Androgenetic Alopecia

Androgenetic alopecia—sometimes called simply “common balding”—is likely to affect approximately one in two men and women by middle age. As its non-scientific name would suggest, androgenetic alopecia is indeed the most common of all causes of hair loss beginning after puberty and is related to how the body processes androgens—“male” hormones, including testosterone. More than cause, however, most people simply want to understand, “How do I know if it’s androgenetic alopecia?”

In men, androgenetic alopecia is almost always genetic—that is to say, inheriting androgenetic alopecia from mom or dad—which makes diagnosing androgenetic alopecia in men relatively easy. Genetics, too, dictate the speed, onset age and final pictures of androgenetic alopecia, i.e. how much hair will be lost and from where. The tendency toward androgenetic alopecia can come from either the maternal or paternal line; a father with a full head of hair is no guarantee for lifelong hair growth, nor is a maternal grandfather lacking in hair an absolute sentence of balding.

In women, no specific blood test for androgenetic alopecia exists, but blood work is almost always necessary to rule out other possible causes of hair loss in women, which include underactive thyroid, polycystic ovarian syndrome, and overuse of chemicals or styling tools such as blowdryers or curling irons.

Specific side effects of androgentic alopecia beyond the potential for distress caused by excessive hair loss are unknown, although anecdotal evidence links common balding types of hair loss in men to an increased risk of diseases for which males are at a higher risk, such as coronary artery disease. It is important to note that such risk is believed to come not from balding but from the way those prone to balding process androgens, especially testosterone. For those with androgenetic alopecia, health should be of particular concern due to the other potential genetic risk factors in those with possible excesses of testosterone.

Treatments for androgenetic alopecia in men are similar to those for other types of hair loss, and include prescription remedies such as minoxidil (Rogaine) and finasteride (Propecia). Failing that, men suffering from androgenetic alopecia who wish to find a permanent or semi-permanent solution can consider hair transplants or surgical scalp reduction. Women can also take Rogaine, though Propecia—shown to raise the potential for birth defects—is off limits. Other potential therapies for women include common oral contraceptives or estrogen/progesterone combinations. Other agents include anti-androgen treatments such as spironolactone (Aldactone) and dexamethasone (Decadron).