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Conflicting Reports Regarding the Histopathological Features of Androgenic Alopecia: Are Biopsy Location, Hair Diameter Diversity, and Relative Hair Follicle Miniaturization Partly to Blame?

Authors English Jnr R, Ruiz S

Received 10 February 2021

Accepted for publication 24 March 2021

Published 7 April 2021 Volume 2021:14 Pages 357—365

DOI https://doi.org/10.2147/CCID.S306157

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Jeffrey Weinberg


Robert English Jnr, Sophia Ruiz

Perfect Hair Health, San Francisco, CA, 94115, USA

Correspondence: Robert English Jnr
Perfect Hair Health, 2021 Fillmore Ste # 98, San Francisco, CA, 94115, USA
Email [email protected]

Abstract: 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.

Keywords: androgenic alopecia, hair diameter diversity, inflammation, fibrosis, prostaglandins

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