What Is Androgenic Alopecia and How Does It Affect Hair Loss?

It is normal to lose 50 to 100 hair strands every day. However, excessive hair fall becomes a matter of concern and induces negative feelings.

In this blog, we will learn about androgenic alopecia or pattern hair loss, how does it start, and how it can be managed. 

What is Androgenic Alopecia? 

It is a type of hair loss concerned with genetics and hormonal changes that occur with age. During this condition, there is sudden hair thinning, falling, and recession. This causes your hair to disappear gradually in distant patches and results in baldness over time. Though it is more common in males, it can also affect females as female pattern hair loss.  

How does it look? 

In men, the symptoms of androgenic alopecia are very defined and begins above the temples. Then, slowly the hairline recedes to form an M-like shape. It affects the scalp more than the rest of hair. Moreover, hair starts disappearing from the crown and vertex (highest point of the head). On the other hand, the process of pattern hair loss is different in women. It causes hair on the scalp to thin out, causing the middle part to become bare and wide.  

What causes pattern hair loss?  

Androgenic alopecia is a hereditary condition characterized by an exaggerated reaction to androgens. It can start any time after puberty but is more common after 40 years in men and post-menopause in women. Although there is no definite cause for this condition, it can sometimes be an outcome of underlying medical conditions. Conditions such as coronary heart disease, benign prostatic hyperplasia, prostate cancer, insulin resistance disorders (including diabetes and obesity), and hypertension have been associated with androgenetic alopecia. 

How is Androgenic Alopecia different from Telogen Effluvium? 

Telogen effluvium refers to a form of hair loss characterized by the rapid loss of hair within a brief timeframe. This condition often arises a few months following a significant physical or emotional stressor. Additionally, it may be triggered by abrupt hormonal fluctuations. Typically, hair loss associated with telogen effluvium is temporary, and once the stressor is removed, hair tends to regrow without the need for medical intervention. 

In contrast, male pattern baldness presents a more gradual progression of hair loss compared to telogen effluvium. The precise causes of male pattern baldness remain unclear. In the absence of medical treatment, this type of hair loss is generally permanent. 

How is it diagnosed?  

It can often be identified by physical appearance. Despite that, a doctor may conduct certain tests to differentiate the condition from other types of hair loss. They may ask for your family’s medical history to make sure it is androgenic alopecia. Other times, they may use a densitometer to measure hair follicle thickness. If they suspect a condition other than pattern hair loss, they may conduct lab analysis or biopsy.  

Treatment for Androgenic Alopecia 

Hair transplant 

In the process of hair transplantation, medical experts relocate androgen-resistant hair follicular units from the back of the head to the regions impacted by hair loss.

There are two main techniques for obtaining donor hair:  

• Follicular Unit Strip Surgery (FUSS)  
• Follicular Unit Extraction (FUE). 

Oral medication 

Antiandrogens can be used to deactivate hormones that trigger alopecia, for example, DHT. Apart from this, a medicine called Finasteride has been approved by the FDA as a remedy for this condition. It has a substance acting as a competitive inhibitor of type II 5-alpha reductase, leading to drops in the level of dihydrotestosterone in the body. 

Low-level laser therapy 

It is another FDA-approved therapy to inhibit androgenic alopecia. During this method, different wavelengths of cold laser are used to regulate inflammation and promote hair growth in barren regions of the scalp.  

Microneedling

Microneedling has become increasingly popular and is recognized for its effectiveness in promoting hair regrowth in individuals with alopecia. Initially utilized for cosmetic enhancements, it has now found a role in enhancing the delivery of topical medications. This technique involves the use of numerous fine needles, typically arranged on a roller, to create minuscule punctures in the skin. This process encourages neovascularization, facilitates the release of growth factors, and enhances the expression of Wnt proteins. 

Ketoconazole shampoo 

Ketoconazole has anti-fungal and anti-inflammatory properties that help in effective management of androgenic alopecia. The 2% formula of this shampoo has shown the best results. it can alleviate inflammation associated with pattern hair loss and provide advantages for women experiencing hyperandrogenemia and female pattern hair loss. Shampoos containing zinc operate in a similar mechanism and offer similar therapeutic benefits. 

Topicals

Topical treatments might be a suitable choice for patients who are already on several medications, as these could potentially interact with other drugs intended for the treatment of AGA. 

Prevention and management 

• Hair loss can make a person insecure and stressed out. The first step is to calm yourself down and understand that it’s completely normal to face this condition. If it is affecting your daily life activities negatively, it is best to visit a therapist and talk to your family and friends.  
• Take a protein-rich diet. Around 40 to 60 g of protein in your meal can prevent hair fall. Moreover, try adjusting multivitamin supplements to your routine. Various vitamins and minerals, such as vitamins A, B, C, D, E, along with zinc and iron, play a crucial role in supporting the health of muscle tissue, skin, and hair. 

Key takeaways 

Androgenic alopecia, often referred to as male or female pattern baldness, represents a widespread type of hair loss that impacts millions globally. This condition is largely determined by genetic factors and hormonal fluctuations, particularly the effects of androgens such as testosterone and dihydrotestosterone (DHT) on hair follicles. Its progressive nature and diverse manifestations can have a profound effect on an individual’s self-esteem and overall quality of life. 

From a biological standpoint, androgenic alopecia is marked by the gradual reduction in size of hair follicles, resulting in finer, shorter hairs and, ultimately, a halt in hair growth in the affected regions. This phenomenon presents in specific patterns for men and women; men typically experience receding hairlines and thinning at the crown, while women tend to show a more diffuse thinning across the entire scalp. Recognizing these patterns is essential for timely diagnosis and effective treatment strategies.