Androgenetic alopecia is a common form of hair loss in both men and women. In men, hair is usually lost in a well-defined pattern, beginning above both temples and is usually referred to as male-pattern baldness. Over time, the hairline recedes to form a characteristic 'M' shape. Hair also thins near the top of the head, often progressing to partial or complete baldness. The pattern of hair loss in women differs from men (female pattern hair loss). In women, the hair becomes thinner all over the head, and the hairline does not recede. Androgenetic alopecia in women rarely leads to total baldness. A variety of genetic and environmental factors likely play a role in causing this condition. Mutations in the AR gene have also been associated with androgenetic alopecia.
Source: GARD Last updated on 05-01-20
In addition to male-pattern baldness, androgenetic alopecia in men has been associated with several other medical conditions including coronary heart disease and enlargement of the prostate. Additionally, prostate cancer, disorders of insulin resistance (such as diabetes and obesity), and high blood pressure (hypertension) have been related to androgenetic alopecia in men. In women, androgenetic alopecia is associated with an increased risk of polycystic ovary syndrome (PCOS), which is characterized by a hormonal imbalance that can lead to irregular menstruation, acne, excess body hair (hirsutism), and weight gain.
Last updated on 05-01-20
Only 2 drugs currently have US Food and Drug Administration (FDA) approved indications for treatment of androgenetic alopecia:
Minoxidil: Appears to lengthen the duration of the anagen phase (the active growth phase of hair follicles), and it may increase the blood supply to the follicle. Regrowth is better at the top of the head than in the front areas and is not noted for at least 4 months. It is used as a 2% or a 5% solution that rubs into the scalp and the 5% solution may work better. However, if the treatment is stopped the baldness returns. It works better in patients who just starting having the alopecia and who have small areas of hair loss.
Finasteride: It can only be used in men and is better for balding at the top of the head. If the treatment is stopped the baldness returns. It cannot be used in women who are still able to have children because it can result in ambiguous genitalia in male babies and it does not seem to be effective in women. The doses are about 1 mg daily by mouth.
Minoxidil use for several months can result in an eye condition known as central chorioretinopathy (an eye disease that lead to temporary visual impairment) , which can go back to normal after 1 months of not using the drug. Finasteride has no known side effects in men, according to several studies, but it cannot be used in women who are still trying to have children because it may produce fetal genital malformations.
Every patient is unique and only the doctor can evaluate and determine the best treatment.
Some drugs that are not approved by the FDA but may be helpful are:
In women with androgenetic alopecia.
Oral contraceptives: In women.
Dutasteride: Is currently in study.
Topical latanoprost 0.1% is currently used to treat glaucoma and using it results in an increase of eyelashes. Some studies have shown that this medication could be useful for stimulating hair follicle activity and treating hair loss.
Follistatin, a human cell derived medication is also in study.
Also, low-level laser light therapy, a red light hairbrush–like device has shown some good results.
Surgical treatment of androgenetic alopecia has good cosmetic results. The main problem is covering the bald area with donor plugs (or follicles) sufficient in number to be effective. Micrografting produces a more natural appearance than the old technique of transplanting plugs.
It is important for the patients with androgenetic alopecia to be evaluated for treatable causes of “telogen effluvium” (diffuse hair shedding, often starting suddenly) like anemia or hypothyroidism, especially in patients who had a rapid progress of their disease or a sudden start of the disease. The following treatment options are recommended for women by some experts:
Spironolactone and cyproterone
These treatments are most effective when started early.
Last updated on 05-01-20
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