Androgenic Alopecia




Androgenic-alopecia Androgenic Alopecia, also known as AGA, is responsible for the majority of hair loss cases in middle-aged people of both sexes. It is estimated that this hair loss condition affects about 40 percent of women approaching menopause and more than 50 percent of men in their mid-life. Causes of AGA can be traced to hormones: hair follicles start gradually balding with the increased rate of conversion of testosterone into dihydrotestosterone.

This conversion, alongside with uptake and metabolism of testosterone, is performed by 5-alpha-reductase. Hormonal changes, which are the basis for developing AGA, provoke gradual and steady hair loss due to minimalisation and shrinkage of hair follicles. The condition if also genetically programmed and runs in families. If to compare the clinical picture of AGA in men with that in women, the pattern and development of the condition differs. In men, AGA provokes hair loss on the vertex of the scalp, as well as in frontal and temporal areas, which gradually leads to complete baldness of the affected areas. In women, the frontal part of the scalp is usually not intact. The balding regions, affected by female-pattern AGA, look more diffused and are located in the central parietal area of the scalp.

Treatment of Androgenic Alopecia may include either life-long usage of pharmaceutical drugs or surgical hair transplantation. Available medication includes topical minoxidil (Rogaine®), which cures men’s AGA in roughly 10 percent of cases and women’s - in about 13 percent, or oral finasteride (Propecia®), which is used only in men’s AGA and shows a significant rate of success, 66 percent in reversing hair growth, and 83 percent - in stabilizing hair growth. Topical minoxidil can stimulate hair re-growth to a cosmetically acceptable degree, especially the 5% solution, but this medication does not seem to be very effective. In addition, it can provoke skin irritation, such as redness, itching, and burning of the scalp, and, in rare cases, it can even cause full-blown allergic reactions. In cases of women’s AGA, systemic androgens, such as flutamide (Eulexin®), spironolactone (Aldactone®), or cyproterone acetate (Androcur®), are proven to be efficient to some degree, mostly in reducing hair thinning. However, all the above medication used in both male and female AGA patters, do not provide a complete cure. Any noted effect lasts only for as long as the drugs are used.

Hair transplantation in cases of AGA is the only procedure that might give a hope for a complete cosmetic cure of the condition. In most cases, about four transplantation sessions are required within the period of two years to fill in the balding areas with adequate hair density. In men’s AGA, permanent hairs are transplanted from the back and sides areas of the scalp to the balding zones in the front of the head. Hair tufting and clumping can be avoided by using new methods in hair transplantation, such as minigrafting and micrografting, which usually guarantee natural looking hair at the end. Recently, more women has started applying to the procedure of hair transplantation, as well. Innovative methods of strip harvesting of donor hair make the process more cosmetically acceptable than the previously used method of plug harvesting.

Robin Makris

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Posted on September 21, 2007 
Filed Under Hair Loss Conditions

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