# Precision therapeutics in non-scarring alopecia: a systemic genomic and pathway-based framework for targeted interventions

## TL;DR

This paper proposes a precision medicine approach for non-scarring hair loss by combining genetic and pathway insights to guide targeted treatments.

## Contribution

It introduces a novel genomic and pathway-based framework for personalized interventions in androgenetic and alopecia areata.

## Key findings

- Androgenetic alopecia involves androgen-receptor signaling and inflammation, with finasteride as a key treatment.
- Alopecia areata is linked to immune dysregulation and responds well to JAK inhibitors.
- Regenerative therapies and AI diagnostics are emerging tools for personalized treatment.

## Abstract

Non-scarring alopecia, principally androgenetic alopecia and alopecia areata is highly prevalent and psychologically burdensome; androgenetic alopecia is androgen-driven, whereas alopecia areata is autoimmune. This review synthesizes genetic architecture and pathway biology to outline a precision framework for targeted interventions.

We reviewed full-text studies from the past decade across PubMed, Web of Science and Google Scholar, applying explicit inclusion/exclusion criteria; emphasis was placed on Genome wide association studies and Next generation sequencing findings, immune and androgen-axis biology, environmental modifiers, and therapeutic evidence (conventional, targeted, and regenerative), alongside artificial Intelligence-enabled diagnostics.

Androgenetic alopecia risk converges on androgen-receptor signalling and related loci, with perifollicular inflammation and oxidative stress as modifiers; finasteride remains a cornerstone therapy. Alopecia areata reflects polygenic immune dysregulation (e.g. Human leukocyte antigen/cytokine axes) with Janus Kinase-pathway inhibition yielding robust regrowth; across phenotypes, wingless-related integration sit/β-catenin and stem-cell programs are central targets. Regenerative options (Protein Rich Plasma, stem-cell/exosome approaches) and artificial Intelligence-assisted stratification are emerging adjuncts.

A pathway-guided, genotype and phenotype-informed strategy, targeting the androgen axis for androgenetic alopecia, immune circuits for alopecia areata, and adding regenerative or microenvironmental therapies where indicated-promises earlier diagnosis and more durable, individualized outcomes, especially as genome-wide association study/next-generation sequencing and artificial Intelligence tools are integrated into care.