Rutnin S, Suchonwanit P. Histopathological Evidence of Occipital Involvement in Male Androgenetic Alopecia. Front Med (Lausanne). 2021;8:790597. doi: 10.3389/fmed.2021.790597
  19. Kondrakhina IN, Verbenko DA, Zatevalov AM, Gatiatulina ER, Nikonorov AA, Deryabin DG, et al. Plasma Zinc Levels in Males with Androgenetic Alopecia as Possible Predictors of the Subsequent Conservative Therapy's Effectiveness. Diagnostics (Basel). 2020;10(5):336. doi: 10.3390/diagnostics10050336

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2. Fig. 1. Trichogram parameters characteristic for parietal (F2) and occipital (F3) hair loss patterns in the initial stages of androgenetic alopecia in men; а — presents F2 and F3 factors structure including significance of trichogram parameters (from +1,0 to –1,0); б — shows the distribution of hair diameter (D) and hair density (HD) ratios in the parietal and occipital zones in patients associated with F2 and F3 factors

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Copyright (c) 2023 Kondrakhina I.N., Verbenko D.A., Zatevalov A.M., Deryabin D.G.

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