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Androgenetic Alopecia

What causes androgenetic alopecia?

Angrogenetic alopecia is also known as common or hereditary balding, as well as male or female pattern hair loss depending on the sex of the patient. At least 80% of men and 50% of women will show some evidence of androgenic alopecia by the age of 70. Those susceptible to an earlier onset often have a genetic predisposition and a positive family history. Androgens (a group of hormones) lead to miniaturization and thinning of the hair in those who have genetically sensitive hair follicles to the hormone. Therefore, hormone levels are often normal in those with this type of hair loss.

 

How does androgenetic alopecia present?

In men, hair thinning often begins in the center of the scalp and/or along the frontal hair line. In women, the most common presentation is diffuse central thinning with widening of the hair part.

How is androgenetic alopecia treated?

The medications prescribed either block or alter the activity of the androgen hormones on the hair follicle or stimulate increased blood flow to the scalp and promote new blood vessel development to support hair growth. Regular use is necessary to sustain growth of the hair. Termination of the medication will lead of the resumption of hair loss. The results of the therapies are slow and can take up to 6 months with regular use. Any medicated treatments are contraindicated in women who are planning on becoming pregnant or who are pregnant.

  • Minoxidil (Rogaine) 5% solution or foam
    • Side Effects: scalp irritation or dryness, increased hair loss 4-6 weeks after starting treatment
  • Oral Medications
    • Finasteride (Propecia) or Dutasteride (Avodart)
      • Side Effects: decreased libido, erectile dysfunction, increased risk for breast cancer and high-grade prostate cancer in elderly men
    • Spironolactone (only for women)
      • Side Effects: increased potassium level, irregular periods, breast tenderness, gastrointestinal upset, headaches, dizziness, feminization of male fetus (only if taken when pregnant), and controversial increased risk for breast cancer (link no longer supported by recent studies)
  • Surgical Hair Transplantation
  • Novel therapies (lacking long-term or large studies)
    • Lower level laser light therapy
    • Platelet-rich plasma injections

For more information and treatment options contact us at Adult and Pediatric Dermatology today. 303-796-8200

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