Abstract
INTRODUCTION: Androgenetic alopecia (AGA) is the most common form of non-scarring hair loss, characterized by progressive follicular miniaturization, shortened anagen phase, and increased telogen hairs. Traditional therapies, including topical minoxidil and oral finasteride, provide variable efficacy and often require long-term adherence, leaving a substantial unmet need. Emerging pharmacological and regenerative approaches aim to target underlying mechanisms of follicle degeneration, stimulate hair regrowth, and improve hair density and quality. METHODS: A review of literature on novel treatments for AGA, focusing on pharmacological innovations and regenerative-medicine strategies, was performed. Original and review articles published before 1 December 2025 were evaluated for relevance. DISCUSSION: Cell-derived exosomes and mesenchymal stromal cell-conditioned media have shown potential to activate dermal papilla cells, stimulate Wnt/β-catenin signaling, and enhance angiogenesis, resulting in improved hair density and shaft diameter in early clinical studies. Peptide-based formulations and growth-factor concentrates similarly demonstrate follicular anabolic effects, while PRP remains one of the most studied regenerative interventions, with evidence of additive benefit when combined with traditional therapies. Investigational pharmacotherapies, such as KX-826 (pyrilutamide), provide targeted androgen receptor modulation without systemic hormonal suppression. Despite promising preclinical and early clinical data, heterogeneity in study design, dosing, delivery methods, and follow-up limits direct comparisons and generalizability. CONCLUSION: Novel therapies for AGA offer biologically targeted, regenerative approaches that may complement or surpass traditional treatments. While preliminary evidence is encouraging, rigorous, standardized, and long-term clinical trials are required to establish efficacy, optimize protocols, and ensure safety. Future research integrating combination strategies and mechanistic insights is critical for translating these innovations into effective, durable treatments for patients with AGA.