What is androgenetic alopecia?
Androgenetic alopecia is a common form of hairloss affecting
both men and women. It is also known as male pattern baldness
and female pattern baldness, respectively.
How common is androgenetic
Androgenetic alopecia is very common and affects 40% of men and
25% of women by the age of forty years. It can begin anytime
after puberty and gets more common with age.
What are the sympoms of androgenetic
The symptoms may differ in men and women:
- Male androgenetic alopecia (male
pattern hairloss) - Begins as a receding hairline around the
temples, producing an M-shaped pattern. Then thinning or a bald
patch develops at the crown. In severe cases, these areas merge
leaving a horseshoe rim of hair at the back and sides of the
head. Doctors use the Norwood classification to grade male androgenetic
alopecia from I - VII, according to increasing severity.
- Female androgenetic alopecia
(female pattern hairloss) - May follow the pattern in men or
more commonly, as diffuse thinning which is most prominent on
the top front of the scalp. Female androgenetic alopecia is graded
from I - III under the Ludwig classification..
- What is the cause of androgenetic
Androgenic alopecia is caused by the effect of androgens (male
hormones) on the hair follicles (roots) of genetically susceptible
individuals. The genetic susceptibility may be inherited from
either the mother or father.
- What happens to the hair
in androgenetic alopecia?
Hair grows through two main stages - a growth stage known as
anagen lasting 2 - 4 years and a rest stage known as telogen
which lasts 2 - 4 months, after which the hair falls out. This
cycle is repeated. In androgenetic alopecia, the anagen stage
is shortened so that the hair grows for a shorter period and
is thinner, shorter and less pigmented. The anagen stage becomes
shorter with each hair cycle so that only a fluff of hair is
produced eventually, and in some people, the area is almost totally
- Can anything be done for
There are two medical treatments that have been shown to improve
androgenetic alopecia. They are minoxidil lotion/gel 2 - 5% and
finasteride tablets 1mg. Minoxidil prolongs the anagen or growth
stage but exactly how it does this is still unknown. Finasteride
works by inhibiting the 5 alpha reductase enzyme that converts
testosterone (the main androgen or male hormone) to dihydrotestosterone
(DHT) which scientists believe is the main androgen causing androgenetic
alopecia. The results are better when the alopecia is milder
and the person is younger. Finasteride cannot be used in women
of child bearing age because it may affect the sexual differentiation
of the male foetus. Hair transplants can be used in men with
severe androgenetic alopecia (grades V - VII)). Hormone therapy
is an alternative that is available to women. It cannot be used
in men because of the risk of feminisation.
- Can androgenetic alopecia
Minoxidil and finasteride can bring about cosmetically acceptable
improvement but treatment must be continued or the newly grown
hair will fall out. Only hair transplant can produce a permanent
result but this involves surgery and a significant degree of
discomfort. Many people still prefer non-surgical treatments.
- Does diet have any effect
on androgenetic alopecia?
There is no evidence that diet has any effect on androgenetic
- Does frequent shampooing
Using the wrong shampoo may make the hair dry, limp or lustreless
but it does not cause hairloss. The hair follicles (roots) are
embedded in the dermis (deepe skin) beyond the reach of shampoos.
In fact, regular shampooing may even help androgenetic alopecia
by removing the androgens present in sebum (skin oil) before
they can re-enter the scalp.
- How effective are over-the-counter
hair growth restorers and tonics?
The only proven remedies are minoxidil and finasteride which
need to be prescribed by a doctor.
- Does scalp massage, brushing
the hair and sleeping on a slant board help?
The idea here is to improve the blood circulation. However, androgenetic
alopecia is not caused by poor blood circulation. In hair transplants,
for example, hair grafts are taken from back of the head and
transplanted to the bald areas. The blood circulation to these
grafts is suddenly cut off and it takes time for it to be re-established
in transplant area and yet the transplanted hair grows.
- Does monosodium glutamate
(MSG) aggravate the hairloss?
- Monosodium glutamate is a flavouring
agent commonly used in Chinese restaurant cooking. It causes
headaches, dizziness, burning sensation in the extremities and
chest pain (Chinese reataurant syndrome) but it does not cause
or aggravate androgenetic alopecia.
- Does taking vitamin supplements
help hair to grow?
Vitamins have been suggested for anything from the common cold
to hairloss. However, there is no evidence vitamin deficiency
causes androgenetic alopecia so taking vitamin supplements is
- Does excessive oiliness cause
The sebaceous glands that produce oil are stimulated by androgens
which you may remember is the cause of androgenetic alopecia.
The two conditions may therefore occur together but one does
not cause the other. The hairloss is not caused by oil clogging
and suffocating the hair follicles because the follcles get all
the nutrients and oxygen from the blood.
- Does dandruff aggravate cause
or aggravate the hairloss?
Dandruff is very common and it is not uncommo to find dandruf
and androgenetic alopecia together. This is coincidental, dandruff
does not cause or aggravate androgenetic alopecia.
- Are bald people more intelligent?
There is a belief that people grow bald because of the heavy
traffic of ideas going through the brain. This is not true and
you may know of some bald people who are not very intelligent.
- Are bald people more virile?
The main androgen that causes androgenetic alopecia is formed
in the scalp. There is no overall increase in circulating andogens
and therefore, no increase in virility.
- Does shaving the scalp bald
No it does not and a study by Drs Lynfield and MacWilliams in
the 1970 issue of the Journal of Investigative Dermatology showed
no difference in the weight, thickness or rate of growth between
the shaven and unshaven leg.
- Does masturbation cause hairloss?
No it doesn't. It may be a myth perpetuated by people who feel
masturbation is unnatural.
- Go to androgenetic
alopecia in Skin A to Z