Introduction
Androgenic alopecia is a type of hair loss that affects both men and women, but the severity of the condition varies depending on ethnicity and gender. It is slow in onset and occurs after puberty. In men, it starts with bitemporal thinning of the frontal scalp and then spreads to the vertex. It is characterized in women by thinning hair between the frontal and vertex of the scalp without affecting the frontal hairline and is usually manifested as a wider part or a visible scalp.
According to studies, white people account for most androgenic alopecia patients, followed by Asians, African Americans, Native Americans, and Eskimos. In Caucasian males, the incidence of the condition tends to increase with age, with 50 percentage affected above 50 years and up to 80 percentage affected above 60 years of age.
What Is Androgenic Alopecia?
Androgenic alopecia is a genetic disorder that causes gradual hair thinning on the scalp, eventually leading to baldness in some cases. It is a type of hair loss that affects both men and women and is also known as male-pattern baldness or female-pattern baldness. The condition can have a negative impact on a person's self-esteem and cause anxiety and distress. Androgenic alopecia is also known as androgenetic alopecia.
What Causes Androgenic Alopecia?
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Androgenic alopecia, also known as pattern alopecia, is a type of hair loss caused by androgens and genetics. Androgens are hormones that promote the growth of male characteristics such as facial hair and a deeper voice. When androgens are present in high concentrations, they can cause hair follicles to shrink and eventually stop producing hair.
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A combination of genetic and hormonal factors contributes to androgenic alopecia. It is known to run in families and affects men more than women. The presence of dihydrotestosterone (DHT), a hormone derived from testosterone, in hair follicles, characterizes the condition. DHT is known to shrink hair follicles, resulting in hair loss.
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According to research, pattern alopecia is a polygenic disorder, which means it is caused by multiple genes that interact with each other and with environmental factors. Both maternal and paternal genes cause the condition, and there is a strong familial predisposition to pattern alopecia. For example, sons of balding fathers have a five to six times higher relative risk of developing the condition than those without a family history.
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In men, androgenic alopecia usually begins with a receding hairline and a thinning crown, which eventually merge to form a horseshoe-shaped pattern of the hair on either side and back of the head. Hair loss is much more diffuse in women, and the hairline remains intact. Although, the hair on top of the head thins, resulting in a wider part and overall hair thinning.
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Certain medications, such as anabolic steroids, oral contraceptives, and anti-androgenic drugs, can also cause or worsen androgenic alopecia. In addition, hair loss can also be caused by medical conditions such as thyroid disorders, iron deficiency anemia, and autoimmune diseases.
What Are the Symptoms of Androgenic Alopecia?
The symptoms of androgenic alopecia vary depending on the stage of the disease. The condition is distinguished by gradual hair thinning on the scalp, which usually begins at the crown or temples. It is important to note that androgenic alopecia may not be the only cause of hair loss, and other underlying conditions may need to be ruled out by a medical professional. The most common symptoms of androgenic alopecia include:
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Gradual Hair Thinning: The main symptom of androgenic alopecia is gradual hair thinning on the scalp. This type of hair loss is often called "male pattern baldness" or "female pattern baldness." In men, the hairline at the temples may recede, and the crown of the head may become bald. The hairline usually remains intact in women, but the hair on the scalp thins out.
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Miniaturization Of Hair Follicles: Hair follicles on the scalp shrink over time, producing shorter and finer hair strands. Miniaturization is the process by which hair on the scalp becomes less visible.
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Increased Hair Shedding: When people with androgenic alopecia comb, brush, or wash their hair, they may experience increased hair shedding. This shedding can be very upsetting, and it can cause feelings of anxiety or depression.
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Visible Scalp: As the hair on the scalp thins, more of the scalp may be visible. This is especially noticeable when the hair is wet or in direct sunlight.
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Hair Texture Changes: Hair texture can change over time, becoming finer and more fragile. This can make styling the hair more difficult and lead to breakage.
What Are the Treatment Options for Androgenic Alopecia?
While there is no cure for androgenic alopecia, several treatments can help slow or reverse hair loss. Medication, hair restoration surgery, and hair replacement systems are among the treatment options. The treatment choice depends on the severity of the hair loss, the patient's age, and overall health.
1. Medication:
Minoxidil and Finasteride are two Food and Drug Administration (FDA)-approved drugs commonly used to treat androgenic alopecia. Minoxidil is a topical solution that is available over the counter and works by widening blood vessels, allowing more oxygen, blood, and nutrients to reach hair follicles. Finasteride is an oral prescription medication that prevents testosterone from converting to dihydrotestosterone (DHT), the hormone responsible for hair follicle shrinkage. Both drugs must be used for at least four to six months before noticeable improvements in hair growth can be seen, and they must be used indefinitely to remain effective.
While these medications can be effective, they do have some side effects. Minoxidil can cause skin irritation, itching, and flaking, whereas Finasteride can cause sexual dysfunction and an increased risk of developing high-grade prostate cancer. In addition, pregnant or trying-to-conceive women should not take Finasteride because it can cause birth defects in male fetuses.
Dutasteride, Spironolactone, and Cyproterone acetate are some other medications used to treat androgenic alopecia. Dutasteride is a stronger version of Finasteride that is occasionally prescribed for patients who do not respond well to the latter. Spironolactone is an antiandrogen commonly used to treat androgenic alopecia in women, whereas cyproterone acetate is not available in the United States but is occasionally used in other countries.
2. Hair Restoration Surgery:
Hair restoration surgery, also known as hair transplantation, entails extracting hair from a donor site, mostly from the back of the head, and then transplanting it to balding areas. The procedure is usually done under local anesthesia and can last several hours. Hair transplants typically grow in the same manner as natural hair.
In addition to these treatments, natural remedies and alternative therapies are occasionally used to treat androgenic alopecia. Red light therapy, saw palmetto extract and platelet-rich plasma (PRP) therapy are among them. The scalp is exposed to low-level laser light during red light therapy, which is thought to stimulate hair growth. Saw palmetto extract is a herbal remedy thought to inhibit DHT production, whereas PRP therapy involves injecting a patient's own blood plasma into the scalp to stimulate hair growth.
Conclusion
Androgenic alopecia is a genetic condition characterized by gradual hair thinning on the scalp, eventually leading to baldness. The condition is caused by androgens and genetics, with a combination of hormonal and genetic factors contributing to its development. While there is no cure for hair loss, medication, hair restoration surgery, and hair replacement systems can help to slow or reverse the process. It is important to note that androgenic alopecia might not be the only cause of hair loss, and a medical professional may need to rule out other underlying conditions.
