头皮微生态失衡在雄激素性脱发中的作用机制与干预策略研究进展

Research Progress on the Mechanism and Intervention Strategies of Scalp Microecological Imbalance in Androgenetic Alopecia

摘要: 雄激素性脱发(AGA)是临床上极为常见的进行性脱发，受遗传因素、激素因素、局部微环境等多种因素共同影响。近年来，人们越来越关注头皮微生态失衡在AGA发生、发展中的作用。本文梳理了毛囊周围丙酸杆菌属、马拉色菌属、葡萄球菌属等核心菌群组成变化与AGA的关系，通过菌群失调引起免疫反应、破坏毛囊周围屏障、影响毛囊干细胞微环境、介导炎症信号通路等过程形成促脱发炎症微环境，介绍了从“菌群失调”到“炎症微环境”的级联反应机制，探讨了以头皮微生态为靶点的AGA诊断和治疗新策略。

Abstract: Androgenetic alopecia (AGA) is an extremely common progressive hair loss disease in clinical practice, which is affected by multiple factors such as genetic factors, hormonal factors and local microenvironment. In recent years, increasing attention has been paid to the role of scalp microecological imbalance in the occurrence and development of AGA. This paper reviews the relationship between changes in the composition of core flora around hair follicles (such as Cutibacterium, Malassezia, Staphylococcus) and AGA. It elaborates that flora imbalance forms a hair loss-promoting inflammatory microenvironment by triggering immune responses, damaging the perifollicular barrier, affecting the hair follicle stem cell microenvironment, and mediating inflammatory signaling pathways. The cascade mechanism from “flora imbalance” to “inflammatory microenvironment” is introduced, and new strategies for the diagnosis and treatment of AGA targeting scalp microecology are discussed.