注射治疗在雄激素性脱发中的应用进展

doi:10.3760/cma.j.cn441417-20241213-14006

摘要/Abstract

摘要： 注射治疗是雄激素性脱发（androgenic alopecia，AGA）的重要治疗手段。目前，血小板浓缩提取物（platelet concentrates，PC）、A型肉毒毒素（botulinum toxin type A，BoNT/A）、干细胞和自体脂肪基质血管成分（stromal vascular fraction，SVF）的局部注射已被应用于临床。本文就这些注射治疗方法在AGA中的应用进行综述。

关键词: 雄激素性脱发, 注射治疗, 血小板浓缩提取物, A型肉毒毒素, 进展

Abstract:

Injection therapy is a significant treatment method for androgenic alopecia (AGA). Currently, local injections of platelet concentrates, botulinum toxin type A (BoNT/A), stem cells, and stromal vascular fraction (SVF) have been used in clinical practice. This article offers a comprehensive review of these injection therapy methods in AGA.

Key words: Androgenetic alopecia, , Injection therapy, , Platelet concentrates, , Botulinum toxin type A, , Progress

曹影菡高昱.

注射治疗在雄激素性脱发中的应用进展 [J]. 国际医药卫生导报, 2025, 31(14): 2313-2316.

Cao Yinghan, Gao Yu.

Application of injection therapy in androgenic alopecia [J]. International Medicine and Health Guidance News, 2025, 31(14): 2313-2316.

参考文献

[1]周城,范卫新,方红,等.中国雄激素性秃发诊疗指南(2023)[J].临床皮肤科杂志,2024,53(12):752-758. DOI: 10.16761/j.cnki.1000-4963.2024.12.015.

[2]Wang TL, Zhou C, Shen YW, et al. Prevalence of androgenetic alopecia in China: a community-based study in six cities[J]. Br J Dermatol, 2010, 162(4): 843-847. DOI: 10.1111/j.1365-2133.2010.09640.x.

[3]孙彩红,赖永贤,汪青良,等. 342例雄激素性脱发患者生活质量与心理状况分析[J].中国中西医结合皮肤性病学杂志,2023,22(3):259-261. DOI:10.3969/j.issn.1672-0709.2023.03.011.

[4]Heilmann S, Kiefer AK, Fricker N, et al.Androgenetic alopecia: identification of four genetic risk loci and evidence for the contribution of WNT signaling to its etiology[J]. J Invest Dermatol, 2013, 133(6):1489-1496. DOI: 10.1038/jid.2013.43.

[5]王敏,王霞.热激蛋白27联合miR-1介导雄激素受体上调导致雄激素性脱发发病[J].中南大学学报(医学版),2022,47(1):72-78. DOI: 10.11817/j.issn.1672-7347.2022.210131.

[6]Upadhyay DK, Sharma A, Sarma GS, et al. Mechanism of androgenic alopecia: addressing speculations through empirical evidences[J]. Dermatol Ther, 2019, 32(6): e13120. DOI:10.1111/dth.13120.

[7]王超凡,范卫新.女性型秃发的发病特点及临床诊疗更新[J].临床皮肤科杂志,2024,53(12):759-763. DOI:10.16761/j.cnki.1000-4963.2024.12.016.

[8]Tang X, Cao C, Liang Y, et al. Adipose-derived stem cell exosomes antagonize the inhibitory effect of dihydrotestosterone on hair follicle growth by activating Wnt/β-Catenin pathway[J]. Stem Cells Int, 2023: 5548112. DOI: 10.1155/2023/5548112.

[9]程飚,朱絮,杨域,等.浓缩血小板在毛发再生中的临床应用专家共识(2022版)[J].中国美容整形外科杂志,2023,34(1): 6-13.

[10]Calciolari E, Dourou M, Akcali A, et al. Differences between first- and second-generation autologous platelet concentrates[J]. Periodontol 2000, 2025, 97(1):52-73.DOI: 10.1111/prd.12550.

[11]Sharma A, Chouhan K, Bhatia S, et al. Platelet-rich plasma in androgenetic alopecia[J]. Indian Dermatol Online J, 2021, 12 Suppl 1: S31-S40. DOI: 10.4103/idoj.idoj_328_21.

[12]Pakhomova EE, Smirnova IO. 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[J]. Int J Mol Sci, 2020, 21(18): 6516. DOI: 10.3390/ijms21186516.

[13]Li M, Qu K, Lei Q, et al. Effectiveness of platelet-rich plasma in the treatment of androgenic alopecia: a meta-analysis[J]. Aesthetic Plast Surg, 2024, 48(5): 977-984. DOI: 10.1007/S00266-023-03603-9.

[14]Pereira VBS, Lago CAP, Almeida RAC, et al. Biological and cellular properties of Advanced Platelet-Rich Fibrin (A-PRF) compared to other platelet concentrates: systematic review and meta-analysis[J]. Int J Mol Sci, 2023, 25(1): 482. DOI: 10.3390/ijms25010482.

[15]Shashank B, Bhushan M. Injectable Platelet-Rich Fibrin (PRF): the newest biomaterial and its use in various dermatological conditions in our practice: a case series [J]. J Cosmet Dermatol, 2021, 20(5): 1421-1426. DOI: 10.1111/jocd.13742.

[16]Karimi K, Rockwell H. The benefits of platelet-rich fibrin[J]. Facial Plast Surg Clin North Am, 2019, 27(3): 331-340. DOI: 10.1016/j.fsc.2019.03.005.

[17]Cervino G, Oteri G, D'Amico C, et al. Molecular features and tissue engineering techniques applied to regenerative surgery: an overview of recent data[J]. Minerva Dent Oral Sci, 2021, 70(3): 119-127. DOI: 10.23736/S2724-6329.21.04517-9.

[18]Pohching T,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. DOI:10.3969/j.issn.1673-0364.2019.03.008.

[19]Tan PC, Zhang PQ, Xie Y, et al. Autologous concentrated growth factors combined with topical minoxidil for the treatment of male androgenetic alopecia: a randomized controlled clinical trial[J]. Facial Plast Surg Aesthet Med, 2021, 23(4): 255-262. DOI: 10.1089/fpsam.2020.0288.

[20]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. DOI:10.19593/j.issn.2095-0721.2022.07.013.

[21]程飚.富血小板血浆依然是整形美容外科治疗的希望[J].中国美容医学, 2020, 29(10): 2-7. DOI:10.15909/j.cnki.cn61-1347/r.003966.

[22]Cole JP, Cole MA, Insalaco C, et al.Alopecia and platelet-derived therapies[J]. Stem Cell Investig, 2017, 4:88. DOI: 10.21037/sci.2017.11.01.

[23]Guan Q, Guo ZH, Dai DM, et al. Platelet lysate promotes hair growth: in vitro and in vivo mechanism and randomized, controlled trial[J]. Biomed Pharmacother, 2023, 161: 114517. DOI: 10.1016/j.biopha.2023.114517.

[24]Shirshakova M, Morozova E, Sokolova D, et al. The effectiveness of botulinum toxin type A (BTX-A) in the treatment of facial skin oily seborrhea, enlarged pores, and symptom complex of post-acne [J]. Int J Dermatol, 2021, 60(10): 1232-1241. DOI: 10.1111/ijd.15574.

[25]Jung BH., Song SH, Yoon SJ, et al. The effect of botulinum toxin on hair follicle cell regeneration under continuous stress conditions: a pilot animal study[J]. Neurotox Res, 2022, 40(1): 103-110. DOI: 10.1007/s12640-021-00453-8.

[26]Zhou Y, Yu S, Zhao J, et al. Effectiveness and safety of botulinum toxin type a in the treatment of androgenetic alopecia[J]. Biomed Res Int, 2020: 1501893. DOI: 10.1155/2020/1501893.

[27]Hussein RS, Dayel SB, Abahussein O. Botulinum toxin a for hair loss treatment: a systematic review of efficacy, safety, and future directions[J]. JPRAS Open, 2023, 38: 296-304. DOI:10.1016/j.jpra.2023.09.006.

[28]吴艳,吴琳,于波.肉毒毒素注射在皮肤美容中应用的专家共识(2023版)[J].中国美容医学, 2023, 32(11): 1-9. DOI:10.15909/j.cnki.cn61-1347/r.006008.

[29]Shon U, Kim MH, Lee DY, et al. The effect of intradermal botulinum toxin on androgenetic alopecia and its possible mechanism[J]. J Am Acad Dermatol, 2020, 83(6): 1838-1839. DOI: 10.1016/j.jaad.2020.04.082.

[30]周亚光,于水,赵纪敏,等. A型肉毒毒素治疗雄激素性脱发的临床研究[J].中国美容医学, 2021, 30(5): 101-103. DOI: 10.15909/j.cnki.cn61-1347/r.004413.

[31]Elmaadawi IH, Mohamed BM, Ibrahim ZAS, et al. Stem cell therapy as a novel therapeutic intervention for resistant cases of alopecia areata and androgenetic alopecia[J]. J Dermatolog Treat, 2018, 29(5): 431-440. DOI: 10.1080/09546634.2016.1227419.

[32]Gentile P, Scioli MG, Bielli A, et al. Stem cells from human hair follicles: first mechanical isolation for immediate autologous clinical use in androgenetic alopecia and hair loss[J]. Stem Cell Investig, 2017, 4: 58. DOI: 10.21037/sci.2017.06.04.

[33]Fukuoka H, Narita K, Suga H. Hair regeneration therapy: application of adipose-derived stem cells [J]. Curr Stem Cell Res Ther, 2017, 12(7): 531-534. DOI: 10.2174/1574888X12666170522114307.

[34]Bak DH, Choi MJ, Kim SR, et al. Human umbilical cord blood mesenchymal stem cells engineered to overexpress growth factors accelerate outcomes in hair growth[J]. Korean J Physiol Pharmacol, 2018, 22(5): 555-566. DOI: 10.4196/kjpp.2018.22.5.555.

[35]温立霞,吴为民.自体脂肪基质血管成分的临床研究进展[J].医学综述, 2020, 26(18): 3553-3558. DOI: 10.3969/j.issn.1006-2084.2020.18.004.

[36]Kim SJ, Kim MJ, Lee YJ, et al. Innovative method of alopecia treatment by autologous adipose-derived SVF[J]. Stem Cell Res Ther, 2021, 12(1): 486. DOI: 10.1186/S13287-021-02557-6.

[37]El-Khalawany M, Rageh MA, Elnokrashy I, et al. Efficacy of autologous stromal vascular fraction injection in the treatment of androgenic alopecia[J]. Arch Dermatol Res, 2023, 315(5): 1269-1276. DOI: 10.1007/S00403-022-02501-5.

[38]Butt G, Hussain I, Ahmad FJ, et al. Stromal vascular fraction-enriched platelet-rich plasma therapy reverses the effects of androgenetic alopecia[J]. J Cosmet Dermatol, 2020, 19(5): 1078-1085. DOI: 10.1111/jocd.13149.