Androgenetic alopecia

Androgenetic alopecia

Description, Causes and Risk Factors:

Alternative Name: Male pattern baldness.

Abbreviation: AGA.

Androgenetic alopecia or male pattern baldness is truly a distressful condition that can predominantly occur in men. This shows visible patterns on their scalp, starts with a receding hairline which is very progressive, displaying an "M" or horseshoe pattern at the front and a gradual thinning of hair at the top or the crown area going to the middle that meets the receding hairline. Androgenetic alopecia is strictly to be a natural occurrence in men's body and is never considered a disease.

Androgenetic alopecia

Androgenetic Alopecia is one of the natural processes of the body and is influenced by race, gender, age, heredity and hormones. The risk of this form of baldness is higher if it runs in the family.

Stages of male pattern baldness according to the Norwood Hamilton Scale:

    Stage 1: No hair loss. The head is full of hair.

  • Stage 2: Minor recession at the front of hairline and some temporal recession. This stage may not even be called as balding.

  • Stage 2A: Recession progresses across the entire frontal hairline.

  • Stage 3: Temporal recession deepens.

  • Stage 3A: Frontal recession keeps progressing backwards.

  • Stage 3V: Besides the loss of hair in the frontal and temporal regions, there is early hair loss from the crown (vertex).

  • Stage 4: Frontal and temporal hair loss progresses and there is enlargement of the bald patch at the crown.

  • Stage 4A: Hair loss progresses past the mid-crown.

  • Stage 5: Bald area in the front enlarges and starts joining the bald area at the crown.

  • Stage 5A: Bald patches in the front and at the crown fuse and keep enlarging. The back part of the bald area is narrower are compared to stage 6.

  • Stage 5V: The bald patch at the crown enlarges although it has still not fused with the bald area at the front.

  • Stage 6: Frontal bald area and the one at the crown are fused and continue to enlarge. The back part of the bald area is wider than in stage 5.

  • Stage 7: Extensive baldness where only a strip of hair remains at the back and sides of the head.

In androgenetic alopecia androgens (sex hormone that is produced in the testes and responsible for typical male sexual characteristics) plays an important role. The genetic program for balding is not understood but there is a familial tendency. Under the influence of androgen, terminal hairs undergo gradual miniaturization then disappear as one goes bald. It is no coincidence that the pattern of balding closely parallels the density of DHT receptors in the scalp. Hormonal levels in men with androgenetic alopecia are normal.

While the genetic and hormonal factors are the ones most influencing the advent of male pattern baldness, it has also been noticed that few lifestyle related factors also lead to the hastening of the procedure. A high calorie, fat diet and a lazy lifestyle, result in the setting of the male pattern baldness. At times, stress has also been noticed to accelerate the hair fall amongst men.

Androgenetic alopecia in women is less frequent. The etiology is in principle the same as in men. However, it is always necessary to exclude the possibility of endocrine dysfunction. Conversion of dehydroepiandrosterone (DHEA) into testosterone and the lack of aromatase which contributes to the conversion of androgens into estrogens are more often seen in females than in males. Apart from androgens, reduced levels of estrogens may also contribute to the incidence of AGA (hypoestrogenous AGA in women after menopause or after ovariectomy). The same may be said concerning higher levels of prolactin. Adrenal or ovarian tumors producing androgens may be a further cause. In women with AGA the hair boundary line above the forehead is maintained, but frontally and parietally hairs are thin. The density of hair remains the same in the occipital and parietal areas. Exceptionally, a retraction of the frontoparietal hairline or the formation of a bald spot (as in men) may occur after the menopause.

Risk factors may include:

    Positive family history.

  • Advancing age.

  • Pregnancy.

  • Poor nutrition

  • Stress.

In order to save yourself from the male pattern baldness, start caring for your lifestyle. Exercise and aerobics have been proved to reduce the levels of free testosterone in the male body, thereby reducing the hair fall and damage to the follicles. Eat traditional, non-complex food, while also reducing usage of chemicals on your hair. In case you are worried about the hair fall, contact the doctors immediately and seek for a treatment. Further, try using soft shampoos, or shampoos containing chemicals like minoxidil in them.


    Hair loss in patches.

  • Diffuse shedding of hair.

  • Breaking of hair shafts.

  • Hair thins over the entire head.

  • Hair comes out when brushing.

  • Itching, not always.


The diagnosis of androgenetic alopecia in men is generally straightforward. It is made byobserving a “patterned” distribution of hair loss and confirmed by the presence of miniaturizedhairs in the areas of thinning. The diagnosis is supported by both the inexorable progression ofthe hair loss according to a recognizable pattern and a history of baldness in the family.Inwomen, the diagnosis is more complex, as the most common presentation, a diffuse pattern, canbe mimicked by a host of non-androgenetic etiologies.

This physical exam may include:

    Gentle pulling on the hair.

  • Taking samples of scalp areas with inflammation to examine under a microscope.

  • Analyzing samples of hair.

  • Checking for hair loss on other parts of the body.

A skin biopsy or other procedures may be needed to diagnose other disorders that cause loss of hair.


Medical Treatment Options:

    Minoxidil (Rogaine): This is now available in 2% and 5% solutions. If used for at least 32 weeks, a modest increase in thickness and density of hair occurs in 30% of individuals, possibly more with the higher strength solutions. If stopped, reversal to the pretreatment state occurs within three months. Local irritation can be a side-effect. Pregnant women should not use minoxidil.

  • Propecia (finasteride): This medication is an androgen inhibitor, taken orally. It is not effective in women. Modest improvement in frontal hair loss was seen in men (by self-assessment) after one year of using 1 mg per day by mouth. One percent to 2% of men may experience decreased libido, or problems with erection.

Surgery may include:

    Hair Transplant: Taking hair from the back and sides of the head and transplanting it in bald areas. As many as 300 grafts may be needed. You must return multiple times for the grafts.

  • Scalp reduction with flaps: Cutting the scalp and pulling the areas with hair closer together.

NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.

Reference and Source are from:

DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.


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