Open AccessConflicting Reports Regarding the Histopathological Features of Androgenic Alopecia: Are Biopsy Location, Hair Diameter Diversity, and Relative Hair Follicle Miniaturization Partly to Blame?
Author(s) -
Robert S. English,
Sophia Ruiz
Publication year - 2021
Publication title -
clinical, cosmetic and investigational dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 35
ISSN - 1178-7015
DOI - 10.2147/ccid.s306157
Subject(s) - histopathology , biopsy , hair follicle , fibrosis , hair loss , medicine , pathology , dermatology
Despite decades of study, debate persists over the role of inflammation, fibrosis, and prostaglandins in the histopathology of androgenic alopecia (AGA). This brief review proposes that inconsistent findings across histological studies are a consequence of three inadequately controlled variables: 1) biopsy location, 2) hair diameter diversity (HDD), and 3) relative hair follicle miniaturization (HFM) within and across subjects. We suggest new methodological considerations to improve AGA histopathological research, as well as a novel classification system to quantify HFM by its stages. Finally, we hypothesize a dynamic relationship between inflammation, fibrosis, and prostaglandin activity dependent on relative HFM.