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Randomized Controlled Trial
. 2024 Aug 30;16(17):2900.
doi: 10.3390/nu16172900.

Randomized Clinical Trial to Evaluate the Effect of Probiotic Intake on Androgenic Alopecia

Alejandro García-Navarro  1 , María Isabel Vasallo-Morillas  2   3 , Roge Navarro-Belmonte  1 , Cristina Vilanova  4 , Daniel Torrent  4 , Alina Kilasoniya  3 , Isabel Moles-Ugeda  1 , Estefanía Gallego-Herrera  1 , Ana Ramírez-Boscá  1   3   5
Affiliations
Randomized Controlled Trial

Randomized Clinical Trial to Evaluate the Effect of Probiotic Intake on Androgenic Alopecia

Alejandro García-Navarro et al. Nutrients. .

Abstract

This study aimed to assess the impact of a combination of probiotic strains of Lactiplantibacillus on the treatment of androgenic alopecia (AGA). To this end, 136 individuals with AGA (62 men and 74 women) aged 18-65 years were enrolled in a double-blind, parallel-group clinical trial. A total of 115 individuals (57 in the probiotic group and 58 in the placebo group) completed this study within a 16-week intervention period. Capillary density, thickness, and length of hair were analyzed before and after the intervention using FotoFinder Trichoscale Pro. In addition, the gut microbiota was assessed by paired-end sequencing on the Illumina MiSeq platform (2 × 300 bp). At the conclusion of the treatment period, a notable decline (p < 0.05) in the number of telogen hairs was evident in the probiotic group while hair thickness decreased in the placebo group (p < 0.05). However, the remaining variables did not exhibit any statistically significant changes. In the probiotic-treated group, individuals aged less than 37.5 years exhibited a reduction in the number and density of telogen hair (p = 0.0693 and p = 0.0669, respectively) and an increase in hair length (p = 0.0871). Furthermore, a notable decline in the number and density of vellus hair (p < 0.05) was observed, and this was accompanied by no change in the hair thickness. The probiotic-treated group exhibited a significantly higher abundance of Lactobacillus (p-adjusted < 0.05, DEseq2 test) and demonstrated a notable reduction in the number and density of telogen hair, and this was accompanied by an increase in the percentage of anagen hair. The probiotic mixture was well tolerated by the participants, with a treatment adherence rate of 90%. In light of this study's limitations, it can be concluded that a mixture of three strains of Lactiplantibacillus promotes the presence of terminal follicles, preventing their gradual miniaturization, which is a characteristic of AGA.

Keywords: androgenetic alopecia; gut microbiota; probiotic; trichoscopy.

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Conflict of interest statement

Authors Cristina Vilanova and Daniel Torrent were employed by the company Darwing Bioprospecting Excaellence S.L. They participated in the taxonomic analysis of the participants’ gut microbiomes. The samples analyzed were anonymized. So, the author did not know which treatment group each sample belonged to. The role of the company was to analyze the gut microbiome of the participants and the effect of probiotic/placebo supplementation on it. Authors Alejandro García-Navarro, Isabel Moles-Ugeda and Estefanía Gallego-Herrera were employed by Centro Dermatológico Estético. They participated in patient recruitment and blinded assessments, applying the study protocol. The role of the company was to conduct the study according to the approved protocol by the Ethics Committee. Author Roge Navarro-Belmonte was employed by Centro Dermatológico Estético. She participated in the management of the technical resources required to carry out the study. The role of the company was to conduct the study according to the approved protocol by the Ethics Committee. Author María Isabel Vasallo-Morillas was employed by San Antonio Technologies, S.L. She participated in the design, monitoring and management of the study. The role of the company was to manage and monitor the study according to the approved protocol by the Ethics Committee. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
CONSORT diagram of the randomized controlled trial.
Figure 2
Figure 2
(A) Boxplots of the alpha diversity metrics, including the observed richness, Shannon index, and Simpson index. These metrics were calculated using ASVs (99.9% similarity threshold) for each experimental group (control and treatment) at V1 and V2. (B) A principal coordinate analysis (PCoA) plot based on Bray–Curtis distances at the ASV level of the gut microbiome of volunteers in both groups at V1 and V2. The axes of the plot represent the two dimensions that explained the highest proportion of variance in the communities for each analysis.
Figure 3
Figure 3
Relative abundances of the most prevalent phyla and genera (including Lactobacillus) present in each group (control and treatment) at each sampling point (V1, before; V2, after). The color scale represents relative abundance levels, with dark blue and dark red indicating the lowest and highest abundances, respectively.
Figure 4
Figure 4
Relative abundances of the genus Lactobacillus for volunteers who were experimented on, with different responses to the treatments in terms of the number of telogen hairs, density of telogen hairs, and percentage of anagen hairs. p-adjusted derived DESeq2 differential abundance analyses were included for each comparison.
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