Expanding Hair Growth Strategies Address Metabolic, Hormonal, and Aging Pathways

Emerging therapies for hair loss are increasingly targeting metabolic, hormonal, and cellular aging pathways, reflecting a broader understanding of hair biology beyond traditional treatments, according to Carolyn I. Jacob, MD, during her presentation, “Novel Therapies for Hair Growth.​”

The session highlighted the complex relationship between systemic health and hair growth, including the impact of insulin signaling. Insulin and insulin-like growth factor were described as “key promoters of hair follicle growth,” with deficiencies leading to premature transition from the anagen to catagen phase. In contrast, insulin resistance may worsen androgenic alopecia by increasing androgen production and altering binding proteins.

Hair loss associated with rapid weight loss, including in patients using GLP-1 receptor agonists, was also discussed. This pattern is typically characterized as telogen effluvium, in which metabolic stress and hormonal shifts disrupt the hair cycle and trigger shedding.

Standard therapies remain foundational, including minoxidil, finasteride, dutasteride, spironolactone, and corticosteroids. However, newer approaches are expanding options. Supplements, topical serums, and procedural interventions are increasingly incorporated into treatment plans, particularly for patients seeking adjunctive or nonprescription options.

Nutraceutical formulations were noted to include ingredients such as spermidine, pumpkin seed extract, NAD+, and botanical compounds targeting inflammation and hormonal pathways. Topical serums combine peptides, amino acids, and botanical extracts, while microneedling-based delivery systems may enhance penetration of bioactive agents.

Procedural therapies continue to evolve. Microneedling combined with growth factor or exosome-based solutions, as well as radiofrequency microneedling, were highlighted as options to stimulate follicular activity. Early data from small studies suggest potential benefit, although standardized protocols remain limited.

Aging-related changes were a central focus. Dr Jacob emphasized that “hair follicles, like other tissues, are affected by the natural aging process,” with downstream effects on collagen, autophagy, and cellular function. Reduced collagen and increased cellular senescence contribute to follicular weakening and thinning hair.

Additional contributors include oxidative stress, nutritional deficiencies, and microbiome changes, which may impair follicular health over time. Stress was described as “the first domino in the hair health chain,” with prolonged cortisol exposure shortening the growth phase and accelerating follicular miniaturization.

Reference

Jacob CI. Novel therapies for hair growth. Presented at: Music City SCALE Symposium; May 13–17, 2026; Nashville, TN.