雄激素性脱发注射治疗的前沿探索与展望
Frontier Exploration and Prospect of Injection Therapy of Androgenetic Alopecia
摘要: 雄激素性脱发(Androgenetic Alopecia, AGA)是最常见的非瘢痕性脱发，治疗方案多样但效果不一。注射治疗作为一种新兴的治疗方法，主要包括浓缩血小板及衍生制品注射、A型肉毒毒素注射、间充质干细胞注射等，逐年受到关注。该类方法通过将药物或生物制剂直接注射到脱发区，提高药物局部浓度，更精准地作用于毛囊，增强疗效的同时减少全身不良反应，为AGA的治疗提供了新的思路和方法。本文综述了注射治疗在AGA中的临床研究进展，汇总了不同注射疗法在AGA中的试验成果，并分析其前景。
Abstract: Androgenetic alopecia (AGA) is the most common non-scarring alopecia, and the treatment options are diverse but the effects are different. As an emerging treatment method, injection therapy mainly includes concentrated platelet and derivative products injection, botulinum toxin type A injection, mesenchymal stem cells injection, etc., which has attracted attention year by year. These methods provide new ideas and methods for the treatment of AGA by directly injecting drugs or biological agents into the hair loss area, increasing the local concentration of drugs, acting more accurately on the hair follicles, enhancing the efficacy and reducing systemic adverse reactions. This article reviews the clinical research progress of injection therapy in AGA, summarizes the experimental results of different injection therapies in AGA, and analyzes its prospects.
文章引用：高元师, 谢林海. 雄激素性脱发注射治疗的前沿探索与展望[J]. 临床医学进展, 2025, 15(4): 3249-3255. https://doi.org/10.12677/acm.2025.1541293

参考文献

[1] 胡志奇, 苗勇. 中国人雄激素性脱发诊疗指南[J]. 中国美容整形外科杂志, 2019, 30(1): 8-12.
[2] Wang, T.L., Zhou, C., Shen, Y.W., Wang, X.Y., Ding, X.L., Tian, S., et al. (2010) Prevalence of Androgenetic Alopecia in China: A Community-Based Study in Six Cities. British Journal of Dermatology, 162, 843-847. [Google Scholar] [CrossRef] [PubMed]
[3] 中国老年医学学会烧创伤分会. 浓缩血小板制品在创面修复中应用的全国专家共识(2020版) [J]. 中华烧伤杂志, 2020, 36(11): 993-1002.
[4] Gentile, P. and Garcovich, S. (2020) Systematic Review of Platelet-Rich Plasma Use in Androgenetic Alopecia Compared with Minoxidil®, Finasteride®, and Adult Stem Cell-Based Therapy. International Journal of Molecular Sciences, 21, Article 2702. [Google Scholar] [CrossRef] [PubMed]
[5] 冯歆越, 赵梓纲. 富血小板血浆治疗雄激素性脱发的临床应用进展[J]. 武警医学, 2023, 34(9): 825-828.
[6] Cervelli, V., Scioli, M.G., Gentile, P., Doldo, E., Bonanno, E., Spagnoli, L.G., et al. (2012) Platelet-Rich Plasma Greatly Potentiates Insulin-Induced Adipogenic Differentiation of Human Adipose-Derived Stem Cells through a Serine/Threonine Kinase AKT-Dependent Mechanism and Promotes Clinical Fat Graft Maintenance. Stem Cells Translational Medicine, 1, 206-220. [Google Scholar] [CrossRef] [PubMed]
[7] Cervelli, V., Gentile, P., Scioli, M.G., Grimaldi, M., Casciani, C.U., Spagnoli, L.G., et al. (2009) Application of Platelet-Rich Plasma in Plastic Surgery: Clinical and in Vitro Evaluation. Tissue Engineering Part C: Methods, 15, 625-634. [Google Scholar] [CrossRef] [PubMed]
[8] Kapur, S.K. and Katz, A.J. (2013) Review of the Adipose Derived Stem Cell Secretome. Biochimie, 95, 2222-2228. [Google Scholar] [CrossRef] [PubMed]
[9] Gupta, A.K. and Carviel, J. (2016) A Mechanistic Model of Platelet-Rich Plasma Treatment for Androgenetic Alopecia. Dermatologic Surgery, 42, 1335-1339. [Google Scholar] [CrossRef] [PubMed]
[10] Shen, H., Cheng, H., Chen, H. and Zhang, J. (2016) Identification of Key Genes Induced by Platelet-Rich Plasma in Human Dermal Papilla Cells Using Bioinformatics Methods. Molecular Medicine Reports, 15, 81-88. [Google Scholar] [CrossRef] [PubMed]
[11] Ince, B., Yildirim, M.E.C., Dadaci, M., Avunduk, M.C. and Savaci, N. (2017) Comparison of the Efficacy of Homologous and Autologous Platelet-Rich Plasma (PRP) for Treating Androgenic Alopecia. Aesthetic Plastic Surgery, 42, 297-303. [Google Scholar] [CrossRef] [PubMed]
[12] Pakhomova, E.E. and Smirnova, I.O. (2020) Comparative Evaluation of the Clinical Efficacy of PRP-Therapy, Minoxidil, and Their Combination with Immunohistochemical Study of the Dynamics of Cell Proliferation in the Treatment of Men with Androgenetic Alopecia. International Journal of Molecular Sciences, 21, Article 6516. [Google Scholar] [CrossRef] [PubMed]
[13] Peng, X., Li, S., Zhou, X., Zhu, K., Ni, X. and Qi, X. (2024) A Prospective Self-Controlled Clinical Trial of Nonactivated Low Leukocyte PRP in Female Pattern Hair Loss Patients of Childbearing Age. Dermatologic Surgery, 50, 926-930. [Google Scholar] [CrossRef] [PubMed]
[14] Papakonstantinou, M., Siotos, C., Gasteratos, K.C., Spyropoulou, G. and Gentile, P. (2022) Autologous Platelet-Rich Plasma Treatment for Androgenic Alopecia: A Systematic Review and Meta-Analysis of Clinical Trials on Patient Safety, Efficacy and Outcomes. Plastic & Reconstructive Surgery, 151, 739e-747e. [Google Scholar] [CrossRef] [PubMed]
[15] 杨晓双. 浓缩生长因子在雄激素性脱发中的治疗进展[J]. 中国美容医学, 2021, 30(2): 179-183.
[16] 江举, 郭宏恩, 何丽霞, 等. 自体浓缩生长因子联合5%米诺地尔酊治疗男性雄激素性脱发的临床疗效分析[J]. 中国医疗美容, 2023, 13(10): 54-58.
[17] 徐林刚, 陈龙金, 李彦锋, 等. 自体浓缩生长因子联合A型肉毒毒素治疗男性雄激素性脱发临床疗效[J]. 中国医疗美容, 2022, 12(7): 51-56.
[18] Tan Pohching, 周双白, 吴巍, 等. 自体浓缩生长因子治疗男性雄激素源性脱发的临床应用20例[J]. 组织工程与重建外科杂志, 2019, 15(3): 159-162, 184.
[19] Tan, P., Zhang, P., Xie, Y., Gao, Y., Li, Q., Zhou, S., et al. (2021) Autologous Concentrated Growth Factors Combined with Topical Minoxidil for the Treatment of Male Androgenetic Alopecia: A Randomized Controlled Clinical Trial. Facial Plastic Surgery & Aesthetic Medicine, 23, 255-262. [Google Scholar] [CrossRef] [PubMed]
[20] 杨堃, 付聪, 凌佳琦, 等. A型肉毒毒素治疗雄激素性脱发的机制及研究进展[J]. 中国美容整形外科杂志, 2022, 33(1): 23-25.
[21] Goldman, B.E., Fisher, D.M. and Ringler, S.L. (1996) Transcutaneous PO2 of the Scalp in Male Pattern Baldness: A New Piece to the Puzzle. Plastic and Reconstructive Surgery, 97, 1109-1116. [Google Scholar] [CrossRef] [PubMed]
[22] Giordano, C.N., Matarasso, S.L. and Ozog, D.M. (2017) Injectable and Topical Neurotoxins in Dermatology: Basic Science, Anatomy, and Therapeutic Agents. Journal of the American Academy of Dermatology, 76, 1013-1024. [Google Scholar] [CrossRef] [PubMed]
[23] Wang, Y., Zhang, H., Zheng, Q., Tang, K., Fang, R. and Sun, Q. (2020) Botulinum Toxin as a Double‐Edged Sword in Alopecia: A Systematic Review. Journal of Cosmetic Dermatology, 19, 2560-2565. [Google Scholar] [CrossRef] [PubMed]
[24] Inui, S. and Itami, S. (2011) Molecular Basis of Androgenetic Alopecia: From Androgen to Paracrine Mediators through Dermal Papilla. Journal of Dermatological Science, 61, 1-6. [Google Scholar] [CrossRef] [PubMed]
[25] Shon, U., Kim, M.H., Lee, D.Y., Kim, S.H. and Park, B.C. (2020) The Effect of Intradermal Botulinum Toxin on Androgenetic Alopecia and Its Possible Mechanism. Journal of the American Academy of Dermatology, 83, 1838-1839. [Google Scholar] [CrossRef] [PubMed]
[26] Melo, D.F., Müller-Ramos, P., Cortez de Almeida, R.F., Machado, C.J., Frattini, S., Donda, A.L.V., et al. (2024) Efficacy of Botulinum Toxin in Male Androgenetic Alopecia: A Triple-Blind, Randomized Clinical Trial. Journal of the American Academy of Dermatology, 91, 996-998. [Google Scholar] [CrossRef] [PubMed]
[27] Landau, M., Klein, J., Leizgold, F.R. and Kroumpouzos, G. (2024) Rare and Novel Complications of Botulinum Neurotoxin Type A and Dermal Filler Injections. Clinics in Dermatology, 42, 701-708. [Google Scholar] [CrossRef] [PubMed]
[28] Seoudy, W.M., Metwally, O.A., Elfangary, M.M. and Mohamed, T.M. (2023) Assessment of Efficacy of Different Botulinum Toxin a Concentrations in the Treatment of Androgenetic Alopecia Assessed by Dermoscopy. Journal of Cosmetic Dermatology, 23, 417-425. [Google Scholar] [CrossRef] [PubMed]
[29] Li, J., Zhang, S., Zhao, W., Yang, F., Liu, M., Li, X., et al. (2024) Intradermal Injection in Balding Region versus Intramuscular Injection in Surrounding Muscles: A Split-Scalp, Randomized Trial on Bont for Androgenetic Alopecia. Dermatology and Therapy, 14, 1671-1682. [Google Scholar] [CrossRef] [PubMed]
[30] Yan, W., Liu, J., Xie, X., Jin, Q., Yang, Y., Pan, Y., et al. (2024) Restoration of Follicular β-Catenin Signaling by Mesenchymal Stem Cells Promotes Hair Growth in Mice with Androgenetic Alopecia. Stem Cell Research & Therapy, 15, Article No. 439. [Google Scholar] [CrossRef] [PubMed]
[31] Mathen, C. and Dsouza, W. (2021) In Vitro and Clinical Evaluation of Umbilical Cord‐Derived Mesenchymal Stromal Cell‐Conditioned Media for Hair Regeneration. Journal of Cosmetic Dermatology, 21, 740-749. [Google Scholar] [CrossRef] [PubMed]
[32] Lee, Y.I., Kim, J., Kim, J., Park, S. and Lee, J.H. (2020) The Effect of Conditioned Media from Human Adipocyte-Derived Mesenchymal Stem Cells on Androgenetic Alopecia after Nonablative Fractional Laser Treatment. Dermatologic Surgery, 46, 1698-1704. [Google Scholar] [CrossRef] [PubMed]
[33] Gentile, P., Scioli, M.G., Bielli, A., De Angelis, B., De Sio, C., De Fazio, D., et al. (2019) Platelet-Rich Plasma and Micrografts Enriched with Autologous Human Follicle Mesenchymal Stem Cells Improve Hair Re-Growth in Androgenetic Alopecia. Biomolecular Pathway Analysis and Clinical Evaluation. Biomedicines, 7, Article 27. [Google Scholar] [CrossRef] [PubMed]
[34] Gimble, J.M., Bunnell, B.A., Chiu, E.S. and Guilak, F. (2011) Concise Review: Adipose-Derived Stromal Vascular Fraction Cells and Stem Cells: Let’s Not Get Lost in Translation. Stem Cells, 29, 749-754. [Google Scholar] [CrossRef] [PubMed]
[35] 中国整形美容协会毛发医学分会, 中国非公立医疗机构协会整形与美容专业委员会毛发移植修复外科与头皮健康管理学组, 中国非公立医疗机构协会皮肤专业委员会毛发医学与头皮健康管理学组. 头皮美塑疗法技术操作规范专家共识[J]. 中国美容整形外科杂志, 2022, 33(5): 251-256.
[36] Melo, D.F., de Mattos Barreto, T., Plata, G.T., Araujo, L.R. and Tortelly, V.D. (2019) Excellent Response to Mesotherapy as Adjunctive Treatment in Male Androgenetic Alopecia. Journal of Cosmetic Dermatology, 19, 75-77. [Google Scholar] [CrossRef] [PubMed]
[37] Gupta, A.K., Polla Ravi, S., Wang, T., Talukder, M., Starace, M. and Piraccini, B.M. (2023) Systematic Review of Mesotherapy: A Novel Avenue for the Treatment of Hair Loss. Journal of Dermatological Treatment, 34, Article ID: 2245084. [Google Scholar] [CrossRef] [PubMed]
[38] Tang, Z., Hu, Y., Wang, J., Fan, Z., Qu, Q. and Miao, Y. (2022) Current Application of Mesotherapy in Pattern Hair Loss: A Systematic Review. Journal of Cosmetic Dermatology, 21, 4184-4193. [Google Scholar] [CrossRef] [PubMed]

为你推荐