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Volume 14
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Iron Chelators in the Management of Autoimmune-Induced Alopecia: A Focus on Hypoxia-Inducible Factor 1 Modulation and Hair Restoration

by
Andrea Pagani
1,*,
Dominik Thor
2,
Adriana C. Panayi
3,
Silvan M. Klein
1,
Sebastian Geis
1,
Leonard Knoedler
1,
Samuel Knoedler
4,
Filippo A. G. Perozzo
5,
Giuseppe Sofo
6,
Rafael Loucas
1,
Lukas Prantl
1 and
Dominik Duscher
1
1
Department of Plastic, Reconstructive, and Aesthetic Surgery, University Hospital of Regensburg, Franz-Josef S. Allee 11, 93053 Regensburg, Germany
2
Department of Research and Development, Geneva College of Longevity Science, GCLS, 1204 Geneva, Switzerland
3
Department of Oral and Maxillofacial Surgery, Charitè—Universitätsmedizin Berlin, 10117 Berlin, Germany
4
Department of Plastic Surgery and Hand Surgery, Klinikum Rechts der Isar, Technical University of Munich, 80333 Munich, Germany
5
Department of Plastic and Reconstructive Surgery, Cleveland Clinic Foundation, Cleveland, OH 44195, USA
6
Instituto Ivo Pitanguy, Hospital Santa Casa de Misericordia Rio de Janeiro, Pontificia Universidade Catòlica do Rio de Janeiro, Rio de Janeiro 22453-900, Brazil
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2025, 14(7), 2133; https://doi.org/10.3390/jcm14072133
Submission received: 27 February 2025 / Revised: 13 March 2025 / Accepted: 19 March 2025 / Published: 21 March 2025
(This article belongs to the Special Issue Autoimmune-Induced Alopecia and Emerging Therapies in Hair Loss)
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Abstract

Autoimmune-induced alopecia, such as alopecia areata, involves immune-mediated damage to hair follicles, leading to significant hair loss. Emerging therapies that stabilize hypoxia-inducible factor 1-alpha (HIF-1α) show promise in counteracting follicular degradation and supporting hair regrowth. This communication highlights the potential of iron chelators, specifically deferoxamine (DFO) and deferiprone (DFP), to stabilize HIF-1α by reducing iron availability, thereby promoting vascularization, cellular proliferation, and a regenerative environment in the hair follicle niche. Clinical trials with iron chelators demonstrated improvements in hair density, thickness, and elasticity, as well as a reduction in hair loss by up to 66.8% over six months. These findings underscore the therapeutic potential of iron chelators in autoimmune alopecia management. Future research should explore the synergistic use of iron chelators with immune-modulating therapies, positioning them as viable options in the evolving field of alopecia treatment.
Keywords: autoimmune-induced alopecia; iron chelators; HIF-1 alpha; hair restoration autoimmune-induced alopecia; iron chelators; HIF-1 alpha; hair restoration

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MDPI and ACS Style

Pagani, A.; Thor, D.; Panayi, A.C.; Klein, S.M.; Geis, S.; Knoedler, L.; Knoedler, S.; Perozzo, F.A.G.; Sofo, G.; Loucas, R.; et al. Iron Chelators in the Management of Autoimmune-Induced Alopecia: A Focus on Hypoxia-Inducible Factor 1 Modulation and Hair Restoration. J. Clin. Med. 2025, 14, 2133. https://doi.org/10.3390/jcm14072133

AMA Style

Pagani A, Thor D, Panayi AC, Klein SM, Geis S, Knoedler L, Knoedler S, Perozzo FAG, Sofo G, Loucas R, et al. Iron Chelators in the Management of Autoimmune-Induced Alopecia: A Focus on Hypoxia-Inducible Factor 1 Modulation and Hair Restoration. Journal of Clinical Medicine. 2025; 14(7):2133. https://doi.org/10.3390/jcm14072133

Chicago/Turabian Style

Pagani, Andrea, Dominik Thor, Adriana C. Panayi, Silvan M. Klein, Sebastian Geis, Leonard Knoedler, Samuel Knoedler, Filippo A. G. Perozzo, Giuseppe Sofo, Rafael Loucas, and et al. 2025. "Iron Chelators in the Management of Autoimmune-Induced Alopecia: A Focus on Hypoxia-Inducible Factor 1 Modulation and Hair Restoration" Journal of Clinical Medicine 14, no. 7: 2133. https://doi.org/10.3390/jcm14072133

APA Style

Pagani, A., Thor, D., Panayi, A. C., Klein, S. M., Geis, S., Knoedler, L., Knoedler, S., Perozzo, F. A. G., Sofo, G., Loucas, R., Prantl, L., & Duscher, D. (2025). Iron Chelators in the Management of Autoimmune-Induced Alopecia: A Focus on Hypoxia-Inducible Factor 1 Modulation and Hair Restoration. Journal of Clinical Medicine, 14(7), 2133. https://doi.org/10.3390/jcm14072133

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