Metformin and hair loss
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Metformin and Hair Loss: A Comprehensive Review
Introduction to Metformin and Hair Loss
Metformin, a widely used medication for managing type 2 diabetes, has been investigated for its potential effects on hair growth and hair loss. This article synthesizes findings from multiple studies to provide a clear understanding of how metformin may influence hair health.
Metformin and Central Centrifugal Cicatricial Alopecia (CCCA)
Hair Regrowth in CCCA Patients
Central centrifugal cicatricial alopecia (CCCA) is a progressive scarring alopecia predominantly affecting women of African descent. A study reported hair regrowth in two patients with recalcitrant CCCA after the topical application of metformin. The study suggests that metformin's efficacy in improving fibrosis, mediated through adenosine monophosphate-activated protein kinase (AMPK), may contribute to its positive effects on hair regrowth in CCCA patients.
Metformin and Hair Cell Protection
Gentamicin-Induced Hair Cell Death
Metformin has shown protective effects against gentamicin-induced hair cell death in vitro. In murine cochlear explants, metformin blocked the gentamicin-induced translocation of endonuclease G into the nucleus of outer hair cells, thereby attenuating hair cell loss. However, in vivo studies in guinea pigs revealed that metformin did not prevent gentamicin-induced ototoxicity and, at higher dosages, even aggravated auditory threshold shifts and caused additional adverse reactions.
Metformin and Hirsutism in Polycystic Ovary Syndrome (PCOS)
Improvement in Hirsutism
In women with polycystic ovary syndrome (PCOS), metformin has been shown to significantly improve hirsutism, a condition characterized by excessive hair growth. A double-blind placebo-controlled crossover study involving 16 women with PCOS and hirsutism demonstrated that metformin treatment led to a significant reduction in hirsutism scores and patient self-assessment of hair growth. Additionally, metformin treatment improved other parameters such as weight, cycle frequency, and sex hormone binding globulin (SHBG) levels.
Metformin and Hair Follicle Regeneration
Hair-Inductive Activity in 3D Aggregates
Research on a mouse hair-follicle reconstitution model has shown that metformin can promote hair follicle regeneration. In this study, metformin treatment of three-dimensional aggregates of epidermal and dermal cells resulted in the upregulation of molecular markers associated with hair-inductive activity, such as hepatocyte growth factor (HGF), prominin-1 (CD133), alkaline phosphatase (ALP), β-catenin, and SRY-box transcription factor 2 (SOX2). These findings suggest that metformin enhances the trichogenic capacity of dermal cells, which could be beneficial for treating male or female pattern hair loss.
Conclusion
The research on metformin and hair loss presents promising yet varied results. While metformin shows potential in promoting hair regrowth in conditions like CCCA and improving hirsutism in PCOS, its protective effects against hair cell death in ototoxicity are less clear and may even be detrimental at higher dosages. Further clinical studies are warranted to fully understand the mechanisms and therapeutic potential of metformin in hair loss and hair growth treatments.
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