Androgenic Alopecia (Pattern Baldness)

Introduction:

Male pattern hair loss is more common in many people and is called androgenic alopecia. Usually, it begins around the temples and on the top of the head. It is M-shaped at first before reaching around the head and insides. The complete scalp can be involved at times. Generally, it is associated with sex hormone imbalance, especially androgens, and is genetic. The main culprit is dihydrotestosterone (DHT), which, when increased, can cause a shortening of the hair growth cycle and delay new hair growth. No new hair follicles will be formed, but if follicles are still alive, they can be considered for treatment to grow the dormant follicles. Pattern baldness has a gradual onset and occurs after puberty.

What Is the Frequency of Androgenic Alopecia?

Androgenetic alopecia impacts around 50 million men and 30 million women across the United States. This condition can commence as soon as a person reaches their teenage years, and the likelihood of experiencing it rises with age; over 50 percent of men aged 50 and above encounter some level of hair loss. For women, hair loss is the most common post-menopause.

What Are the Symptoms Of Androgenic Alopecia?

The symptoms of male pattern baldness include:

• Thinning or loss of hair on the crown of the head.

• Thinning or loss of hair around the temples.

• A receding hairline.

• Male pattern baldness is typically painless. Many people start noticing the initial signs of male pattern baldness in their 30s, although it can begin as early as the late teenage years or early 20s.

Hair loss on the crown area often manifests in a circular pattern. A receding hairline commonly forms an "M" shape. As hair loss progresses, the thinning around the crown and temples may merge, creating a "U" shape.

What Are the Causes of Pattern Baldness?

The causes of pattern baldness include:

1. Hormonal imbalance.

2. Injury or burns.

3. Scalp infections like ringworm.

4. Aging.

5. Insufficient protein intake.

6. Iron deficiency.

7. Radiation or chemotherapy.

8. Drug-induced.

9. Psychological disorders such as trichotillomania (it is a recurrent urge to pull out hair due to a mental illness).

10. Different hairstyles and hair treatments.

11. Use of hair procedures, including coloring.

12. Handling hair roughly while brushing.

13. Some medical conditions like lichen planus, celiac disease, psoriasis, syphilis, lupus, sarcoidosis, etc.

14. Telogen effluvium, where all the follicles go to the resting phase and become dormant.

What Are the Medical Treatment Options Available?

• Minoxidil - It is available as a 2 percent solution or 5 percent foam that can be applied to the scalp and is FDA-approved. It is directly applied to the scalp, slows hair loss, and grows new hair, but one should continue the treatment for a long time. Adverse effects can happen but are negligible.

• Finasteride - They are oral preparations that bind to the enzyme and block DHT, which slows down the growth of hair follicles. Thus, it slows hair loss but has side effects like chills and rigors, erectile dysfunction, etc.

• Antifungal shampoos like Nizoral are also helpful.

• Dutasteride, a five alpha-reductase inhibitor, inhibits DHT and helps slow hair loss.

• Topical Spironolactone can also be used. In women, oral anti-androgens are usually used. Anti-androgens are more useful and effective if the signs of virilization are present.

• Derma roller plastic can be tried to massage the scalp.

• Prevent insulin resistance.

• Stimulate hair follicle growth by laser therapy; low-level laser therapy (LLLT) is done to stimulate the follicle's growth.

• JAK (Janus kinase) inhibitor Tofacitinib is new in the market and is used in alopecia areata.

• Stem cells can also be implanted, which can grow as hair.

• The fibroblast growth factor can also help in hair growth.

• Hair follicle engineering is a new concept in hair growth, and its procedures are quite expensive.

• Quorum sensing is a new concept and is still in the evolutionary stage.

• Leech therapy is also helpful for baldness, and it improves circulation, which causes hair to grow.

• Acupuncture has also gained an advantage as it improves circulation and activates trigger points to stimulate hair follicle growth.

• A hair transplant is the last option, and several hair follicles can be moved from one area to the bald area. There are two types of procedures - follicle unit transplant and follicle unit extraction. It is a very effective and permanent solution that can be done under local anesthesia.

What Are the Home Remedies for Treating Pattern Baldness?

1. Eat energy-rich foods such as oranges, avocado, carrots, yogurt, sweet potato, pepper, fatty fish like salmon having omega 3 fatty acids, spinach (vitamin A, iron, and folate), beans, green leafy vegetables, iron-fortified grains, eggs, lean meat like chicken and turkey, biotin (vitamin B7) containing foods like onion, sweet potato, eggs, fortified cereals, chicken, oats, nuts and zinc-containing foods like oysters, lobsters, and fortified cereals.

2. Drink a lot of water.

3. Drink green tea.

4. Do not drink a lot of caffeine.

5. Apply onion juice extract to the scalp, leave it for 30 minutes, and wash it.

6. Saw palmetto is a berry plant that can be applied topically.

7. Hibiscus and Bhringraj (Eclipta Alba or false daisy) are also helpful if the extract is applied to the scalp or used in oil.

8. Scalp massage is one of the best methods to improve circulation and cause hair follicle growth. Many oils are best applied to the scalp and are very effective. Essential oils like thyme, rosemary, cedarwood, and lavender are the best. A person can even use peppermint oil, pumpkin seed oil, coconut oil, castor oil, almond oil, olive oil, and amla (Indian gooseberry) oil, and all are found to benefit hair growth.

9. Fenugreek seeds (methi) paste can be directly applied for 40 minutes, left, and washed. It can be mixed with water or milk.

10. Aloe vera gel also improves hair growth if applied.

11. Licorice root paste can be applied with water or saffron and milk and applied.

12. Coffee, honey, and olive oil can be mixed and applied.

13. Chinese hibiscus flowers can be put into coconut or olive oil to char it, collect oil, and apply.

14. Beetroot, flax seeds, and coconut milk are all tried in this aspect.

15. Mustard oil and henna leaves are the best combinations.

16. Beer, honey, and boiled wheat, along with banana and egg yolk, can be a great combination for a hair pack tried with good results.

17. Stop smoking since it can cause reduced growth of a hair follicle.

Conclusion:

Androgenic alopecia shows an inheritance pattern and tends to cluster in families. Many genetic and environmental factors are responsible for this condition. This condition starts as early as the teenage years, and the risk increases with age. Medications and home remedies can help with the regrowth of hair. The key to this condition is patient education and awareness.