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12.10.2018 | Alopezie | cme fortbildung

Ein Haarausfall mit vielen Facetten

Alopecia androgenetica der Frau

verfasst von: PD Dr. med. Gerhard Lutz

Erschienen in: ästhetische dermatologie & kosmetologie | Ausgabe 5/2018

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Zusammenfassung

Aufgrund der Vielgestaltigkeit der Ausfallsmuster und der zahlreichen möglichen Ursachen betrachten viele Ärzte Haarausfall bei Frauen als crux medicorum. Doch das Problem ist beherrschbar. Grundsätzlich ist zu unterscheiden, ob der Haarausfall durch hormonelle oder nicht hormonelle Ursachen bedingt ist und ob im Fall einer androgenetischen Alopezie eine manifeste Hyperandrogenämie oder nur eine erhöhte Sensitivität der Haarfollikel gegenüber Androgenen vorliegt.

Ludwig E. Classification of the types of androgenetic alopecia (common baldness) occurring in the female sex. Br J Dermatol 1977; 97: 247–54CrossRef

Rojhirunsakool S, Suchonwanit P. Parietal scalp is another affected area in female pattern hair loss: an analysis of hair density and hair diameter. Clin Cosmet Investig Dermatol 2017; 11: 7–12CrossRef

Harries M et al. Towards a consensus on how to diagnose and quantify female pattern hair loss — The ‚Female Pattern Hair Loss Severity Index (FPHL-SI)‘. J Eur Acad Dermatol Venereol 2016; 30: 667–76CrossRef

Hamilton JB. Patterned loss of hair in man; types and incidence. Ann N Y Acad Sci 1951; 53: 708–28CrossRef

Norwood OT. Male pattern baldness: classification and incidence. South Med J 1975; 68: 1359–65CrossRef

Thigpen AE et al. Tissue distribution and ontogeny of steroid 5 alpha-reductase isozyme expression. J Clin Invest 1993; 92: 903–10CrossRef

Whigley et al. Natural mutagenesis study of the human steroid 5-alpha-reductase 2 isozyme. Biochemistry 1994; 33: 1265–70CrossRef

Lutz G. Alopecia androgenetica des Mannes — Status Quo. Der Deutsche Dermatologe 2002; 5: 324–33

Sawaya ME, Price VH. Different levels of 5-alpha-reductase type I and II, aromatase, and androgen receptor in hair follicles of women and men with androgenetic alopecia. J Invest Dermatol 1997; 109: 296–300CrossRef

10.

Redler S et al. Selected variants of the steroid-5-alpha-reductase isoforms SRD5A1 and SRD5A2 and the sex steroid hormone receptors ESR1, ESR2 and PGR: no association with female pattern hair loss identified. Exp Dermatol 2012; 21: 390–3CrossRef

11.

Messenger AG, Sinclair R. Follicular miniaturization in female pattern hair loss: clinicopathological correlations. Br J Dermatol 2006; 155: 926–30CrossRef

12.

Price VH. Androgenetic alopecia in women. J Investig Dermatol Symp Proc 2003; 8: 24–7CrossRef

13.

Adachi K, Kano M. Adenyl cyclase in human hair follicles. Its inhibition by dihydrotestosterone. Biochem Biophys Res Commun 1970; 41: 884–90CrossRef

14.

Riedel-Baima B, Riedel A. Female pattern hair loss may be triggered by low oestrogen to androgen ratio. Endocr Regul 2008; 42: 13–6PubMed

15.

Skalnaya MG, Tkachev VP. Trace elements content and hormonal profiles in women with androgenetic alopecia. J Trace Elem Med Biol 2011; 25 Suppl 1: 50–3CrossRef

16.

Urysiak-Czubatka I et al. Assessment of the usefulness of dihydrotestosterone in the diagnostics of patients with androgenetic alopecia. Postepy Dermatol Alergol 2014; 31: 207–15CrossRef

17.

Lutz G. Hair loss and hyperprolactinemia in women. Dermatoendocrinol 2012; 4: 65–71CrossRef

18.

Lutz G. Drug- induced hair loss. In: Dyall-Smith D, Marks R (eds.), Dermatology at the Millenium. The Proceedings of the 19th World Congress of Dermatology, Sydney, Australia, June 15–20, The Parthenon Publishing Group Ltd, New York, Carnforth 1999; 706–10

19.

Levy LL, Emer JJ. Female pattern alopecia: current perspectives. Int J Womens Health 2013; 5: 541–56PubMedPubMedCentral

20.

Hillmer AM et al. Genetic variation in the human androgen receptor gene is the major determinant of common early-onset androgenetic alopecia. Am J Hum Genet 2005; 77: 140–8CrossRef

21.

Brent JR et al. Male-pattern baldness susceptibility locus at 20p11. Nat Genet 2008; 40: 1282–4CrossRef

22.

Brockschmidt FF et al. Six novel susceptibility Loci for early-onset androgenetic alopecia and their unexpected association with common diseases. Fine mapping of the human AR/EDA2R locus in androgenetic alopecia. PLoS Genet 2012; May; 8(5): e1002746CrossRef

23.

Redler S et al. Investigation of variants of the aromatase gene (CYP19A1) in female pattern hair loss. Br J Dermatol 2011; 165: 703–5CrossRef

24.

Redler S et al. Investigation of the male pattern baldness major genetic susceptibility loci AR/EDA2R and 20p11 in women with female pattern hair loss. Br J Dermatol 2012; 166: 1314–8CrossRef

25.

Redler S et al. Investigation of six novel susceptibility loci for male androgenetic alopecia in women with female pattern hair loss. J Dermatol Sci 2013; 72: 186–8CrossRef

26.

Yip L et al. Gene-wide association study between the aromatase gene (CYP19A1) and female pattern hair loss. Br J Dermatol 2009; 161: 289–94CrossRef

27.

Mahmoudi H et al. Selected variants of the melanocortin 4 receptor gene (MC4R) do not confer susceptibility to female pattern hair Loss. Arch Dermatol Res 2013; 305: 249–53CrossRef

28.

Yip L et al. (2012) Association analysis of estrogen receptor beta gene (ESR2) polymorphism with female pattern hair loss. Br J Dermatol 2012; 166: 1131–4CrossRef

29.

Lutz G. Das Trichogramm — Indikation, Durchführung und Interpretation. Der Deutsche Dermatologe 2001; 4: 254–61

30.

Hoffmann R. TrichoScan: Combining epiluminescence microscopy with digital image analysis for the measurement of hair growth in vivo. Eur J Dermatol 2001; 11: 362–8PubMed

31.

van Neste DJ. Hair growth evaluation in clinical dermatology. Dermatology 1993; 187: 233–4CrossRef

32.

Canfield D. Photographic documentation of hair growth in androgenetic alopecia. Dermatol Clin 1996; 14: 713–21CrossRef

33.

Blumeyer A et al. Evidence-based (S3) guideline for the treatment of androgenetic alopecia in women and in men. J Dtsch Dermatol Ges 2011; 9 Suppl 6: 1–57CrossRef

34.

Adil A, Godwin M. The effectiveness of treatments for androgenetic alopecia: A systematic review and meta-analysis. J Am Acad Dermatol 2017; 77: 136–41CrossRef

35.

Lachgar S et al. Minoxidil upregulates the expression of vascular endothelial growth factor in human hair dermal papilla cells. Br J Dermaltol 1998; 138: 407–11CrossRef

36.

Blume-Peytavi U et al. Efficacy and Safety of Once-Daily Minoxidil Foam 5% Versus Twice-Daily Minoxidil Solution 2% in Female Pattern Hair Loss: A Phase III, Randomized, Investigator-Blinded Study. J Drugs Dermatol 2016; 15: 883–9PubMed

37.

Bergfeld W et al. A Phase III, Multicenter, Parallel-Design Clinical Trial to Compare the Efficacy and Safety of 5% Minoxidil Foam Versus Vehicle in Women With Female Pattern Hair Loss. J Drugs Dermatol 2016; 15: 874–81PubMed

38.

Price VH et al. Changes in hair weight and hair count in men with androgenetic alopecia, after application of 5% and 2% topical minoxidil, placebo, or no treatment. J Am Acad Dermatol 1999; 41: 717–21CrossRef

39.

Mc Coy et al. Minoxidil dose response study in female pattern hair loss patients determined to be non-responders to 5% topical minoxidil. J Biol Regul Homeost Agents 2016; 30: 1153–5

40.

Orfanos CE, Vogels L. Lokaltherapie der Alopecia androgenetica mit 17 α-Estradiol-Östradiol. Dermatologica 1980; 161: 124–32CrossRef

41.

Wozel G et al. Alfatradiol (0,025%) — Eine wirksame und sichere Therapieoption zur Behandlung der androgenetischen Alopezie bei Frauen und Männern. Akt Dermatol 2005; 31: 549–52CrossRef

42.

Kim HJ et al. The Efficacy and Savety of 17 α-Estradiol (Ell-Cranell®)alpha 0,025%) Solution on Female Pattern Hair Loss: Single Center, Open-Label, Non-Comporative, Phase IV Study. Ann Dermatol 2012; 24: 295–305CrossRef

43.

Schriefers H et al. Hemmung des Testosteronstoffwechsel durch 17 α-Estradiol in Rattenleberschnitten. Arzneimittelforschung/Drug Res 1991; 41: 1186–9

44.

Hoffmann R et al. 17alpha-estradiol induces aromatase activity in intact human anagen hair follicles ex vivo. Exp Dermatol 2002; 11: 376–80CrossRef

45.

Georgala S et al. Topical Estrogen Therapy for Androgenetic Alopecia in Menopausal Females. Dermatology 2004; 208: 178–9CrossRef

46.

Abadjieva TI. Treatment of androgenetic alopecia in females in reproductive age with topical estradiolbenzoate, prednisolon and salicylic acid. Folia Med (Plovdiv) 2000; 42: 26–9

47.

Emons G et al. Postmenopausal bleeding following the application of an estrogen-containing hair lotion — concomitant endocrine changes. Geburtshilfe Frauenheilkd 1984; 460–2

48.

Choe SJ et al. Therapeutic Efficacy of a Combination Therapy of Topical 17α-Estradiol and Topical Minoxidil on Female Pattern Hair Loss: A Noncomparative, Retrospective Evaluation. Ann Dermatol 2017; 29: 276–82CrossRef

49.

Gassmueller J et al. Topical fulvestrant solution has no effect on male and postmenopausal female androgenetic alopecia: results from two randomized, proof-of-concept studies. Br J Dermatol 2008; 158:109–15PubMed

50.

Emer J et al. Novel treatment of female-pattern androgenetic alopecia with injected bimatoprost 0.03% solution. Drugs Dermatol 2011; 10: 795–8

51.

Allergan Safety and Efficacy Study of Bimatoprost in the Treatment of Women With Female Pattern Hair Loss Available from http://clinicaltrials.gov/ct2/show/NCT01325350. NLM identifier: NCT01325350; Accessed April 9, 2013

52.

Cohen JL. Enhancing the growth of natural eyelashes: the mechanism of bimatoprost-induced eyelash growth. Dermatol Surg 2010; 36: 1361–71CrossRef

53.

Wester ST et al. Eyelash growth from application of bimatoprost in gel suspension to the base of the yelashes. Ophthalmology 2010; 117: 1024–31CrossRef

54.

Legro RS et al. Diagnosis and treatment of polycystic ovary syndrome: an Endocrine Society clinical practice guideline. In: The Journal of clinical endocrinology and metabolism. 2013, Bd 98, 12: 4565–92CrossRef

55.

Dadachanji R et al. Genetic Variants Associated with Hyperandrogenemia in PCOS Pathophysiology. Genet Res Int 2018; 2018: 7624932PubMedPubMedCentral

56.

Orfanos CE et al. „The SAHA syndrome“. Horm Res 2000; 54: 251–8PubMed

57.

Simard J et al. Characteristics of interaction of the antiandrogen flutamide with the androgen receptor in various target tissues. Mol Cell Endocrinol 1986; 44: 261–70CrossRef

58.

Carmina E, Lobo RA. Treatment of hyperandrogenic alopecia in women. Fertil Steril 2003; 79: 91–5CrossRef

59.

Yazdabadi A, Sinclair R. Treatment of female pattern hair loss with the androgen receptor antagonist flutamide. Australas J Dermatol 2011; 52: 132–34CrossRef

60.

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: 469–75CrossRef

61.

Spinucci G, Pasquali R. Finasteride: a new drug for the treatment of male hirsutism and androgenetic alopecia? Clin Ter 1996; 147: 305–15PubMed

62.

Trueb RM. Finasteride treatment of patterned hair loss in normoandrogenic postmenopausal women. Dermatology 2004; 209: 202–7CrossRef

63.

Iorizzo M et al. Finasteride treatment of female pattern hair loss. Arch Dermatol 2006; 142: 298–302CrossRef

64.

Camacho-Martinez FM. Hair loss in women. Semin Cutan Med Surg 2009; 28: 19–32CrossRef

65.

Price VH et al. Lack of efficacy of finasteride in postmenopausal women with androgenetic alopecia. J Am Acad Dermatol 2000; 43: 768–76.CrossRef

66.

Lee SW et al. A Systematic Review of Topical Finasteride in the Treatment of Androgenetic Alopecia in Men and Women. J Drugs Dermatol 2018; 17: 457–63PubMed

67.

Olszewska M, Rudnicka L. Effective treatment of female androgenic alopecia with dutasteride. J Drugs Dermatol 2005; 4: 637–40.PubMed

68.

Moftah N et al. Mesotherapy using dutasteride-containing preparation in treatment of female pattern hair loss: photographic, morphometric and ultrustructural evaluation. J Eur Acad Dermatol Venereol 2013; 27: 686–93CrossRef

69.

Wolff H et al. Diagnostik und Therapie von Haar- und Kopfhauterkrankungen. Dtsch Arztebl 2016; 113: 377–86.

70.

Seale LR et al. Side Effects Related to 5α-Reductase Inhibitor Treatment of Hair Loss in Women: A Review. J Drugs Dermatol 2016; 15: 414–9PubMed

71.

Roque LV et al. Design of Finasteride-Loaded Nanoparticles for Potential Treatment of Alopecia. Skin Pharmacol Physiol 2017; 30: 197–204CrossRef

72.

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: 992–9CrossRef

73.

Santos Z et al. Drug discovery for alopecia: gone today, hair tomorrow. Expert Opin Drug Discov 2015; 10: 269–92CrossRef

74.

Conrad F et al. Substantial sex-dependent differences in the response of human scalp hair follicles to estrogen stimulation in vitro advocate gender-tailored management of female versus male pattern balding. J Investig Dermatol Symp Proc 2005; 10: 243–6.CrossRef

75.

Conrad F, Paus R. Estrogens and the hair follicle. J Dtsch Dermatol Ges 2004; 2: 412–23.CrossRef

76.

Mirmirani P. Hormonal changes in menopause: do they contribute to a ‚midlife hair crisis‘ in women? Br J Dermatol 2011; 165 Suppl 3: 7–11CrossRef

77.

Adenuga P et al. Hair regrowth in a male patient with extensive androgenetic alopecia on estrogen therapy. Am Acad Dermatol 2012; 67: 121–3CrossRef

78.

Gabrilove JL, Luria M. Persistent gynecomastia resulting from scalp inuction of estradiol: a model for persisting gynecomastia. Arch Dermatol 1978; 114: 1672–3CrossRef

79.

Orfanos CE, Wüstner H. Penetration and side effects of local estrogen application in alopecia androgenetica. Hautarzt 1975; 26:367–9PubMed

80.

Robbins C et al. What women want — quantifying the perception of hair amount: an analysis of hair diameter and density changes with age in caucasian women. Br J Dermatol 2012; 167: 324–32CrossRef

81.

Check JH, Cohen R. An update on the treatment of female alopecia and the introduction of a potential novel therapy. Clin Exp Obstet Gynecol 2015; 42: 411–5PubMed

82.

Harfmann KL, Bechtel MA. Hair loss in women. Clin Obstet Gynecol 2015; 58:185–99CrossRef

83.

Guida M et al. Review of the safety, efficacy and patient acceptability of the combined dienogest/estradiol valerate contraceptive pill. J Womens Health Int 2010; 2: 279–90

84.

Kossard S. Postmenopausal frontal fibrosing alopecia. Scarring alopecia in a patter distribution. Arch Dermatol 1994; 130: 770–4CrossRef

85.

Kossard S et al. Postmenopausal frontal fibrosing alopecia: a frontal variant of lichen planopilaris. J Am Acad Dermatol 1997; 36: 59–66CrossRef

86.

Lutz G, Löser C. Primäre vernarbende Alopezien. Der Deutsche Dermatologe 2015; 4: 294–300CrossRef

87.

Kanti V et al. Vernarbende Alopezien. J Dtsch Dermatol Ges 2018; 4: 435–61

88.

Olsen EA et al. Iron deficiency in female pattern hair loss, chronic telogen effluvium, and control groups. J Am Acad Dermatol 2010; 63: 991–9CrossRef

89.

Lutz G. Nutritive Haarwachstumsförderung mit Spurenelementen, Vitaminen und sekundären Pflanzenbegleitstoffen bei Frauen. Akt Dermatol 2012; 38: 199–205CrossRef

90.

Gerkowicz A et al. The Role of Vitamin D in Non-Scarring Alopecia. Int J Mol Sci 2017; Dec 7; 18(12). pii: E2653CrossRef

91.

Conic RRZ et al. Vitamin D Status in Scarring and Non-Scarring Alopecia. J Am Acad Dermatol 2018 Apr 21. pii: S0190–9622(18)30631–5

92.

Halsner U. Eigenhaartransplantion — Punch Technik. Kosmet Med 2000; 21: 16–8

93.

Neidel G, Leonhardt K. Haartransplantation bei Frauen — eine normale Prozedur? derm 2004; 10: 1–6

94.

Unger RH. Female hair restoration. Facial Plast Surg Clin North Am 2013; 21: 407–17CrossRef

95.

Sinclair R et al. Hair loss in women: medical and cosmetic approaches to increase scalp hair fullness. Br J Dermatol 2011; 165 Suppl 3: 12–8CrossRef

Titel: Ein Haarausfall mit vielen Facetten
Alopecia androgenetica der Frau
verfasst von: PD Dr. med. Gerhard Lutz
Publikationsdatum: 12.10.2018
Verlag: Springer Medizin
Schlagwörter: Alopezie
Minoxidil
Lichen planopilaris
Androgene
Antiandrogene
Estradiol
Ästhetische Chirurgie
Ästhetische Dermatologie
Ästhetisch-Plastische Chirurgie
Erschienen in: ästhetische dermatologie & kosmetologie / Ausgabe 5/2018
Print ISSN: 1867-481X
Elektronische ISSN: 2198-6517
DOI: https://doi.org/10.1007/s12634-018-5562-z

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