Androgenetic Alopecia: Causes, Treatment and Prevention
What is Androgenetic Alopecia?
Androgenetic alopecia, otherwise known as male/female pattern baldness, is a hereditary disorder that affects both men and women. Whilst this type of hair loss is typically recognised as a male dominant issue, women can also experience androgenetic alopecia, primarily through the thinning of their hair (Mayo Clinic, 2020). It is a very common condition, with roughly 80% of men experiencing some sort of balding by the age of 80 (Cranwell & Sinclair, 2016).
In men, androgenetic alopecia typically presents as a receding hairline and loss of hair at the top of the head. In woman, hair loss usually starts at the crown of the scalp with nearly complete preservation of the frontal hairline.
What Causes Androgenetic Alopecia?
There are four stages to the life of a hair strand: growing phase (anagen), transition phase (Catagen), resting phase (telogen) and the Shedding phase (exogen). Androgenetic alopecia is thought to occur due to a genetically predetermined sensitivity to dihydrotestosterone (DHT), resulting in a shortened anagen phase and extended exogen phase. This leads to a shorter period of hair growth and a longer duration of hair loss (Harvard Medical School, 2020).
Genetics play a large role in androgenetic alopecia. In 2017, a study published in Nature Communications concluded that a total of 63 genes play a role in the loss of hair (Heilmann-Heimbach et al., 2017). For example, the AR gene is responsible for making a protein called the androgen receptor. This allows the body to react with dihydrotestosterone (DHT) and other androgens. In androgenetic alopecia, changes to this gene increase its sensitivity to DHT, leading to baldness (Jewell, 2019).
Hair loss without a genetic component can often indicate other conditions such as alopecia areata (an immune disorder that attacks hair follicles), medication induced hair loss, pregnancy, stress, improper hair care and hormonal imbalances (American Academy of Dermatology Association, n.d.).
Treatments
- Minoxidil is used as the first line treatment to assist hair growth. It is an over the counter medication that appears to work by lengthening the anagen phase allowing for extended period of hair growth.
- Finasteride is used as a second line treatment in men. It works by decreasing the amount of DHT in the body, thus reducing its effects on androgen receptors.
- Cosmetic options, hair transplant surgery and wigs are alternatives to pharmacological agents and may be investigated if there is no success with the above treatments.
Non-Pharmacological Prevention and Treatments
Diet
A balanced diet is an important part of our lifestyles. There are several vitamins and minerals that have been shown to be effective in helping reduce hair loss (Jennifer T., 2020):
- Biotin (vitamin B7) – These can be found in foods such as: meat, whole grains and egg yolks.
- Iron – These can be found in foods such as: red meat, leafy greens, legumes
- Vitamin C – These can be found in foods such as: citrus fruits, leafy greens, bell pepper
- Vitamin D – These can be found in foods such as: fatty fish and fortified milk
- Zinc – These can be found in foods such as: shellfish, meat, beans, nuts and seeds
Exercise
Regular exercise can improve blood flow throughout the body. This allows the skin to receive the necessary oxygen and nutrition hair requires to grow. It is recommended to do at least 150 minutes of moderate exercise or 75 minutes of vigorous exercise a week (NHS, 2019).
Stress-Related Hair Loss
Stress can cause hair loss. If you do feel stressed throughout the day, talk to a friend or family member. Take time out of your day to relax or listen to music. Your mental health is very important and is the foundation for your body’s wellbeing.
External Damage to Hair
Adding unnatural chemicals or using heat products on your hair can also cause damage by making them brittle and weak. Moisturising your hair and using hair oil will help benefit the growth and strength of your hair.
Our hair is a vital part of our life and can cause emotional distress at the slightest of inconveniences. Genetic hair loss is something that may be unavoidable, but with good healthcare and the right medication, can be managed effectively.
Further information
If you notice unusual hair loss of any kind, it is important to see your primary care provider or a dermatologist, to determine the cause and appropriate treatment. For further information on the topic, explore our ‘Androgenetic Hair Loss’ module on NIRAH.
References
American Academy of Dermatology Association. (n.d.). Hair loss: Who gets and causes. Www.aad.org. Retrieved July 4, 2021, from https://www.aad.org/public/diseases/hair-loss/causes/18-causes
Cranwell, W., & Sinclair, R. (2016, February 29). Male Androgenetic Alopecia. NCBI; MDText.com, Inc. https://www.ncbi.nlm.nih.gov/books/NBK278957/
Harvard Medical School. (2020, January 1). Hair thinning? Get to the root of the problem. Harvard Health Publishing. https://www.health.harvard.edu/womens-health/hair-thinning-get-to-the-root-of-the-problem
Heilmann-Heimbach, S., Herold, C., Hochfeld, L. M., Hillmer, A. M., Nyholt, D. R., Hecker, J., Javed, A., Chew, E. G. Y., Pechlivanis, S., Drichel, D., Heng, X. T., del Rosario, R. C.-H. ., Fier, H. L., Paus, R., Rueedi, R., Galesloot, T. E., Moebus, S., Anhalt, T., Prabhakar, S., & Li, R. (2017). Meta-analysis identifies novel risk loci and yields systematic insights into the biology of male-pattern baldness. Nature Communications, 8(1). https://doi.org/10.1038/ncomms14694
Jennifer T., H. (2020, November 18). The 5 Best Vitamins for Hair Loss Prevention, Based on Research. WebMD. https://www.webmd.com/connect-to-care/hair-loss/best-vitamins-for-hair-loss-prevention
Jewell, T. (2019, January 10). DHT: How It Causes Hair Loss and How to Slow It. Healthline. https://www.healthline.com/health/dht#hair-loss
Mayo Clinic. (2020, May 22). Hair loss - Symptoms and causes. Mayo Clinic; https://www.mayoclinic.org/diseases-conditions/hair-loss/symptoms-causes/syc-20372926
NHS. (2019, October 8). Exercise. NHS. https://www.nhs.uk/live-well/exercise/