Introduction
Men and women experience androgenetic alopecia, a frequent hair loss. This disorder is also referred to as male-pattern baldness in men. A distinct pattern of hair loss starts above both temples. The hairline gradually recedes until it takes on the recognizable "M" shape. Near the top of the head, the hair at the crown also becomes thinner, frequently leading to partial or total baldness.
In contrast to male-pattern baldness, women lose their hair in a different pattern. While the hairline does not recede, women's hair thins down all over their heads. Women with androgenetic alopecia rarely develop complete baldness.
During puberty, androgens encourage more visible body hair (such as a beard) and continue to grow different hair follicles and hair sizes for many years. In contrast, androgens paradoxically can slowly suppress some scalp follicles, which results in androgenetic alopecia (balding). Because human hair plays an important social communication role, androgen-dependent hair diseases, including hirsutism (male pattern hair distribution) in women and androgenetic alopecia in both sexes, cause severe psychologic discomfort.
How Male Sex Hormones Affect Hair Growth?
A number of genetic and environmental causes likely cause androgenetic alopecia. The androgen hormones, notably the androgen known as dihydrotestosterone, have been linked to this type of hair loss. Androgens play a crucial role in the normal development of male sexuality in both fetal life and adolescence. In addition to controlling hair growth and sex drive, androgens play other crucial roles in both men and women.
Follicle-like structures under the skin are where hair development starts. Normally, each hair strand grows for two to six years before falling out after resting. When the hair follicle starts to generate new hair, the cycle begins again. A shorter hair growth cycle and the development of shorter and thinner strands of hair can result from higher amounts of androgens in hair follicles. To compensate for the lost hair, there is also a delay in new hair growth.
Even though multiple genes may be involved in androgenetic alopecia, only one gene, AR, has been proven to be altered in research. A protein known as an androgen receptor is made according to instructions from the AR gene. The body can properly process dihydrotestosterone and other androgens due to androgen receptors. Polymorphisms in the AR gene cause increased androgen receptor activation in hair follicles.
What Are Hormonal Effects on Hair at Different Stages of the Life of Women?
Depending on the stage of the woman's life, hormones affect their hair in the following ways:
1. Reproductive Age
Several hormonal problems, such as hyperandrogenism, thyroid gland illnesses, and hyperprolactinemia, might influence the reproductive cycle in women. These endocrine abnormalities can cause hirsutism, female pattern hair loss, and other types of alopecia, as well as hypercortisolism and excessive growth hormone secretion, which happen far less frequently. Hirsutism is a common endocrine condition that affects 5 to 10 percent of reproductive-age women and is defined as excessive terminal hair in a male pattern in females. Approximately 70 to 80 percent of women with increased androgens have hirsutism, while many have abundant hair without hyperandrogenemia.
2. Pregnancy
The physiological increase in testosterone levels caused by pregnancy could have comparable negative effects. However, pregnancy-specific mechanisms are engaged to protect both the mother and the fetus against pregnancy-induced androgen excess. High amounts of androgens would promote hirsutism and or virilization of both the mother and the female fetus without these 'protective' mechanisms.
3. Menopause
Menopause is frequently accompanied by FPHL (female pattern hair loss) and face hirsutism. The perimenopausal stage or menopause transition is accompanied by noticeably reduced hair density and diameter. After menopause, estrogen levels drop suddenly, whereas androgen output steadily decreases with age and is maintained until the later stages of life. The increase in luteinizing hormone (LH) after menopause keeps the level of ovarian androgen constant. There is a sharp drop in sex hormone binding globulin (SHBG) concentrations and a corresponding rise in free androgen in the absence of estrogens and with the propensity to build visceral adipose tissue and lead to hirsutism.
What Is Hirsutism?
Hirsutism is a female disorder characterized by excessive dark or coarse hair growth in a male-like pattern on the face, chest, and back. Extra hair growth caused by excess male hormones (androgens), particularly testosterone, is common in hirsutism. Hirsutism is characterized by stiff or dark body hair that appears in areas of the body where women do not normally have hair, primarily the face, chest, lower belly, inner thighs, and back.
When excessive androgen levels produce hirsutism, other symptoms, such as virilization, may emerge.
Virilization symptoms include:
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Voice deepening.
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Balding.
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Acne.
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Reduced breast size.
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Muscle mass growth.
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The clitoris has been enlarged.
Hirsutism can be quite upsetting emotionally. Some women are embarrassed by their unwanted hair. Some people become depressed. Furthermore, while hirsutism alone does not result in physical difficulties, the underlying cause of a hormone imbalance can result in physical difficulties.
What Is Androgenetic Alopecia?
A genetically predetermined condition called androgenetic alopecia results from an overactive androgen response. This disorder, which affects up to 50 percent of both sexes, is characterized by the progressive loss of the scalp's terminal hair at any point after puberty. Both in males and females, it is distributed distinctively. While women's frontal hairlines are often spared from diffuse hair loss at the crown and top of the head, frequently identified by a broader center part, men experience hair loss most noticeable at the vertex and frontotemporal regions.
What Are Grading of Androgenetic Alopecia?
The following is the grading of androgenetic alopecia:
Grade 1 - This pattern is common in all girls prior to puberty, but only 45 percent of women aged 80 and over have it.
Grade 2 - The central portion has been widened.
Grade 3 - Widens the core part while the hair on either side of the central part thins.
Grade 4 - Demonstrates the onset of scattered hair loss on the scalp's top.
Grade 5 - Signs of advanced baldness.
What Are the Treatment Modalities to Treat Androgenetic Alopecia?
The following are the treatment modalities to treat androgenetic alopecia:
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Finasteride or Minoxidil can be used to treat men.
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Spironolactone or Minoxidil can be used to treat women.
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Finasteride is sometimes applied to female patients.
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In some circumstances, platelet-rich plasma injections, laser light devices, and surgical treatments may also be taken into account.
How to Diagnose Androgenetic Alopecia?
The following are the way to diagnose androgenetic alopecia:
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Clinical diagnosis is made based on the pattern of hair loss.
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In some circumstances, the patient will require blood testing to check for any deficiency or any other pathological changes.
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Scalp biopsy to look for further hair loss causes.
Conclusion
Due to the role of hair in human communication, irregularities such as excess hair in hirsutism or hair loss in alopecia create psychological anguish. Androgens are the primary regulators of human hair follicles, transforming small vellus follicles that produce tiny, nearly undetectable hairs into larger intermediate and terminal follicles that produce larger, pigmented hairs. The reaction to androgens differs by body site because it is unique to the hair follicle. Androgens normally increase axillary and pubic hair in both sexes, as well as the beard, etc., in men. Still, they can also impede scalp hair development later in life, causing androgenetic alopecia. To know more about the condition, consult the doctor online.
