ANDROGENETIC ALOPECIA

Overview of androgenetic alopecia

Hair loss is a common problem that impacts people worldwide, regardless of age or gender. The most common type of hair loss is androgenetic alopecia (AGA), or, more commonly known as, male pattern baldness (MPB). Thinning hair or a receding hairline is the warning sign for AGA. This condition can have a significant impact on an individual’s self-esteem and confidence.

Man exposes top of head to show androgenetic alopecia (male pattern baldness or MPB)

what is androgenetic alopecia?

Androgenetic alopecia is commonly referred to as male or female pattern baldness. It is a hereditary condition that causes a gradual loss of hair due to genetic and hormonal factors. AGA is the most common type of hair loss for both men and women. While it impacts both genders, the pattern of hair loss differs between men and women, as listed below:

In Men:

  • AGA typically starts with a receding hairline, often forming an “M” shape.
  • Hair loss then progresses to thinning at the crown (top) of the head, leading to a “bald spot.”
  • Over time, these areas of hair loss may expand, eventually leaving a horseshoe-shaped pattern of hair around the sides and back of the head.

In Women:

  • Female pattern baldness usually presents as diffuse thinning of hair across the crown of the head.
  • Unlike men, women rarely develop a receding hairline or complete baldness. Instead, they experience a widening part or overall hair thinning.

causes of androgenetic alopecia

Androgenetic alopecia is primarily caused by a combination of genetic and hormonal factors. The most common causes are listed below:

  • Genetic Predisposition: A strong family history of AGA increases an individual’s changes of experiencing hair loss. It is believed that specific genes influence this predisposition and condition.
  • Hormonal Influence: Dihydrotestosterone (DHT) is derived from testosterone and negatively affects hair follicles. This happens in genetically predisposed individuals and causes hair to thin and eventually stop growing.
  • Age: AGA typically becomes more noticeable with age. Evidence shows that this most commonly begins at age 30.
  • Gender: While it affects both genders, it manifests differently in each. Men experience receding hairlines, crown baldness, and thinning hair while women often have diffuse crown thinning.
  • Hormonal Changes: Hormonal shifts, like those during menopause or due to medical conditions like PCOS, can worsen hair loss.
  • Environmental Factors: While genetics and hormones are primary, environmental factors like stress, nutrition, and exposure to toxins can play a role in hair loss.

Although androgenetic alopecia’s exact mechanisms are not fully understood, it’s generally understood that it’s attributed to genetics and hormones. It’s recommended to consult with a healthcare professional or dermatologist to be properly diagnosed. Early intervention and treatments offer the best chance of maintaining the hair and stimulating regrowth.

symptoms of androgenetic alopecia

The primary symptom of androgenetic alopecia is hair loss; however, the specific symptoms and patterns can differ. Some of the common associated symptoms for each gender are listed below:

In Men:

  • Receding Hairline: Men with AGA often notice their hairline receding from the forehead, forming an “M” shape. The hairline may gradually move further back over time.
  • Balding at the Crown: Hair loss typically occurs at the crown (the top of the head), resulting in a circular or oval-shaped bald spot. This balding at the crown is often referred to as a “bald spot” or “bald patch.”
  • Thinning Hair: In addition to receding hairlines and crown balding, men with AGA may also experience general thinning of the hair throughout the top of the scalp. The hair becomes finer, shorter, and less dense.
  • Patterned Hair Loss: AGA in men follows a characteristic pattern, with the hair loss usually occurring in a specific sequence: receding hairline, crown balding, and then progressive thinning on top.

In Women:

  • Diffuse Thinning: Female pattern baldness typically presents as diffuse hair thinning across the crown of the head, rather than receding hairlines or bald patches. Women may notice that their part widens, and their hair becomes noticeably thinner.
  • Maintained Hairline: Unlike men, women with AGA usually maintain their natural hairline, which doesn’t recede significantly.
  • Widened Part: The part in a woman’s hair may appear wider and more noticeable as the hair becomes thinner.
  • Hair Miniaturization: Hair in affected areas may become finer, shorter, and less pigmented. This phenomenon is known as “hair miniaturization.”
  • Overall Hair Loss: While women tend to experience more diffuse thinning, in severe cases, AGA can lead to noticeable hair loss throughout the top of the scalp.

It’s important to note that the severity and progression of androgenetic alopecia can vary from person to person. Some individuals may experience mild thinning, while others may have more pronounced hair loss.

Progression of male and female androgenetic alopecia or male or female pattern baldness

Progression of male and female androgenetic alopecia

treatment options for androgenetic alopecia

Treatment options for androgenetic alopecia are aimed at slowing down hair loss, maintaining existing hair, and promoting new hair growth. The effectiveness of these treatments can vary between individuals, and not everyone will respond to all treatments.

FDA Approved Hair Loss Treatments:

  • Minoxidil: Minoxidil is an over-the-counter topical medication available in liquid or foam forms. It is one of the most used treatments for androgenetic alopecia. When applied directly to the scalp, minoxidil can help stimulate hair follicles, increase blood flow, and promote hair growth. It is available without a prescription.
  • Finasteride: Finasteride is an oral prescription medication that works by reducing the levels of dihydrotestosterone (DHT), a hormone associated with hair follicle shrinkage and hair loss. It is typically more effective in men than in women. Women of childbearing age should avoid using finasteride due to potential birth defects.
  • Platelet-Rich Plasma (PRP) Therapy: PRP therapy involves drawing a small amount of the patient’s blood, processing it to concentrate the platelets, and then injecting the platelet-rich plasma into the scalp. PRP stimulates hair follicles and encourages hair growth.
  • Low-Level Laser Therapy (LLLT): LLLT devices, such as laser combs or helmets, emit low-energy laser light that stimulates hair follicles and promote hair growth. Studies show that LLLT can be effective in slowing hair loss and promoting hair regrowth, especially when used regularly.
  • Hair Transplant Surgery: In cases of advanced androgenetic alopecia, hair transplant surgery can be an effective option. This procedure involves removing hair follicles from a donor area (typically the back of the head) and transplanting them into areas with thinning or no hair. There are different techniques, including follicular unit transplantation (FUT) and follicular unit extraction (FUE).

Non-FDA Approved Hair Loss Treatments:

  • Minoxidil & Dermarolling: Minoxidil is an over-the-counter topical medication available in liquid or foam forms. When combined with dermarolling or microneedling, it can increase absorption of the minoxidil. The combined treatments can have a synergistic effect on treating hair loss.
  • Setipiprant & PGE2: Setipiprant works by inhibiting PGD2, which contributes to hair follicle miniaturization, which treats hair loss. In contrast, PGE2 encourages hair growth by increasing PGE2 levels. The combination of setipiprant and PGE2 can have synergistic benefits to treating hair loss. 
  • RU-58841: RU-58841 is a topical antiandrogen blocker that works by blocking the effects of dihydrotestosterone (DHT), a hormone linked to hair follicle miniaturization.
  • CB-03-01: CB-03-01 works by blocking androgens, such as DHT, to prevent miniaturization of hair follicles. 
  • Pyrilutamide: Pyrilutamide is an androgen receptor antagonists. It works by blocking the androgen receptors in the hair follicles, inhibiting hair loss. 
  • Spironolactone: Sprinolactone is an anti-androgen that works by blocking the effects of testosterone and DHT. By blocking these androgens, it works to slow down and halt hair loss. 
  • Latanoprost: Users have explored lanatoprost as an off-label treatment for hair loss due to it’s side effect of increasing eyelash length and thickness. 
  • Ketoconazole: Ketoconazole is an antifungal and treats dandruff and seborrheic dermatitis. This creates a healthier environment for hair growth.
  • Fluridil: Fluridil is a topical anti-androgen that targets hair loss by preventing DHT from binding to androgen receptors on hair follicles.
  • Procyanidin B2: Procyanidin B2 is believed to stimulate hair follicles and extend their growth phase. It also possesses antioxidant properties that protect hair follicles from oxidative stress.
  • Stemoxydine: Stemoxydine is thought to activate dormant hair follicles, increasing hair density and thickness.

Natural Hair Loss Treatments:

  • Scalp Massages: Scalp massages can promote hair loss by improving blood circulation and nourishing the hair follicles.
  • Aloe Vera: Aloe vera is rich in vitamins, minerals, and amino acids that can strengthen hair strands and reduce breakage. It has anti-inflammatory and moisturizing properties that provide an optimal environment to encourage new hair growth. 
  • Onion Juice: Onion juice helps treat hair loss due to it’s high sulfur content, which is essential for regeneration of hair follicles. 
  • Green Tea: Green tea is rich in antioxidants, particularly catechins like epigallocatechin gallate (EGCG). These compounds stimulate hair follicles and promote regrowth. 
  • Saw Palmetto: Saw palmetto combats hair loss with its ability to inhibit 5-alpha-reductase, which is the enzyme responsible for converting testosterone into DHT.
  • Pumpkin Seeds: Pumpkin seeds are rich in nutrients like zinc and fatty acids, which are essential for hair growth, repair, and promoting hair thickness. 
  • Essential Oils: Essential oils treat hair loss by stimulating blood circulation, balancing the scalp health, and nourishing hair follicles, depending on the essential oil(s) being used. 
  • Coconut Oil: Coconut oil is rich in medium-chain fatty acids, particularly lauric acid, which is know to penetrate the hair shaft effectively. This property allows coconut oil to nourish and strengthen hair, and reduce protein loss. 

It’s essential to consult with a healthcare professional or dermatologist before starting any treatment for androgenetic alopecia. They can assess your condition, provide a proper diagnosis, and recommend the most suitable treatment options based on your specific needs.

conclusion

Androgenetic alopecia is a common cause of hair loss that affects both men and women of all ages. While it is primarily driven by genetic factors and hormonal imbalances, there are effective treatment options available to slow down hair loss and promote regrowth. Knowing the cause of your hair loss is the first step to help you treat it and bring back your self-confidence!

If you are concerned about AGA, consult a healthcare professional or dermatologist who can provide a personalized treatment plan to address your specific needs.

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