Diagnosis of androgenetic alopecia
March 8th 2024

Androgenetic alopecia: Everything you need to know

Hair loss is multifactorial, that is, it can be due to various reasons depending on the type of alopecia in question. The hair loss that accompanies hairless areas at the receding hairline and crown in the case of men, and widening of the hair part and diffuse baldness in women, is usually androgenetic alopecia. Is he most common type of alopecia, affecting around 60% of men and 25% of women.

Androgenetic alopecia requires medical treatment to stop its progression. Otherwise, it will continue to advance until it causes total baldness in the patient. Next, we delve into this most common type of alopecia.

Causes of androgenetic alopecia

Androgenetic alopecia is of hormonal and genetic origin, so it is very common for those who suffer from it to have a family history with this type of alopecia, although it is not an essential condition.

Irreversible hair loss in these cases is due to the hormonal action of androgens. Specifically, the enzyme 5 alpha reductase converts testosterone into the so-called dihydrotestosterone, which attacks healthy hair follicles, causing their gradual atrophy. When the hair follicle begins to atrophy, it generates miniaturization of the hair, that is, it becomes finer until it eventually disappears. This type of fall is irreversible, so the hair that falls does not come back, generating bald areas.

Symptoms of androgenetic alopecia

The symptoms of androgenetic alopecia vary depending on whether the patient is a man or a woman.

Androgenetic alopecia in men

In men, alopecia begins with a loss of density mainly in areas such as the hairline and crown of the head. It begins with thinning of the hair and the amount of hair decreases, until it disappears completely, generating baldness.

This type of alopecia in men is measured with the Hamilton-Norwood scale, which includes 7 stages that range from a slight lack of density in the frontal area to generalized alopecia or total baldness.

Androgenetic alopecia in women

In cases of androgenetic alopecia in women, hair loss occurs diffusely and does not usually cause total baldness as in men. The patient experiences a general lack of density and frequently also a widening of the hair part.

This type of alopecia in women is measured with the Ludwig scale, which recognizes 3 stages based on its progression from a slight widening of the hair part to a marked loss of hair density throughout the frontoparietal region. 

Diagnosis of androgenetic alopecia in a woman

Treatment of androgenetic alopecia

It is important to note that there is currently no cure as such for androgenetic alopecia. The treatments are aimed at slowing its progress, reducing hair loss and significantly improving its quality. They are highly effective with visible results in a few months, but when they are stopped, the hair loss will be significant again, so it could be said that the treatment is for life or until an advanced age.

oral drugs

The oral drugs most used in both men and women to treat androgenetic alopecia are finasteride and the Minoxidil: A Targeted Approach for Early Hair Loss . They are usually used together, although their dose and schedule will depend exclusively on the criteria of the specialist doctor.

Finasteride is an antiandrogen that inhibits the action of the 5 alpha reductase enzyme, thereby regulating the hormonal alteration that causes irreversible hair loss. Therefore, this drug stops hair loss.

On the other hand, minoxidil is a vasodilator that promotes blood circulation in the scalp, facilitating the arrival of nutrients to the hair follicles. Thanks to this drug, it is possible to thicken the hair and considerably improve its quality, avoiding miniaturization of the hair.

Infiltrated treatments

Oral treatment can be combined with infiltrated hair treatments, although these can also be used alone to replace these drugs. The most effective currently are Platelet Rich Plasma and hair mesotherapy.

Platelet Rich Plasma, or PRP, is a hair regeneration treatment that consists of extracting a small amount of blood from the patient and subjecting it to a centrifugation process. Thanks to this, the platelet-rich plasma with growth factors is separated from the rest of the blood components. This enriched plasma is injected into the patient's scalp, stopping hair loss and improving hair quality, achieving visibly healthier hair.

On the other hand, hair mesotherapy involves the infiltration of vitamins, trace elements and dutasteride, a drug with an action similar to finasteride, to stop the progression of alopecia and hair loss.

Capillary graft

The hair treatments mentioned above will not cause hair to grow back in areas where it stopped growing naturally. The only way to grow hair back in those areas is through hair graft.

It is an outpatient, minimally invasive intervention that consists of extracting healthy hair follicles and implanting them in bald areas. The results of this technique are given one year after surgery, although after 6 months a significant change is already seen.

Man before and after hair transplant

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