23 June 2021 Author : Vasco Vieira Serrão Androgenic alopecia is very common, it is the most common type of hair loss, both in men and women. It can even affect: 80% of men; 40% of women. Although with different pattern and evolution, male and female androgenic alopecia have a common cause : Some hair follicles respond to androgens (hormones) with progressive atrophy. This is reflected in a shorter growth phase (anagenesis) and in a progressive reduction in the thickness and dimension of the hair strands, until eventually they fall out; The response of hair follicles to androgens is genetically determined, but the exact way how family history determines androgenic alopecia is not fully understood. The responsible enzyme (5α-reductase) has been identified, and there are specific medications to reduce its activity. The age of onset, speed of evolution and extent of alopecia are variable, depending on the distribution of susceptible follicles (genetic) and hormonal factors. Male androgenic alopecia In men, the pattern of baldness is very characteristic: It usually starts in the area of hair implant and in the vertex (top of the head); It can stabilize and be located only in these areas, but in many men, it evolves reaching the entire top of the head. The presence of hair with different lengths and textures in the affected areas is characteristic of male androgenic alopecia . Female androgenic alopecia In women, there is a diffuse reduction in hair mass in the area at the top of the head, without any areas being completely hairless and with the hair implantation line preserved. Therefore, androgenic alopecia is not as evident in women as it is in men . Diagnosis Diagnosis is based on clinical history and visual assessment of the affected areas. In specific situations, trichoscopy can be used, that is, an evaluation is carried out with image magnification, which allows the analysis of the hair and scalp in detail. In androgenic alopecia, an increased number of thin and atrophied hairs in the affected areas is observed on trichoscopy. Treatment Despite being a benign disease aesthetic issues lead to a growing tendency to seek solutions that prevent the progression of androgenic alopecia. The decision to treat androgenetic alopecia and the treatment to be performed should always be discussed on a case-by-case basis , considering: Age; Sex; Time evolution of baldness; General health status; Particularities of the patient. Although, in most cases, androgenetic alopecia is slowly progressive (years), follicles that fully atrophy are no longer recoverable. Therefore, it is important that the treatment began timely to optimize the results and preserve the hair mass. Medicines for androgenic alopecia The most common treatment is with locally applied or orally administered medications. The available drugs act: Reducing the production of hormones associated with androgenic alopecia; Prolonging the growth phase and increasing hair production by hair follicles. In either case, treatments are more effective if they are started before a significant progression of hair loss is present. The medications used in the treatment of androgenic alopecia must also be taken consistently and continuously , so that it is possible to counteract the chronic tendency of androgenic alopecia. Hair transplant Hair transplant surgery is also an option for the treatment of androgenic alopecia, more indicated when the disease is stabilized , when permanent improvement is desired and if there is a sufficient reserve of follicles for the transplant. Hair loss from non-transplanted areas can continue after surgery, which requires continued treatment with medications to minimize these losses. Meet the dermatology team from Hospital da Luz network and book your consultation The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
