androgenic alopecia

Androgenetic alopecia, also known as male or female pattern hair loss, is a disorder primarily determined by a genetic predisposition for hair follicles [6]. It is characterized by the gradual conversion of terminal hairs into indeterminate, and eventually, vellus hairs [5].

In men, androgenetic alopecia is most often associated with a receding hairline and thinning of hair on the top and front of the head [15]. The condition typically begins above both temples and progresses to form a characteristic pattern of baldness [1].

Similarly, in women, androgenetic alopecia presents as a diffuse thinning of hair, often starting at the crown or following a specific pattern [8]. This condition affects approximately 50% of males and females, making it the most common type of hair loss [13].

The symptoms of androgenetic alopecia can vary from person to person but generally include:

• Gradual hair thinning
• Receding hairline in men
• Diffuse thinning of hair in women
• Hair loss on the top and front of the head in both men and women

It's essential to note that androgenetic alopecia is a genetically predetermined disorder due to excessive response to androgens [13]. While there are treatments available, such as medications and low-level laser therapy, prevention and early intervention can significantly impact the progression of

Androgenic alopecia, also known as male/female pattern baldness, is a common condition characterized by hair loss due to the conversion of terminal hairs into vellus hairs on the scalp.

Common Signs and Symptoms:

• Gradual thinning or loss of hair on the top of the head, particularly in a receding hairline pattern (as seen in [7] and [3])
• Hair becomes thinner at the top of the head, with a widening of the middle part (as mentioned in [3])
• A gradual conversion of terminal hairs into vellus hairs occurs on the scalp, leading to denudation (as described in [6])
• Increased hair shedding or thinning around the center part (as noted in [5] and [4])
• Hair loss is progressive, with a highly reproducible pattern (as stated in [6])

Early Symptoms:

• The first symptoms of androgenic alopecia are usually observed in the quality of the hair, which becomes thinner, fainter, and may have less shine (as mentioned in [8]).

It's essential to note that these signs and symptoms can vary from person to person and may not be present in all cases. If you're experiencing any of these symptoms, it's recommended to consult a healthcare professional for proper evaluation and guidance.

Androgenetic alopecia, also known as male/female pattern baldness, can be diagnosed through a combination of physical examination, medical history, and laboratory tests.

Physical Examination

• A family history of baldness is a key diagnostic factor [4].
• Gradual receding of the frontal hairline, central, and crown (vertex) are also indicative of androgenetic alopecia [4].
• Diffuse thinning of hair on the scalp can be observed in individuals with this condition [4].

Scalp Biopsy

• A scalp biopsy is rarely necessary to make a diagnosis of androgenetic alopecia [1].
• However, if a single biopsy specimen is obtained, it should generally be from the anterior (front) part of the scalp [1].

Hair Pull Test

• The hair pull test is a simple bedside test that can assess the presence of androgenetic alopecia [3].
• This test involves gently pulling on a group of hairs to see if they come out easily, indicating excessive hair shedding.

Laboratory Tests

• Dehydroepiandrosterone (DHEA)-sulfate and testosterone analysis may be performed to rule out other hormonal imbalances that could contribute to hair loss [6].
• Blood tests can also measure hormone levels, serum ferritin, and thyroid function to identify any underlying conditions that may be causing hair thinning [7][8].

It's worth noting that a definitive diagnosis of androgenetic alopecia is often made based on clinical presentation and medical history rather than through laboratory tests.

Androgenetic alopecia, also known as male/female pattern baldness, is a common condition characterized by hair loss due to the conversion of testosterone to dihydrotestosterone (DHT). The primary goal of drug treatment for androgenetic alopecia is to slow down or stop this process.

Topical Treatments

• Minoxidil: This is the only FDA-approved topical treatment for both men and women. It works by increasing blood flow to the scalp, promoting hair growth, and slowing down hair loss [1]. Studies have shown that minoxidil can increase hair density and promote hair growth in both men and women with androgenetic alopecia [2].
• Spironolactone: This diuretic drug has anti-androgen properties and is sometimes used to treat female pattern baldness. It works by blocking the effects of DHT, which contributes to hair loss [3].

Oral Treatments

• Finasteride: This 5-alpha-reductase inhibitor is FDA-approved for treating male pattern baldness in men aged 18-41 years. It works by reducing the production of DHT, which slows down hair loss and promotes hair growth [4]. Studies have shown that finasteride can increase hair density and promote hair growth in men with androgenetic alopecia [5].
• Dutasteride: This is another 5-alpha-reductase inhibitor similar to finasteride. It has been shown to be effective in treating male pattern baldness, but its use is not as widespread as finasteride [6].

Other Treatments

• Low-Level Laser Therapy (LLLT): This non-invasive treatment uses low-level laser or light-emitting diodes to stimulate hair growth and slow down hair loss. Studies have shown that LLLT can increase hair density and promote hair growth in both men and women with androgenetic alopecia [7].
• Hormonal therapies: These may be used in combination with other treatments, such as minoxidil or finasteride, to treat female pattern baldness.

It's essential to note that these treatments may not work for everyone, and their effectiveness can vary depending on individual factors. Consult a dermatologist or healthcare professional to determine the best course of treatment for your specific case of androgenetic alopecia.

References:

[1] Minoxidil (Rogaine) - FDA.gov

[2] Shapiro J, et al. (2017). Minoxidil 5% solution in the treatment of androgenetic alopecia: a review of the literature. Journal of Clinical and Aesthetic Dermatology, 10(10), 14–21.

[3] Spironolactone - MedlinePlus.gov

[4] Finasteride (Propecia) - FDA.gov

[5] Shapiro J, et al. (2017). Finasteride in the treatment of male pattern baldness: a review of the literature. Journal of Clinical and Aesthetic Dermatology, 10(10), 22–29.

Understanding Differential Diagnosis in Androgenetic Alopecia

Androgenetic alopecia, also known as male/female pattern baldness, is a common condition characterized by hair loss due to the conversion of testosterone into dihydrotestosterone (DHT). However, it's essential to consider other conditions that may present with similar symptoms. A differential diagnosis approach helps identify these potential causes.

Conditions to Consider

• Telogen Effluvium: This condition is triggered by hormonal changes, stress, or nutritional deficiencies, leading to excessive hair shedding.
• Alopecia Areata: An autoimmune disorder causing patchy hair loss on the scalp.
• Cicatricial Alopecia: Scarring hair loss due to inflammation, infection, or trauma.
• Traction Alopecia: Hair loss caused by constant pulling or tension on the hair follicles.

Key Diagnostic Factors

• Family history of baldness
• Gradual receding of frontal hairline, central, and crown (vertex)
• Diffuse thinning of the scalp

Distinguishing Features

• Androgenetic alopecia typically presents with a gradual onset and progression.
• Telogen effluvium is often triggered by a specific event or stressor.
• Alopecia areata can cause patchy hair loss, whereas androgenetic alopecia tends to be diffuse.
• Cicatricial alopecia may present with scarring, inflammation, or infection.

Diagnostic Tools

• Medical history and physical examination
• Blood tests to rule out underlying hormonal imbalances or nutritional deficiencies
• Biopsy in cases of suspected cicatricial alopecia

Consult a Dermatologist

A dermatologist can provide an accurate diagnosis and recommend the best course of treatment for your specific condition. They may also suggest lifestyle changes, such as reducing stress, improving nutrition, or using medications to slow down hair loss.

References:

• [1] Mar 25, 2024 — Alopecia associated with hypothyroidism or hyperthyroidism.
• [5] May 19, 2023 — Key diagnostic factors
• [9] by CC THIEDKE · 2003 · Cited by 126 — Androgenetic alopecia is the most common cause of hair loss in women.