Androgenetic alopecia is the most common type of progressive hair loss. It is also known as male-pattern baldness, female-pattern baldness, or just common baldness. It affects about 50% of men over the age of 50, and about 50% of women over the age of 65. In women the severity varies, it may present as widespread hair thinning but in some cases it can lead to complete baldness.
What causes androgenetic alopecia?
Androgenetic alopecia is caused by a combination of genetic and hormonal factors. Dihydrotestosterone (DHT) is the main hormone responsible for androgenetic alopecia in genetically susceptible individuals. DHT causes scalp hair loss by inducing a change in the hair follicles on the scalp. The hairs produced by the affected follicles become progressively smaller in diameter, shorter in length and lighter in colour until eventually the follicles shrink completely and stop producing hair.
What are the symptoms of androgenetic alopecia?
Males typically become aware of scalp hair loss or a receding hairline, beginning at any time after puberty. In women, the age of onset is later compared to men. Occasionally, androgenetic alopecia in women may start earlier than this, in the 30s or 40s. In some women, this condition can be associated with an excess of male hormones such as in polycystic ovary syndrome (PCOS). Acne, increased facial hair, irregular periods and infertility are all signs of PCOS.
Is androgenetic alopecia hereditary?
Yes. It is believed that genetic susceptibility to this condition can be inherited from either or both parents.
What does androgenetic alopecia look like?
Androgenetic alopecia looks different in males and females. Hairs in the affected areas are initially smaller in diameter, and shorter compared to hairs in unaffected areas, before they become absent. Androgenetic alopecia looks different in males and females. Hairs in the affected areas are initially smaller in diameter, and shorter compared to hairs in unaffected areas, before they become absent. In men, the usual pattern of hair loss is a receding hairline, and loss of hair from the top and the front of the head. In women, hair loss or thinning typically occurs at the crown of the scalp, with widening of partition and complete or nearly complete preservation of the frontal hairline.
How is androgenetic alopecia diagnosed?
The diagnosis is usually based on the history, pattern of hair loss and family history of a similar pattern of hair loss. The skin on the scalp looks normal on examination. Occasionally blood tests may be carried out.
How can androgenetic alopecia be treated?
- Licensed topical and oral treatments: Applying minoxidil solution to the scalp may help to slow down the progression and restore hair in majority of males and females. For men, Inasteride tablets reduce levels of dihydrotestosterone which may slow hair loss and helps the regrowth of hair.
- Surgical treatments: Hair transplantation, which is a procedure whereby hair follicles are taken from the back of the scalp and transplanted onto the bald areas.