Androgenic Alopecia
Advanced Treatments for the Most Common Form of Hair Loss
Definition
Androgenetic alopecia is the most frequent cause of non-scarring alopecia and presents with a characteristic hair-thinning pattern in both men and women. The condition is characterized by progressive, symmetrical, and patterned miniaturization of hair due to the influence of androgens, particularly dihydrotestosterone (DHT). It results from a combination of genetic and hormonal factors, leading to follicular shrinkage, shortening of the hair growth cycle, and production of weaker hairs. The psychological impact is often significant, as hair loss strongly affects self-esteem.
• Accurate Diagnosis
• Innovative Treatments
• Personalized Approach
• Natural & Long-lasting Results
Epidemiology
Up to 80% of men are affected, with onset often beginning in adolescence (14% between ages 15–17). In women, signs typically appear after menopause but may also occur in the premenopausal period.
Pathogenesis
The condition is multifactorial, with heredity playing a major role. Other key factors include:
- Androgens:As mentioned, dihydrotestosterone (DHT) binds to receptors in hair follicles, shortening the anagen phase and reducing follicle diameter and length, thus altering hair morphology.
- Genetics:One of the most critical genes is the androgen receptor gene located on the X chromosome, often associated with specific polymorphisms.
Clinical Presentation
Men:
Hair thinning or permanent loss typically begins in the temples and vertex, including the frontal hairline, following a pattern classified by the Hamilton-Norwood scale (Types I–VII).
Women:
Characterized by diffuse thinning in the frontal scalp and crown, with preservation of the frontal hairline. This follows the Ludwig scale (Types I–III).
Diagnosis
Diagnosis involves a combination of medical history, clinical examination, and laboratory testing. The physician assesses the onset and pattern of hair loss, accompanying symptoms, medications, and family history.
During physical examination, the clinician may observe hairline recession or diffuse thinning and perform the hair pull test. Blood tests, including hormonal and thyroid function panels, are used to rule out conditions like thyroid disorders, anemia, or hyperandrogenism. In some cases, a scalp biopsy may be required.
Trichoscopy is used to examine the scalp and follicles in detail using a dermatoscope or digital camera, assessing the severity and extent of the alopecia. Phototrichograms help monitor progression and guide treatment selection.
Treatment Approaches
Pharmacological Treatments
Minoxidil is used topically or orally to increase blood flow to the follicles and prolong the anagen phase. Results are visible after several months and persist only with continued use.
Finasteride inhibits the conversion of testosterone to DHT and may take up to 6 months to show results.
Dutasteride has a similar mechanism, also targeting the same enzyme.
Spironolactone blocks androgens but is not recommended for men due to the risk of gynecomastia.
Autologous Hair Mesotherapy & Microneedling
This technique uses platelet-rich plasma (PRP), which is injected into the scalp to stimulate hair growth. A non-invasive method that improves blood circulation, promotes cell regeneration, and strengthens follicles.
Microneedling may also be performed, using fine needles to create micro-injuries and microchannels in the scalp. This stimulates collagen and elastin production, promoting hair regeneration and improving absorption of topical agents or medications mentioned above.
PRP (Platelet-Rich Plasma)
PRP is an autologous therapy in which a small amount of the patient’s blood is centrifuged to isolate plasma rich in growth factors. This plasma is then injected via mesotherapy or applied through microneedling.
Recent studies have shown that combining PRP with minoxidil enhances both hair follicle quantity and quality.
Surgical Treatment
Hair transplantation is recommended for patients with sufficient donor follicles. Suitable candidates include those in Ludwig stages I–II and Hamilton-Norwood stages I–III. Surgical intervention is typically combined with topical or oral therapies for optimal outcomes.
At Optimum Dermatology, our expert physicians and innovative treatment protocols ensure optimal, long-lasting results.