130 Irreversibility of hair follicle changes after 30 months of Androgenetic Alopecia.

Konstantinova N, Korotkii N.G, Sharova N, Barhunova E, Gaevski D. Nioxin Research Inc, Atlanta, USA Moscow Medical University

We studied horizontal and vertical biopsy from 15 caucasian 24-41 year old males diagnosed with bitemporal recession Androgenetic Alopecia (AA) for 1.5 –18 years (average 7.4 years). All 15 biopsies were stained with H&E, Van Gieson and with other collagen specific stainings. 1. Eleven pts with AA longer than 3 years had perifollicular fibrosis - collagen fibers were compact and formed a small scar-like formation around each anagen hair follicle(HF). Two patients - 33 year old with 18 month AA and 23 year old with 20 month AA did not have these hair follicle changes. Two 26-year-old patients with 30 and 36 month AA respectively were found to have some not so severe collagen fiber changes. 2. Infundibulum of HF dilatated 124-192 mm and most of them covered with keratinazed plug lacking normal hair shaft growth. 3. Decreased number of hair follicles 1.75-2,45 per sq. mm from 3.5-5 per sq. mm in control group. 4. None of anagen HF was situated in subcutaneous fat. We showed a correlation between length of the AA and severity/ thickness of perifollicular fibrosis. The result of this study is that any treatment of AA is recommended to start earlier than 30 months from first signs of AA. This should prevent irreversible collagen changes associated with “fibrotic incapsulation” of most anagen HF in involved areas, which usually leads to loss of normal blood supply, innervation, and subsequent miniaturization and prevention of hair from normal cycling.