ANDROGENETIC ALOPECIA 

(MALE PATTERN HAIR LOSS) 

 

Q: WHAT IS ANDROGENETIC ALOPECIA?

Male pattern hair loss (MPHL) is also known as androgenetic alopecia (AGA). This condition is considered to be the most common type of hair loss in men, and the severity of progress can vary from person to person. It is considered a hormonally driven condition with a strong genetic susceptibility.

In androgenetic alopecia, the hair follicles are progressively reduced in length and diameter, and gradually the hairs growing in the follicle become smaller in number and size, exposing the scalp over time. This process is known as miniaturisation.

 

KEY STATS:

One study shows that the proportion of males with MPHL increases with age, with 16% of men aged 18-29 experiencing this condition rising to 53% of men aged 40-49.

We know that up to 30% of Caucasian men will have AGA by the age of 30, up to 50% by the age of 50, and 80% by the age of 70. Other ethnic groups are less affected than Caucasians.

 

Q: WHO IS AFFECTED BY ANDROGENETIC ALOPECIA? WHO IS AT MOST RISK?

Men are affected by AGA, and women can also experience this condition. As it is thought to be an inherited condition, if one or both parents have AGA, then the likelihood is their children will experience it.

AGA is known to be androgen-dependent and higher levels of serum testosterone are associated with increased risk. Thinning of the hair usually begins between the ages of 12 and 40 years, and its natural course may be either slowly or rapidly progressing. Factors that may accelerate progression include androgen metabolism, inflammatory scalp disorders, and lifestyle.

 

Q: HOW DO YOU GET ANDROGENETIC ALOPECIA? WHAT CAUSES IT?

A combination of genetic and hormonal factors causes MPHL. For instance, 5a Reductase is an enzyme found under the scalp region. When this enzyme is combined with the hormone testosterone and receptors, a more potent hormone called Dihydrotestosterone (DHT) is created. If the hair follicles in the scalp are sensitive to DHT, this can contribute to the onset of miniaturisation.

The miniaturisation process occurs when hairs produced inside the affected follicles gradually become smaller in diameter, shorter in length and lighter in colour as the hair follicle reduces in size until, eventually, the follicles shrink completely and close over, leaving them unable to produce hair.

 

Q: WHAT ARE THE PRESENTING SYMPTOMS?

Following the onset of MPHL, the hair's widespread thinning occurs mainly through the hairline's frontal area and the scalp's crown area.

Hairs in the affected areas gradually become finer and shorter than hairs in unaffected areas, creating a pattern of hair loss throughout the front and top of the head.

 

Q: HOW IS IT DIAGNOSED?

The diagnosis is usually based on the history of gradual hair thinning or increased hair shedding on the top of the head, the pattern of hair loss and any family history of similar hair loss.

 

Q: WHAT IS THE PROGNOSIS?

Androgenetic alopecia is a slow, gradual process that can be unpredictable. Depending on an individual's unique genetics, the hair loss process is not always consistent and can be accelerated and, at times, stable with no apparent progression. This can be over months and years.

Without treatment medications, MPHL often progresses in severity over the following decades.

 

Q: WHAT TYPES OF TREATMENT IS AVAILABLE? HOW DO YOU PREVENT ANDROGENETIC ALOPECIA? WHAT CAN I DO TO CONTROL MY SYMPTOMS?

Treatment depends on age, prognosis review, hormone levels and medical history. Further tests or investigations may be necessary to support the most effective treatment pathway.

Treatments can include a bespoke prescription with ingredients such as minoxidil, finasteride, or dutasteride.

Low laser light therapy (LLLT) penetrates the soft tissue and can stimulate cell division.

Coloured hair powders and sprays can disguise areas of pattern loss.

Scalp micro pigmentation (tattoo) on the scalp provides a more sustainable option to coloured hair powders.

Hair replacement systems can conceal hair loss.

Hair transplantation using donor follicles surgically transferred onto the scalp or Platelet Rich Plasma Therapy (PRP) can provide a long-term replacement option.

Nutritional plans can support optimising hair and scalp health – this considers dietary requirements, supplements, vitamin replacements, and restricting foods or increasing foods that can increase hormone levels.

Your trichologist will discuss and recommend a treatment pathway appropriate to your needs.

 

JULY 2023