Alopecia is a serious concern for many people. In recent years, advances in genetic testing have made it possible to understand an individual’s genetic background and select effective treatments based on that. In this article, we will take a closer look at the relationship between genetic testing and alopecia, as well as the treatments that are best suited to each individual.
1. Types and causes of alopecia
There are several main types of alopecia:
Androgenetic alopecia (AGA): This type of hair loss is caused by male hormones and gradually leads to thinning of hair on the forehead and top of the head.
Female pattern hair loss: A type of hair loss seen in women, characterized by thinning hair on the top of the head.
Alopecia areata: An autoimmune disease that causes sudden, circular patches of baldness.
Telogen effluvium: A condition in which the hair growth cycle is disrupted due to stress or nutritional deficiencies, resulting in temporary increased hair loss.
2. Risk assessment for alopecia through genetic testing
Genetic testing has become a powerful tool for assessing an individual’s risk for hair loss. Specifically, studies have shown that the following genes are associated with hair loss:
Androgen receptor (AR) gene: Involved in susceptibility to male pattern baldness, with certain polymorphisms thought to increase risk.
PAX1 and FOXA2 genes: Polymorphisms near these genes on chromosome 20 have been reported to be associated with the risk of male pattern baldness.
CCHCR1 gene: Identified as the gene that causes alopecia areata, and certain mutations are believed to increase the risk of developing the condition.
Detecting mutations in these genes makes it possible to grasp an individual’s risk of alopecia in advance, enabling early prevention and countermeasures.
3. Personalized treatment using genetic testing
Based on the results of genetic testing, it is possible to select the treatment that is best suited to the individual. Below, we will introduce treatment approaches based on gene type.
Male pattern baldness patients with AR gene polymorphism: Because the androgen receptor is highly sensitive, 5α-reductase inhibitors such as finasteride and dutasteride are considered to be effective.
Patients with PAX1/FOXA2-related polymorphisms: The role of these genes has not been fully elucidated, but if genetic testing indicates an increased risk, early therapeutic intervention is recommended.
Patients with alopecia areata who have a CCHCR1 mutation: Treatments that modify the immune system, such as immunosuppressants or biologics, may be effective.
4. Limitations and precautions of genetic testing
Genetic testing is a useful tool, but it is important to keep the following in mind:
Multifactorial disease: Alopecia is a multifactorial disease that involves not only genetic factors, but also environmental factors and lifestyle habits. Genetic testing alone cannot assess all risks.
Interpretation of test results: The presence or absence of gene polymorphism does not necessarily mean that you will develop the disease. It is important to consult with a specialist and perform a comprehensive risk assessment.
5. Future outlook for genetic testing
Advances in genetic testing technology are expected to lead to more detailed risk assessments and the development of new treatments, including gene editing and personalized medicine based on individual genetic profiles.
As mentioned above, genetic testing plays an important role in the prevention and treatment of alopecia. However, in order to correctly understand the results and take appropriate measures, collaboration with a specialist is essential.
6. New treatment approaches using genetic testing
When genetic testing reveals an individual’s risk of hair loss, it becomes possible to select the most appropriate treatment based on that information. Here we will explain in detail the treatment approach that utilizes the latest genetic data.
A. Individual application of 5α-reductase inhibitors
5α-reductase is an enzyme that converts testosterone into the more potent androgen dihydrotestosterone (DHT), which is believed to be the main cause of male pattern baldness (AGA).
1. Finasteride (Propecia)
This is expected to be particularly effective for patients with AR gene polymorphisms.
By inhibiting type II 5α-reductase, it suppresses the production of DHT and slows the progression of hair loss.
The Japanese Dermatological Association’s guidelines also classify it as a “strongly recommended treatment.”
2. Dutasteride (Zagalo)
It inhibits both type I and type II 5α-reductase enzymes and is therefore more effective than finasteride.
If genetic testing reveals high activity of 5α-reductase, dutasteride may be more effective.
B. Genetic Adaptation of Minoxidil
Minoxidil is a drug that promotes hair growth by dilating blood vessels and increasing blood flow to hair follicles, but its effectiveness varies depending on an individual’s genetic background.
1. SULT1A1 gene and the effects of minoxidil
The SULT1A1 gene is involved in the activation of minoxidil.
Minoxidil may be of limited benefit in people with low SULT1A1 activity.
If genetic testing reveals low SULT1A1 activity, high concentration minoxidil (≥5%) or another treatment is recommended.
2. Oral vs. Topical Minoxidil
If genetic testing shows abnormalities in genes related to blood flow, oral minoxidil may be more effective.
Oral administration is easier than topical application in stabilizing blood levels, and longer-lasting effects can be expected.
C. Stem Cell Therapy and Gene Editing
In recent years, advances in genetic research have led to the emergence of cutting-edge approaches that differ from conventional treatments.
1. Stem Cell Therapy
Treatments that use stem cells to stimulate hair follicle regeneration are being investigated.
Treatments containing CD34-positive stem cells have been reported to promote hair growth.
2. Gene editing (CRISPR-Cas9)
It may be possible to correct the genetic mutations that cause AGA and alopecia areata.
Although it is still in the research stage, it may be possible to treat it at the genetic level in the future.
7. The relationship between lifestyle and genes
Hair loss is not only genetic but also influenced by lifestyle habits. In particular, people with certain genetic mutations may be more susceptible to progressive hair loss due to certain lifestyle habits.
A. The relationship between nutrition and genes
Nutritional balance is important for healthy hair, but because genes affect how well certain nutrients are absorbed, individualized treatment is required.
1. Iron and the FTL gene
If the **FTL gene (ferritin light chain gene) ** is mutated, iron absorption decreases, and iron stores are prone to deficiency.
Iron deficiency can be a contributing factor to hair loss, so if genetic testing indicates you are at risk, active iron supplementation is recommended.
2. Biotin (Vitamin B7) and the HCS gene
When a mutation in the HCS gene causes abnormalities in biotin metabolism, it has a negative effect on hair growth.
Taking biotin supplements may be helpful in some cases.
3. Zinc and the ZIP4 gene
Zinc is an essential mineral for hair growth, and its absorption rate is reduced when there is a mutation in the ZIP4 gene.
If genetic testing confirms reduced zinc absorption, a higher-than-normal zinc intake is recommended.
B. Genetic Susceptibility to Stress and Hair Loss
Stress is one of the factors that aggravate hair loss, but stress tolerance also varies depending on genetics.
1. COMT gene and stress resistance
Depending on the polymorphism of the COMT gene , the ability to break down the stress hormone (cortisol) differs.
Low COMT function may make the body more susceptible to the effects of stress and may lead to more progressive hair loss.
2. BDNF gene and psychological stress
It has been shown that genetic mutations in **BDNF (brain-derived neurotrophic factor) ** reduce the brain’s ability to recover from stress.
If a decrease in BDNF is observed, thorough stress management is recommended.
C. Sleep and Genes
Sleep quality is also a factor that affects hair loss. In particular, mutations in genes that regulate the circadian rhythm can make you more susceptible to sleep disorders.
1. CLOCK gene and the effects of sleep
Mutations in the CLOCK gene can disrupt the body’s internal clock, making it difficult to achieve deep sleep.
Poor quality sleep can reduce the secretion of growth hormone, disrupting your hair growth cycle.
2. PER3 gene and lack of sleep
People with truncated PER3 genes have difficulty adapting to short sleep periods and are prone to chronic sleep deprivation.
Be especially careful with sleep disturbances, as they can accelerate the progression of hair loss.
By utilizing genetic testing, it is possible to optimize treatment methods and lifestyle habits to suit each individual’s constitution. As research progresses, it is expected that more precise individualized treatment will be realized, and alopecia treatment will evolve dramatically.
8. Cutting-edge hair loss treatment using genetic testing
Hair loss treatment using genetic testing is not just a diagnostic tool, it is the key to providing optimal treatment for each individual patient. Here we take a closer look at innovative treatments that combine the latest scientific technology with genetic information.
A. New treatments using mRNA vaccine technology
Just as mRNA vaccine technology has revolutionized the treatment of COVID-19, the same technology is now being applied to treat alopecia.
1. Hair growth promoting protein mRNA vaccine
If genetic testing shows that patients have low expression of **FGF-7 (fibroblast growth factor 7)**, administering an mRNA vaccine that increases it may be possible to promote hair growth.
FGF-7 promotes the growth of hair follicles and extends the hair growth cycle.
2. Immunosuppressant protein mRNA vaccine
In people with alopecia areata, an autoimmune reaction attacks the hair follicles.
It may be possible to suppress the progression of alopecia areata by administering an mRNA vaccine that enhances CTLA-4 and PD-1 and modulating the immune system.
B. Next-generation treatment using stem cells
With the development of stem cell technology, treatments combined with genetic testing are becoming a reality.
1. Treatment using autologous adipose tissue stem cells (ADSCs)
Stem cells are extracted from your own fat tissue and transplanted into the scalp to promote the regeneration of hair follicles.
If genetic testing confirms overexpression of TGF-β1 (transforming growth factor β1) , stem cell therapy to regulate this is considered effective.
2. Regeneration of hair follicles using iPS cells
The goal is to completely regenerate hair by creating hair follicles using iPS cells and transplanting them into the scalp.
In particular, individualized iPS cell therapy may be applicable to patients with abnormalities in the FGFR2 gene (fibroblast growth factor receptor 2).
C. Nanotechnology-based gene delivery systems
Advances in nanotechnology have led to the development of techniques to precisely deliver the active ingredients of hair loss treatments to hair follicles.
1. Targeted therapy using gene nanocarriers
Nanoparticles equipped with gene editing technology (CRISPR-Cas9) are used to adjust the expression of hair loss risk genes.
Prevents the progression of AGA by directly suppressing the gene (AR gene) that is sensitive to DHT (dihydrotestosterone).
We will apply RNA interference technology to enhance the expression of SULT1A1 using LNPs , thereby maximizing the effects of minoxidil.
This makes it easier for patients with SULT1A1 genotypes that have low expression to benefit from minoxidil.
9. The importance of genetic testing and psychological care
Finding out you’re at risk for hair loss through genetic testing can be an emotional burden, especially if you have a family history of alopecia and have been diagnosed as being at high risk. Stress can make hair loss even worse.
A. Psychological effects of genetic testing
Being diagnosed with a “high risk of hair loss” can cause patients great anxiety.
In particular, young people may find it difficult to accept the results of genetic testing and may require psychological support.
B. Mental care using cognitive behavioral therapy (CBT)
Cognitive behavioral therapy (CBT) has been shown to be effective in reducing anxiety about genetic test results.
Through CBT, patients can come to understand that alopecia does not mean the end of life.
C. Eliminating the social stigma surrounding alopecia
As genetic testing becomes more widespread, social perception of alopecia is also changing.
It is important to raise awareness to deepen understanding of AGA and alopecia areata and to eliminate prejudice.
10. Genetic testing and lifestyle optimization
By using the results of your genetic test, you can make more effective lifestyle changes and minimize your risk of hair loss.
A. Individualized Nutrition Plan
Based on the results of your genetic testing, you can develop the best nutritional strategy for you.
1. Vitamin D receptor (VDR) gene and sun exposure
Mutations in the VDR gene reduce the efficiency of vitamin D absorption.
If genetic testing confirms the abnormality, adequate vitamin D supplementation and sun exposure are recommended.
2. Omega-3 fatty acids and the ALOX5 gene
Mutations in the ALOX5 gene make hair follicles more susceptible to inflammation .
If genetic testing shows that you are at high risk, taking omega-3 fatty acids (EPA/DHA) is considered effective.
B. Optimal Exercise Program
Genetic testing can determine an individual’s metabolic type and tailor an exercise program accordingly.
1. ACTN3 gene and strength training
If your ACTN3 gene is the “RR” type, high-intensity resistance training is effective .
On the other hand, if you are an “XX type,” it is more effective to combine it with endurance exercise.
2. Exercise and growth hormone (GH1 gene)
If you have a mutation in the GH1 gene, your body’s secretion of growth hormone is likely to decrease, so it is recommended that you avoid exercising at night .
Genetic testing and advances in science and technology are enabling more individualised and effective approaches to hair loss treatment, which, combined with psychological support and lifestyle changes, can help to minimise the risk of hair loss whilst maintaining healthy hair.
11. The relationship between genetic testing and hormone balance
The progression of alopecia is closely related to not only genetic factors but also hormone balance. In particular, the secretion levels of testosterone, estrogen, thyroid hormones, and adrenal hormones (cortisol) are determined by the interaction of genetic and environmental factors. Recent research is expected to enable more effective individualized treatment by identifying hormone-related genes.
A. Androgen (male hormone) and genetic influences
Androgens (male hormones) are particularly involved in the progression of male pattern baldness (AGA).
1. Polymorphisms in the AR (androgen receptor) gene
People with certain polymorphisms in the AR gene are more sensitive to DHT (dihydrotestosterone) and are more likely to develop hair follicle miniaturization.
If genetic testing reveals a susceptible AR gene, 5-alpha-reductase inhibitors such as finasteride or dutasteride may be particularly effective.
2. SRD5A1 and SRD5A2 genes and DHT production
When the SRD5A1/SRD5A2 genes are highly expressed, DHT production becomes active and the risk of AGA increases.
In this case, dutasteride (Zagalo) is more likely to be effective than finasteride (Propecia).
B. Estrogen and Female Pattern Hair Loss (FPHL)
Female pattern hair loss (FPHL) is more sensitive to estrogen and thyroid hormones than androgens.
1. ESR1/ESR2 gene and estrogen receptor
Certain genetic polymorphisms in **ESR1 (estrogen receptor alpha)** may reduce estrogen sensitivity and increase the risk of hair loss.
Hormone replacement therapy (HRT) and taking soy isoflavones may be effective.
2. CYP19A1 gene and estrogen synthesis
Reduced estrogen synthesis due to polymorphisms in the CYP19A1 (aromatase) gene may increase the risk of female pattern hair loss.
If genetic testing indicates a CYP19A1 abnormality, consider nutritional supplementation to increase estrogen (e.g., vitamin D, boron).
C. The relationship between thyroid hormone and hair loss
Thyroid hormone plays a key role in regulating the hair follicle growth cycle.
1. Thyroid-stimulating hormone receptor (TSHR) gene and thyroid function
Polymorphisms in the TSHR gene may lead to slower hair growth when thyroid function is reduced.
If genetic testing reveals a thyroid hormone metabolic abnormality, consider supplementing with iodine and selenium.
2. DIO2 gene and T3 (active thyroid hormone)
When the DIO2 (deiodinase 2) gene mutates, the activity of thyroid hormone decreases, making hair loss more likely to progress.
Iron, vitamin A, and zinc are recommended to maintain thyroid function.
12. The relationship between genes and hair growth cycle
Hair growth cycles go through three phases: anagen, catagen, and telogen. This cycle is known to be influenced by genetic factors.
A. FGFR2 gene and hair follicle growth
Mutations in the FGFR2 (fibroblast growth factor receptor 2) gene shorten the growth phase of hair follicles, making hair loss more likely to progress.
If genetic testing reveals this abnormality, peptide therapy to increase FGF is recommended.
B. KRT35 gene and hair strength
Mutations in the KRT35 (keratin 35) gene can lead to reduced hair strength and increased hair loss.
In this case, supplementing with collagen and silica (silicon) is said to be effective.
C. BMP2 gene and hair follicle regeneration
Polymorphisms in the BMP2 (bone morphogenetic protein 2) gene can lead to impaired hair follicle remodeling, resulting in progressive hair loss.
To increase BMP2 expression, vitamin D supplementation and moderate exposure to ultraviolet light are recommended.
13. New diagnostic technologies using genetic testing
Currently, genetic testing technology is evolving rapidly, and new techniques are emerging to improve the accuracy of diagnosing alopecia.
A. AI-based genetic data analysis
Using artificial intelligence (AI), the system analyzes tens of thousands of pieces of genetic data and predicts the risk of hair loss.
Systems are being developed that can automatically generate individualized treatment plans that take into account gene interactions .
B. Single-cell RNA Sequencing
Gene expression in hair follicle cells is analyzed in real time to identify growth factor expression patterns.
This will enable hair condition to be diagnosed more accurately than conventional DNA testing.
C. Artificial cultivation of hair follicles through genetic modification
Research is being conducted into techniques that use genetic engineering to create new hair follicles from the patient’s own cells and then transplant them .
If this technology is established, complete hair regeneration will be possible.
With advances in genetic testing and research into hormone balance and hair growth cycles, treatments for hair loss will become more precise and individualized. Future technological advances may lead to a fundamental solution to hair loss.
Research is also underway into personalized scalp care using genetic analysis , with shampoos and hair growth products being developed based on an individual’s genetic characteristics, which will enable more effective self-care.
Summary
With the evolution of genetic testing, we are now in an era where we can individually identify the causes and risks of alopecia and select the most appropriate treatment. The AR gene, FGFR2 gene, and hormone metabolism genes are related to AGA and female pattern baldness, and the application of finasteride, minoxidil, stem cell therapy, etc. is now determined based on genetic data. In addition, cutting-edge technologies such as AI diagnosis, mRNA vaccines, and gene editing have also emerged, and in the future, it may be possible to realize a complete treatment for alopecia.
