Androgenetic Alopecia: Male and Female Pattern Thinning

What is Androgenetic Alopecia?

Androgenetic alopecia is a common type of hair loss occurring in  both men and women. As the name suggests this type of hair loss is caused by Androgens or male hormones acting on oversensitive hair follicles due to inherited  genes which are responsible for the condition. In men, this condition is called as as male-pattern baldness or male pattern thinning. Hair is lost in a well-defined pattern, beginning above both temples. Over a period of time, the hairline recedes backwards to form a typical  “M” shape. Hair also thins at the crown (near the top of the head), often progressing to partial or complete baldness.

The pattern of hair loss in women is different than male-pattern baldness. In women, the hair loss is more diffuse and may affects the entire scalp. There is no baldness but frontal area thinning can be more pronounced.

female hair loss stages

Androgenetic alopecia in men has been associated with various other medical problems such as coronary heart disease and prostate enlargement. Additionally, prostate cancer, disorders of insulin resistance (such as diabetes and obesity), and high blood pressure (hypertension) have been related to androgenetic alopecia. In women, this kind of hair loss is usually associated with an increased risk of polycystic ovary syndrome (PCOS). PCOS is characterized by cysts in the ovaries leading to hormonal imbalance and irregular menstruation, acne, excess hair elsewhere on the body (hirsutism), and weight gain.

Norwood classification of male pattern thinning

Norwood classification of male pattern thinning

How common is Androgenetic Alopecia?

Androgenetic alopecia is a very common condition and  cause of hair loss in both men and women. Androgenetic alopecia can start as soon as the child reaches puberty and the risk increases with age; more than 50 percent of men over age 50 have some degree of hair loss. In women, it is being diagnosed earlier during their reproductive age as compared to few decades ago when it was most common during perimenopausal age. There are various stages of hair loss in both men and women and the treatment choice depends on that.

What genes are related to Androgenetic Alopecia?

A variety of genetic and environmental factors are responsible for  causing androgenetic alopecia. The study of the risk factors contributing to this condition is being carried out, most of these factors are still unknown. Researchers have concluded that this form of hair loss is related to male hormones called androgens, particularly an androgen called dihydrotestosterone. Androgens are important for normal male sexual development before birth and during puberty. Androgens also have other important functions in both men and women, such as regulating hair growth and libido.

Hair growth begins under the skin in structural units called hair follicles. Each hair strand normally grows for 2 to 6 years, goes into a resting phase for several months, and then falls out. The cycle starts over when the follicle begins growing a new hair. Increased levels of androgens in hair follicles can lead to a shorter cycle of hair growth and the growth of shorter and thinner strands of hair. Additionally, there is a delay in the growth of new hair to replace strands that are shed.Sometimes there are no high levels of androgens in the body and hair follicles have some special receptors for attracting the dht. These receptors develop due to the inherited genes and are present in the hormonally sensitive area of scalp leading to aatracting more dht and thus leading to diminished blood supply and miniturisation of hair follicles over a period of time. This leads to shortened hair cycle and hair loss, thinner hair and balding.

Treatment of Androgenetic Alopecia

Successful treatment of Andogenetic Alopecia is possible in most cases. The key lies in starting the treatment early when not much damage has been caused to the follicles. The treatments aim at maintaining and thickening existing hair and regrowing lost hair as much as possible with the help of various supplements and topical applications. Sometimes a multitherapy approach is combined to get best results in shortest period.

Other therapies such as mesotherapy, LLLT, PRP therapy, Stem Cell Therapy or hair Transplant can be combined depending on the stage and severity of hair loss.