Definition: Androgenic alopecia, commonly referred to as male pattern baldness (MPB) in men and female pattern baldness in women, is a genetic form of hair loss that affects both sexes. It’s characterised by a gradual thinning and recession of hair, primarily from the scalp, and is influenced by a combination of genetics and male hormones known as androgens. The most significant androgen in this condition is dihydrotestosterone (DHT).

How it Starts:

  1. Genetic Predisposition: Androgenic alopecia is genetically determined. If close family members, like parents or grandparents, have experienced pattern baldness, the chances of one developing it increase.
  2. Role of DHT: Testosterone, present in both men and women, is converted to DHT with the help of an enzyme called 5-alpha reductase. DHT binds to hair follicles, especially in predisposed individuals, causing them to shrink over time. This shortens the hair’s growth phase (anagen phase) and extends its resting phase (telogen phase), leading to thinning and eventual hair loss.
  3. Pattern: In men, hair loss typically starts at the temples and crown, leading to a receding hairline and balding on the top of the scalp. In women, the hair loss pattern is more diffuse, often beginning with widening of the central hair part.

Treatments: While there’s no definitive cure for androgenic alopecia, several treatments have shown efficacy in slowing its progression or helping regrow some of the lost hair:

  1. Minoxidil: An over-the-counter topical treatment, commonly known as Rogaine. Initially developed as a blood pressure medication, it was discovered to have hair growth as a side effect. Regular application can help stimulate hair growth and slow the progression of hair loss, although the exact mechanism of action is not fully understood.
  2. Finasteride: A prescription oral medication, also known as Propecia. It works by inhibiting the enzyme 5-alpha reductase, reducing the production of DHT. It’s primarily prescribed for men, as it can cause birth defects if taken during pregnancy.
  3. Hair Transplant: A surgical procedure where hair follicles from denser-growing areas (typically the back or sides of the head) are transplanted to areas of thinning or baldness.
  4. Low-Level Laser Therapy (LLLT): Devices like laser combs and helmets that use red light to stimulate hair growth. Research suggests LLLT can help thicken hair in some people, but its efficacy varies.
  5. Platelet-Rich Plasma (PRP): A newer treatment where blood is drawn from the patient, processed to concentrate the platelets, and then injected into the scalp. The growth factors in PRP are believed to stimulate hair growth.
  6. Spironolactone: An antiandrogen primarily prescribed for women. It works by reducing the effects of male hormones on the hair follicles.
  7. Hair Growth Shampoos and Topical Products: These contain a variety of ingredients, ranging from biotin to ketoconazole, which may support hair health and growth to varying degrees.

Conclusion: Androgenic alopecia is a common form of hair loss influenced by genetics and hormones. While it can be distressing, numerous treatments can help manage its progression. If someone suspects they have androgenic alopecia, it’s essential to consult with a dermatologist or trichologist to determine the best treatment plan.

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