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Picture of Dr Balwi examining a patient who has an androgenetic alopecia

Androgenetic Alopecia: Our Guide

Androgenic alopecia, also known as hereditary alopecia, is the most common cause of hair loss. It’s also known as male/female pattern baldness and can affect both genders.

Typically, it develops slowly, starting from puberty. This means it can affect people during their growth years. It’s normal to lose hair over the course of one’s life as it’s a natural ageing process that occurs gradually. However, if this happens during the early adult years, it is most often a sign of hereditary alopecia.

Summary

  1. Is Androgenic Alopecia Common? More Common Than You Might Think
  2. What Causes It?
  3. What Are the Treatment Options in 2023?
  4. Hair Transplantation: The Only Long-Term Solution
  5. Our Tips for Managing Androgenetic Alopecia

Is Androgenic Alopecia Common? More Common Than You Might Think


Closeup portrait, shocked man feeling head, surprised he is losing hair, receding hairline, bad news isolated on gray wall background. Negative facial expressions, emotion feeling

Unfortunately, this form of hair loss is more widespread than initially thought. According to studies, the issue usually begins in men as early as in their 20s and increases with age. The prevalence is around 21% in men in their twenties and rises to about 85% by the age of 50. In women, the prevalence is approximately 12% between 20 and 30 years of age and about 75% after 70 years.

The complexity of androgenetic alopecia (AGA) is further compounded by the fact that it can manifest differently among ethnic groups. People of Caucasian origin are the most affected, while it’s less common in Asian and African individuals. The reasons for these differences are not fully understood, but studies have shown varying severity patterns.

The prevalence of AGA increases with age in both men and women of all ethnicities but varies by gender and ethnicity.

What are the symptoms?

This specific type of hair loss manifests distinctly on the scalp. Furthermore, the way this condition presents itself between genders is highly remarkable. Generally, the following symptoms can be observed.

In men

  • Formation of a receding hairline
  • Formation of a bald spot at the back of the head
  • Final formation of a hair crown in the lower back of the head and temples

In women

  • Increased thinning of hair at the crown
  • Partially accentuated hair loss
  • Receding hairline

As described, there are notable differences. Therefore, we will now delve into the differences between androgenic alopecia in men and women in more detail.

Understanding Androgenetic Alopecia by Gender

Hair loss due to androgenic alopecia occurs when hair follicles in sensitive areas shrink and thin over time, eventually falling out and not regrowing.

In men, the hairline begins to recede and takes the shape of an “M.” The area at the back of the head also starts to thin and expand over time. One of the final stages results in a U-shaped hairline on the sides of the head.

In women, hair generally thins at the middle part, revealing the scalp. In many cases, the problem starts at a young age and worsens rapidly during menopause. There is also often a receding hairline above the temples, causing significant distress to affected women. If left untreated, the condition can lead to complete hair loss in both genders.

What Causes It?


Androgenetic alopecia is primarily caused by the hormone dihydrotestosterone (DHT). DHT is produced from a male hormone, testosterone. In men, the enzyme 5-alpha-reductase is particularly active in the hair follicles of the temples and the back of the head. This enzyme converts testosterone into DHT.

DHT affects hair follicles, making them smaller and weaker. As a result, hair falls out and does not regrow. In addition to genetic predisposition, there are other factors that can promote androgenic alopecia, including:

  • Stress
  • Obesity
  • Smoking
  • Alcohol consumption
  • Medications

Genetic predisposition plays a significant role in this type of hair loss, and specific hormone variations, combined with other factors, create ideal conditions for the development of androgenetic alopecia.

The AGA gene is more likely to be expressed in men and women suffering from alopecia who inherit the gene from their father or mother. The gene can remain dormant for years before being expressed. To date, there is no screening to predict when this will occur.

What are the Treatment Options in 2023?


If you have hereditary conditions or are already experiencing androgenetic alopecia, it is important to start treatment as early as possible. It is a chronic and persistent condition, so the earlier you start, the more treatment options you have.

We have listed the different types of existing treatments so you can make the best choice for you. It is also important to follow the advice of a professional to be safely prepared.

Topical Treatments

Minoxidil is the most popular topical treatment on the market for baldness. This active substance is highly regarded as a “gateway” treatment for androgenic alopecia. By stimulating hair follicle growth, it increases blood flow to the scalp and prevents further hair loss.

However, it must be used regularly for lasting results. It is more of a less effective and temporary solution for permanent results. The following side effects may occur:

  • Changes in hair texture
  • Scalp irritation or redness
  • Accidental hair growth on other parts of the body
  • Chest pain
  • Sudden weight gain
  • Swelling of the hands or feet
  • Dizziness

It is important to determine the best concentration and usage frequency under medical supervision.

Oral Medication Treatments

Regarding oral treatments, finasteride and dutasteride are the first choice for many people. They are primarily DHT blockers, allowing hair follicles to remain in the growth phase longer. Results typically appear about three months after starting treatment.

However, what also discourages many concerned individuals are the potential side effects, including:

  • Reduced libido
  • Erectile dysfunction and ejaculation problems

These side effects are more common in men taking higher doses of the medication. Additionally, it can lead to serious complications in women considering pregnancy or who are pregnant.

Before using finasteride or dutasteride for AGA, consult a doctor to understand the risks and benefits of these medications.

Laser Therapy

Low-level laser therapy is a relatively recent treatment method to combat androgenetic alopecia. By penetrating low-intensity light into the scalp, it repairs and regenerates tissue in that area.

Studies have not yet shown definitive results. Currently, the therapy helps stimulate hair growth in men and women, including those with AGA. Moreover, cellular metabolism and blood flow to hair follicles are increased, leading to improved hair growth.

Microneedling

During microneedling treatment, a device with fine needles is used to puncture the skin at regular intervals. The depth of the punctures can vary depending on the skin’s condition and the treatment’s goal. Results are generally visible after several treatments. In cases of hair loss, microneedling can stimulate hair growth and densify it.

The treatment is usually painless and lasts about 30 minutes. After the treatment, the skin may be red and swollen, but this is normal and should fade within a few days. The frequency of microneedling sessions depends on the skin’s condition and the treatment’s goal. For hair loss, treatments may need to be repeated every 4 to 6 months.

It is a fairly reliable procedure, but some risks can occur, including:

  • Redness
  • Swelling
  • Bleeding
  • Infection
  • Scar formation

Microneedling can be an effective and relatively safe method for treating skin or hair issues. If you are interested in this method, consult an experienced doctor or dermatologist to determine if it is suitable for your case.

PRP Therapy

PRP therapy, also known as Vampire-Lifting, is a natural variant for stimulating hair growth. A small amount of autologous blood is taken from the patient (about 12 ml) and then enriched with essential nutrients. The fluid is then injected into the bald areas of the head.

This method uses high-quality platelet-rich plasma to multiply growth factors in local blood cells – in other words, using your own blood to stimulate hair growth.

Reliable studies show that PRP injections can have positive effects on hair loss and are entirely safe. Therefore, PRP is a promising and effective treatment option for hair loss.

Hair Transplantation: The Only Long-Term Solution


The only long-term and most effective method to successfully combat androgenic alopecia is hair transplantation. Healthy hair follicles are taken from the donor area (back of the head), enriched in a special nutrient solution, and then transplanted to the recipient area.

To ensure a perfect result for each patient, Elithair exclusively offers the pre-test system. Six detailed analyses are performed for each patient, including blood tests, Doppler ultrasound, and many others. The results accurately show whether the patient is suitable for a hair transplant and which transplantation technique yields the best result.

The treatment offers long-lasting results with minimal risks compared to the other treatments mentioned above. After just 12 months, patients can once again enjoy abundant and radiant hair.

Our Tips for Managing Androgenetic Alopecia


Hair loss caused by androgenetic alopecia is a problem that affects both men and women. Since it is often a genetic, hormonal, or lifestyle-related condition, affected individuals may believe their case is incurable, but this is not the case.

In addition to the treatment options mentioned above, there are other practical and accessible tips for dealing with the condition:

  • Accept your hair loss. It is important to acknowledge that hair loss is a first step in a natural process that affects many people. By accepting the situation, you can begin to find ways to manage it.
  • Consult a professional. If you are concerned about your hair loss, speak to a doctor or dermatologist. They will provide you with information about the causes and treatments for hair loss.
  • Look for support groups. There are many support groups for people with androgenetic alopecia. These groups can provide you with emotional support and information about the condition.

If you are considering hair transplantation, consult a specialist beforehand. You will receive an assessment of your hair loss and determine if it is possible in your case.