Are you experiencing hair loss in the crown (top of head) or front area of your scalp? You might be suffering from a genetic condition called Androgenetic Alopecia (AGA). Read on to know all about the condition, including its causes, symptoms and treatment options.
What is Androgenetic Alopecia?
It is a condition considered to be the commonest cause for hair thinning and hair loss in humans. There are different variants of the condition that affects men and women. AGA can also affect orangutans and chimpanzees.
The pattern of baldness in males and females are different and are known as male pattern baldness and female pattern baldness. In rare cases, it may also result in hair fall in children.
Androgenetic Alopecia Incidence
Thirty five million men are affected by this genetic condition in the United States.
Androgenetic Alopecia Other Names
AGA is often referred to by other names like:
- Androgenic Alopecia
- Alopecia Androgenetica
Androgenetic Alopecia Classification
The male and the female pattern baldness are divided into several categories. The classifications are conducted depending on the stages of hair loss due to AGA.
Male Pattern Baldness Norwood Classification
The baldness in males is classified into:
This stage represents a juvenile or adolescent hairline and not balding. The juvenile hairline generally rests on the upper brow crease of a person.
It refers to the hairline of an adult that rests approximately 1.5 cm above the upper brow crease with a little temporal recession. Like Class I, this stage does not signify balding.
It is the first level of hair loss in males and is characterized by deepening temporal recession.
Class III Vertex
It refers to the early stage of hair loss in the crown.
Further hair loss in the frontal part of the head and expansion of the vertex characterizes this stage. However, the front and vertex still remain separated by a solid strip of hair.
It is characterized by the continuous receding of hair from the crown and the front as well as the gradual breaking down of the portion of hair separating these two areas.
In this type of balding, the bridge of hair separating the front from the vertex disappears completely, leaving a wide bald area. Hair still remains on both sides of scalp.
It is the last stage that is characterized by extensive hair loss. There is a wide bald patch on the scalp except for some hair remaining in the sides and back.
Female Pattern Baldness Ludwig Classification
The baldness in females is categorized into:
In this type, women suffer from general thinning of the hair with some bald patches in the front part and the crown of the scalp.
In this stage, the thinning of the hair continues to reveal more prominent bald patches in the front and vertex.
This class is characterized by frontal temporal recession of the hairline.
Wide bald patches are visible on the front and crown of scalp.
This is the final stage of this classification and is characterized by extreme hair loss.
Androgenetic Alopecia Causes
The causes of AGA tend to vary in males and females.
Androgenetic Alopecia Causes in Men
The exact causes of AGA are still not known. According to experts, there are various factors that collectively cause this condition. Researches show that a man can experience hair loss due to some hereditary factors and/or hormonal imbalances. This type hair loss can occur in males because of the Androgens, a specific group of hormones. The Dihydrotestosterone or DHT hormone that plays an important role in the sexual development of an individual during adolescence is mainly responsible for initiating hair loss. Excessive amounts of this hormone can make the hair follicles hereditarily sensitive to it. As a result the follicles may shrink which hampers the growths of news hair.
Androgenetic Alopecia Causes in Women
The main causes of this condition in women include various genetic factors and hormonal imbalances. Various factors including menstrual irregularities, acne, stress, hirsuitism and high levels of testosterone can cause this type of hair loss in women. Pregnancy is another common cause while birth control pills such as Loestrin can also lead to Androgenic Alopecia.
Androgenetic Alopecia Genetics
Various researches have been done to find out the genetic components that lead to this condition. According to some researches, x-linked genes that are linked to the genes on the X-chromosomes are involved in the occurrence of AGA at an early age of an individual. However, other non-sex linked genes are also involved in causing this type of hair loss. Men having fathers with a history of hair loss are at 2.5% greater risk of experiencing hair loss, regardless of the similar history on their mother’s family.
Androgenetic Alopecia Signs and Symptoms
The onset of the symptoms can occur at various ages in different individuals. According to some experts, women with AGA experience a peak in their symptoms when they are around 30 years old and again when they reach 50 years of age. The most common symptoms of AGA are:
Gradual Hair Loss on Vertex
This symptom is commonly seen in men affected by the disorder. It causes hair loss from the crown or vertex of the skull which causes a bald patch on top of the head.
AGA causes receding of the hairline, mainly in males. The hairline recedes from the forehead and forms a shape resembling the letter “M”. It finally results in bald patches in the front part of the skull.
Thinning of the Hair
This symptom is mainly seen in women. It causes hair loss across the scalp which leads to thinning of the hair and occasionally causes discrete bald patches. The hair loss caused by AGA is permanent; but, it does not cause baldness in most cases.
Androgenetic Alopecia Prevention
It is not possible to prevent this condition as its exact underlying factors are still unknown. But, various researches are being carried out to understand the causes and ways of prevention of this hair loss.
Androgenetic Alopecia Diagnosis
In males, the diagnosis of AGA depends on the clinical presentations. More complex tests are required for diagnosing this condition in women.
Physicians examine the scalps of the patients and study their family history while diagnosing this genetic condition. Generally, Trichoscopy is very useful for detecting the presence of AGA in an individual. However, a biopsy is required for confirming the diagnosis.
Androgenetic Alopecia Differential Diagnosis
Differential diagnosis of AGA involve ruling out the other factors that may cause hair loss (like poisoning). It also involves comparing the hair loss pattern to a common male or female pattern baldness progression. Blood tests are very useful for ascertaining whether the hair fall is occurring due to Androgenetic Alopecia or for some other reason.
Androgenetic Alopecia and Telogen Effluvium
Both AGA and Telogen Effluvium cause hair fall and other similar symptom which makes it very difficult to differentiate between the two conditions. Various factors such as menopause, pregnancy, thyroid problems and stress can cause these disorders in women. Extensive blood tests are required to find out whether a woman is affected by AGA or Telogen Effluvium.
Androgenetic Alopecia Treatment
The American Academy of Dermatology created a treatment guideline for people having AGA in the year 1996. This treatment aims to prevent the hair thinning and enhance the hair growth. There are two products indicated for treating this condition: minoxidil (Rogaine) and finasteride (Propecia). Both these products can effectively fight this type of hair fall. However, they may not work in same manner for everyone.
This is done by using medications like:
It is the most commonly prescribed treatment option for AGA. Topical Minoxidil is sold under the trade name Rogaine in the US.
Recently, a topical Minoxidil generic version has been made available under the trade name Headway. Minoxidil is believed to work by lengthening and enlarging the hair follicles that have been shrinking because of AGA. It also helps to extend the growth phase of the hair which means the hair can grow longer before falling out. An individual has to use Minoxidil continuously for around 3 to 4 months before the regrowth of the hair becomes evident. The product has to be used for about 6 months to understand whether it will be useful for curing the condition in an individual.
Propecia is the band name for the product Finasteride. It is available in the form of tablet which has to be taken once every day. This product is also available under the trade name Proscar. Finasteride is currently approved for use only in men. This 4 aza steroid is a compound is a particular inhibitor of the 2 5 alpha reductase type. This is the enzyme responsible for the metabolism of androgen testosterone into DHT (Dihydrotestosterone). This way, Propecia prevents the shrinking of the hair follicles and helps the shrunken hair follicles to turn into terminal hair. This product also has to be used for at least 3 months to notice its effects. It is also important to use it continuously to maintain the benefits gained from it.
Hair Transplant Surgery
This is a common form of surgery performed to cure AGA. In a hair transplant surgery, the donor hair follicles genetically non-sensitive to Dihydrotestosterone are taken from the sides and back of the head (donor areas) to transplant them to the bald patches on the scalp so that they can grow there for a long time. However, hair transplant does not fight the underlying causes of AGA. So, it is important to treat these causes by some medication or other appropriate treatment option to stop hair loss.
Artificial Hair Implantation
Artificial plastic hair is sometimes implanted into the scalp. A tiny knot (root loop) at the base of the plastic hair helps to keep the hair attached to the scalp. One should avoid rubbing his or head forcefully after artificial hair implantation as the plastic hair cannot grow again if they fall due to rubbing.
Low intensity or low level lasers that do not damage the skin by producing heat are used for treating this condition. These lasers produce light energy which passes through the skin’s upper layers without harming the skin. The cells in the scalp absorb the energy which improves their functioning and heals the weak hair follicles.
Androgenetic Alopecia Home Remedies
Various home remedies are used to fight this condition and recover from the problem of hair loss. Hair fall, caused by AGA, can be reduced by:
Various natural and herbal remedies can be successfully used for combating AGA. These treatment options include:
- Green tea extracts – These prevent the conversion of testosterones into DHT.
- Grape seeds – The Oligomeric proanthocyanidin (OPC) contents of these seeds promote epithelial cell growth. These also prevent the molecules (that are produced by the hair follicles) affected by androgen from hampering hair growth.
- Licorice – It is a native European herb which is able to control the levels of the estrogen hormone, thus helping to cure this condition in women.
- Saw palmetto extract – It has also gained popularity as a powerful herbal remedy for Androgenetic Alopecia.
Following Proper Diet
Following a diet consisting of healthy foods such as grains, green leafy vegetables, almonds citrus fruits as well as dairy products including milk and fresh cheese makes sure that the hair gets enough nutrients for proper nourishment.
Shampooing the Hair
Patients are recommended to shampoo the hair at least three times every week. One should also apply olive oil or coconut oil 30 minutes before washing the hair with a medicated shampoo. This helps keep the hair follicles healthy.
Androgenetic Alopecia: Other Treatment Options
There are various other options used for treating AGA, which include:
Bacopa monnieri and Nardostachys jatamamsi are two components commonly used in Ayurvedic medicine. A decoction made from these two ingredients is drank everyday for preventing hair loss due to AGA.
Doing exercise and yoga on a regular basis helps regulate the hormones and promote the functioning of the hair follicles, allowing hair to grow properly.
Androgenetic Alopecia Pictures
Here are some pictures displaying the hair fall patterns caused by AGA.
Picture 1 – Androgenetic Alopecia (male)
Picture 2 – Androgenetic Alopecia (female) Image