Androgenic Alopecia In Men And Women - Causes, Treatment

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-07 17:49

Androgenic alopecia in men and women

Content:

• Male androgenic alopecia

  • Causes of androgenic alopecia in men
  • Treatment methods for androgenic alopecia in men
  • Alternative treatments

• Androgenic alopecia in women

  • Causes of androgenic alopecia in women
  • Treatment of androgenic alopecia in women
  • Alternative treatments
  • Treatment with unproven efficacy

Male androgenic alopecia

Hair loss as a result of age-related changes in a man's body is called male androgenic alopecia. This process depends on the production of hormones - androgens. It is this form of baldness that occurs most often in males, in connection with which trichologists receive many complaints like this:

Good afternoon. At the age of 38, I noticed that I began to lose my hair. The baldness area is gradually increasing and is now very noticeable, especially in the forehead area. The process does not stop there, now the crown of the head has begun to thin out.

Dad had the same problem, he also began to lose hair around this age and is now almost bald. This, of course, is not very critical for me, nevertheless, if there is an opportunity to stop baldness, I would like to use it. I saw a lot of advertisements of various means, I would like to know if something really works or is it a waste of money?"

The picture of androgenic alopecia, as a rule, is characteristic of all men. A familiar pattern forms on the head - the absence of hair on the forehead and crown, the preservation of the hairline on the sides. Because of pattern baldness, sometimes androgenic alopecia is also called pattern alopecia. This term comes from the English word pattern, which means "pattern".

Hair loss in men is not always associated with age-related hormonal changes in the body. Sometimes the reason may be taking medications, diseases of internal organs, leading to dysfunction of the hair follicles.

Causes of androgenic alopecia in men

The work of androgens has a direct impact on all vital processes. The main representative of this group of sex hormones is testosterone. It is he who gives the male skeleton the characteristic masculine features, is responsible for the increase in muscle and bone mass and increased hair growth.

However, with age, androgens begin to exert not a stimulating, but, on the contrary, an inhibitory effect on the growth of hair that is directly on the head. So, trapped in the root cells of the hair located on the forehead and crown, testosterone is transformed into dihydrotestosterone. The changes occur under the action of the type 2 5-alpha reductase enzyme.

DHT helps to slow down hair follicles as a man gets older. As a result, the hair becomes thinner, breaks faster, and loses color. Their structure begins to resemble the structure of the hair that covers the body, as a result - the man's head loses hair. Moreover, all these changes occur at a normal level of testosterone in the blood.

• Cause of baldness of the crown in men. Zonal baldness with the predominant localization of hair loss in the crown region is explained by the difference in the biochemical properties of the scalp in different places. The skin that covers the back of the head and temples contains more aromatase than the skin that covers the forehead and parietal area. This enzyme promotes the transformation of testosterone into estrone and estradiol. Their action is opposite to that of dihydrotestosterone. They do not inhibit, but provoke the work of the follicles, therefore, hair remains in greater quantity on the sides of the head.

• Hereditary cause of androgenic alopecia. The studies carried out made it possible to establish the fact that a man prone to baldness, this tendency can be inherited. If the father suffered from androgenic alopecia, then the risk of developing this condition in his son is quite high. Scientists believe that in such men the number of receptors located in the hair roots that are susceptible to such a hormone as dihydrotestosterone is much higher than in those men whose fathers did not suffer from baldness. In addition, the fact of excessive activity of the enzyme responsible for the production of the hormone leading to hair loss cannot be ruled out.

Early male pattern baldness. It is undeniable that a certain proportion of men lose their hair before the rest. There is an assumption that the age at which the process of alopecia manifests itself is genetically laid. In the absence of therapy, the once started process of alopecia will progress.

According to statistics, approximately 16% of men begin to lose their hair before the age of 30. Upon reaching the age of 50, a pronounced degree of alopecia is observed in 50% of the male population. Almost 80% of men lose their hair by the age of 70.

Treatment of androgenic alopecia in men

In order to stop the process of alopecia, as well as restore the already lost part of the hair, modern medicine offers two types of drugs for use:

• Minoxidil, which comes in the form of a foam or lotion. The product should be applied to the scalp affected by alopecia;
• Finasteride tablets.

Treatment of androgenic alopecia with Minoxidil

• The drug was originally developed for the treatment of hypertension. It has not yet been possible to accurately determine the mechanism of its effect on hair follicles.
• It is necessary to use the product twice a day: in the morning and in the evening. Foam or lotion is applied to the scalp in areas that are prone to alopecia.
• After the start of therapy, patients often notice increased hair loss. This process is explained by the fact that the drug prepares the hair follicles for renewal. After the old hair is removed, the follicles will begin to produce substances that are responsible for the growth of new hair. The primary loss will end several months (sometimes weeks) after you start taking Minoxidil.

• The result of the ongoing therapy can be evaluated for the first time in the period from 4 months to six months. The pronounced effect will be noticeable after a year of treatment.
• The percentage of restoration of hair density ranges from 14.5% to 248.5%. These indicators are a comparative characteristic in comparison with the density of the hairline before the start of therapy. Alopecia usually stops as a result of treatment with Minoxidil.
• Persistent results are more often achieved by those men who have resorted to treatment under the age of 40. It is important that the alopecia process manifests itself no later than 10 years ago. In addition, the chance of complete hair restoration is higher in those men whose alopecia areata does not exceed 100 mm in diameter.
• It is generally accepted that even a long course of therapy with Minoxidil is safe. Extremely rare treatment can lead to hypotension, tachycardia and water retention in the body. Similar phenomena are observed in people who are hypersensitive to this drug. Sometimes Minoxidil causes accelerated facial hair growth, but this problem is not significant for males.

Treatment of androgenic alopecia with Finasteride

• The principle of the drug is based on the inhibition of the functioning of the enzyme 5a-reductase. It is this enzyme that causes the transformation of testosterone into dihydrotestosterone, which provokes alopecia. In addition to the treatment of baldness, Finasteride is used in the treatment of prostate adenoma. However, this requires an increase in the dose of the drug.
• Finasteride is easier to use than Minoxidil. It is enough to take the remedy orally once a day.
• The effect of the treatment can be detected after a period of 4 months to six months. After a year, the effect will be noticeable even more, and patients receive maximum results two years after the start of therapy.
• Studies indicate that Finasteride is more effective in relieving men of alopecia than Minoxidil. So, 99% of men who take the drug on a regular basis stop suffering from hair loss.
• Only 2% of patients manage to restore hair in already existing areas of alopecia, their slight growth in areas of baldness is observed in 30%, and the return of the hairline occurs in an average degree in 16% of men.
• The maximum effect will be obtained from Finasteride if therapy was started in a timely manner, that is, until the bald patch has reached a significant size.
• If the result was achieved, then to maintain it, constant intake of the drug will be required. If the therapeutic course is stopped, then the restored hair will fall out after a maximum of a year.
• As for complications, as a rule, they do not occur even with prolonged use of the drug.
• Partial loss of libido and erectile dysfunction as side effects from taking the drug are extremely rare. If such complications arise, the treatment is stopped.

A combination of Finasteride and Minoxidil for the treatment of alopecia in men. Studies have shown that it is possible to combine these two treatments for alopecia. Moreover, the effect will be enhanced if there is a simultaneous intake of Finasteride inside and Minoxidil outside.

Switching from Minoxidil to Finasteride. When a man needs to switch from Minoxidil to taking Finasteride tablets, then for six months he will have to use these two drugs in parallel. After 6 months, one of the drugs is abandoned, while the other continues to be used.

Alternative therapy for androgenetic alopecia in men

It is important to understand that there are no other effective methods of treating pathology. There are other drugs that have an effect similar to the mechanism of work of Finasteride and Minoxidil. For example, this is Dutasteride. However, it is not possible to fully replace any of the main treatments for alopecia at this point in time.

Another treatment for baldness is hair transplant. After that, patients need to take either Minoxidil or Finasteride, since the transplanted hair would otherwise fall out under the influence of hormones and enzymes. Taking drugs will allow you to achieve a persistent cosmetic effect from the operation. Therefore, hair transplantation should be considered as an adjunct therapy against the background of drug treatment. It allows you to restore hair in those places where it was not possible to resume their growth with the help of conservative treatment.

The sequence of treatment for patients with androgenic alopecia does not depend on the degree of hair loss:

• Despite the severity of alopecia, therapy should be started with Finasteride or Minoxidil. You can combine these funds;
• If the patient has severe seborrhea, then it is advisable to carry out parallel treatment of this scalp disease;
• After a year, the patient should notice a stop in hair loss and their partial restoration;
• If the initial degree of alopecia was mild, then the patient can stop the treatment course at his own discretion;
• If the initial degree of alopecia was very pronounced, then it will not be possible to restore the hairline in full with the help of only taking medications, a hair transplant will be required. After its implementation, therapy should be continued.

You should not start treatment yourself. You must first visit a trichologist, who, based on the diagnostic tests performed, will establish the form of alopecia and determine the true cause of hair loss. The doctor will indicate the advisability of taking Finasteride or Minoxidil, and also give advice on their use in each case.

Androgenic alopecia in women

It is not uncommon to come across complaints of hair loss from women. Here is one of the appeals: “Good afternoon, for several years now I have noticed that hair has begun to fall out on my head, mainly in the area of the crown. The parting has become wider, skin is visible through the hair. At the same time, hair grows on the sides and in the forehead area as before. The shampoos did not help, so I had to go to the doctor. He told me that I had started androgenic alopecia. But I thought that only men go bald, and this problem does not concern women. Rather, it concerns, but their hair falls out due to medication or illness. What should I do now, how to restore hair and beauty?"

In fact, androgenetic alopecia is a problem for both sexes. Moreover, in the fair sex, this disease is not as rare as it might seem. Statistics indicate that up to 12% of women who have reached the age of 30 begin to lose hair.

The older a woman becomes, the brighter the main signs of alopecia, and by the age of 50, hair from this type of baldness has already lost 25%. As for 70 years old, 40% of women at this age will be prone to hair loss to one degree or another. Just like in men, female pattern baldness forms a certain pattern on the head.

The causes of androgenic alopecia-like hair loss in women are not the same as in men:

• Thyroid pathology;
• Diffuse forms of alopecia;
• Chronic telogenic alopecia;
• Anemia, etc.

Causes of androgenic alopecia in women

Recent studies have suggested that androgenic alopecia in women occurs against the background of normal blood levels of male sex hormones - androgens. However, the relationship between incipient baldness and the hormonal status of a woman still exists. So, with an increase in the concentration of hormones, as well as with too strong sensitivity to them, a process resembling androgenic alopecia can begin.

In addition to the fact that a woman begins to lose hair, she may note other symptoms, including:

• Menstrual irregularities;
• The appearance of facial hair, increased growth on the body;
• Inability to conceive a child;
• Acne and acne on the skin;
• Polycystic ovary syndrome.

When none of these symptoms accompany the hair loss process, then androgenetic alopecia is most likely a misdiagnosis.

Read more: Causes of Hair Loss in Women

Treatment of androgenic alopecia in women

You can stop hair loss with Minoxidil. This is the only remedy that has proven effectiveness and can really help a woman cope with the pathological process.

• Most often, a lotion containing Minoxidil is used for the treatment of baldness, the concentration of which does not exceed 2%.
• The tool is rubbed into the scalp, precisely in those areas that have undergone alopecia. You will need to apply the lotion in the morning and evening.
• In the initial stages of treatment, the drug causes increased hair loss. When the shedding of the old hairline stops (this process can take several months), the follicles will begin to reproduce new hair.
• Six months later, the woman will be able to evaluate the first results from the therapy. The full effect will be noticeable only after a year.
• Studies have been conducted using placebo and Minoxidil. It was found that after a year, the drug managed to stop androgenic alopecia in 29% of the women participating in the experiment.
• A side effect of using the drug is increased facial hair growth. The higher the concentration of the active substance, the higher the risk of developing this side effect. So, when using a 5% solution, facial hair appeared in 14% of women, and when using a 2% solution, this problem arose only in 6% of patients. When the treatment is stopped, the hair stops growing. A complete inhibition of their growth is observed several months after the cancellation of Minoxidil.

Alternative therapy for androgenetic alopecia in women

There is no information available to the effect that there are any other effective medications available for women to get rid of hair loss. Thus, a study on the use of Finasteride in women with androgenic alopecia indicated that the desired effect could not be achieved. Therefore, the remedy is recognized as effective only for the treatment of men with androgenic alopecia.

There is some data indicating the achievement of a result when taking Finasteride in high concentration. A woman may need to take up to 5 mg per day to stop hair loss. However, there are no specific recommendations.

If a woman has an increased content of male sex hormones, then contraceptives with antiandrogenic components that are part of their composition can help stop baldness. For example, such drugs include Spironolactone, Chlormadinone, Cyproterone Acetate, Flutamide, Drospirenone. However, if the level of male hormones in the woman's blood remains at a normal level, then the effect of taking these drugs will not be. The same applies to conventional hormonal contraceptives with estrogen and progesterone.

As for hair transplant, this method, as well as for men, is auxiliary. It will make it possible to eliminate the cosmetic defect, but after the procedure is completed, you will have to use Minoxidil so that the result is not lost. Therefore, the transplant is done in the case when conservative treatment is powerless.

The process of getting rid of a woman from androgenic alopecia proceeds as follows:

• Referring to a trichologist to establish the true cause of hair loss;
• Initiation of therapy with Minoxidil upon confirmation of the diagnosis of "androgenic alopecia";
• Getting rid of the scalp from seborrhea, if necessary;
• Stopping the pathological process after a year from the start of therapy;
• At the initial stage of baldness, women are most often satisfied with the result. They can continue to use Minoxidil for as long as they think is necessary;
• If alopecia is severe, then most often it is not possible to achieve complete restoration of the hairline. In this case, it is necessary to perform a transplant after a year of therapy, and then continue conservative treatment.

Read more: Medication for alopecia (full list of medicines)

Treatment with unproven efficacy

In order to cope with hair loss, women resort to various methods, including:

• Application of various vegetable oils to the hair;
• Taking vitamins and amino acids, even with a normal diet;
• Use of preparations based on bergamot, green tea, algae, caffeine, hibiscus, Aloe Vera, melatonin, sabal palm (extract);
• The use of Chinese medicine;
• Laser and electromagnetic treatment;
• Use of retinoids, botox;
• The use of funds to stimulate blood circulation at the location of the hair follicles;
• Mesotherapy;
• Capsules with Aminexil;
• Shampoos with ketoconazole and zinc in the absence of dandruff;
• Topical agents with corticosteroids included in their composition;
• Funds based on Fluridil, Alfatradiol, Fulvestrant.

Despite such a variety of remedies, none of them has evidence of efficacy in the treatment of androgenetic alopecia in both women and men.

The author of the article: German Olga Leonidovna, trichologist, specially for the website ayzdorov.ru