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Androgenetic Alopecia

Updated : February 2, 2024





Background

Regardless matter the reason, hair loss is referred to as alopecia. It can occur everywhere on the body and is not only limited to the scalp. There are millions of hairs on each person’s head at birth. The three phases of the hair cycle are referred to as anagen (the growing phase), catagen (the resting period), and telogen (the shedding phase).

90 percent of hair is in the anagen phase of growth, and the remaining ten percent is in the phases of resting as well as shedding. In the telogen phase, while hair is shedding, it will cycle back into the anagen phase, when it will begin to grow once more. Scarring & non-scarring (non-cicatricial) alopecia can be separated into two basic kinds.

The most typical kind is androgenetic or non-scarring (non-cicatricial) alopecia. Men typically begin losing hair in their 20s; however, women typically don’t start losing hair until their 40s or 50s. An individual will lose hair as they age. The pattern is different between hair loss in men and women.

Women typically lose hair from the center part of the scalp, but men typically lose hair from the front and the temporal region. Additionally, whereas male hair loss might result in full baldness, female hair loss does not always result in that. Because the hair in this part of the scalp is resistant to androgenic hormones, men tend to preserve it there.

Epidemiology

Depending on the kind and cause of alopecia, the epidemiology varies. The frequency of alopecia areata is 0.2 percent, and it can afflict people of any race or sexual orientation. A common condition, androgenic alopecia affects 15 percent of women and 50 percent of men, most of whom are postmenopausal.

More white people are affected than people of color. Women typically experience telogen effluvium more than males do. Tinea capitis is more prevalent in children under the age of five and in those with a dark complexion who do not have any sexual preferences. Chemotherapy-treated cancer patients frequently get anagen effluvium.

Anatomy

Pathophysiology

The type of alopecia determines the pathogenesis. It is unknown what causes alopecia areata, although the most popular theory suggests autoimmune in the nature of a T-cell-mediated route. Both hormonal and hereditary androgens contribute to the etiology of androgenic alopecia.

The hair loss associated with telogen effluvium is influenced by hormones and stress, though the exact cause is occasionally unclear. The dermatophyte disease that causes tinea capitis is the cause of loss of hair.

The shedding of hair in anagen effluvium is influenced by chemotherapeutic drugs. The etiology of alopecia mucinosis is aberrant lymphocyte infiltration of the scalp.

Etiology

Non-cicatricial alopecia can be divided into six main groups:

Alopecia areata: Every area of the body, including the face, trunk, scalp, and appendages, may be affected by this type of hair loss. Alopecia areata is the term used when it only impacts a small part of the body. Alopecia totalis is the term used when it affects a whole site.

Alopecia Universalis is the term used when it affects the entire body. Although the cause is uncertain, an autoimmune condition may be involved.

Androgenetic alopecia: is a type of loss of hair influenced by hormones and DNA (androgenic)

Traumatic alopecia: This is comparable to traction alopecia, which develops as a result of the hair being pulled on firmly and frequently in toddlers.

Telogen effluvium comes from a transition from the growing (anagen) phase to the shedding (telogen) phase of the hair cycle. It could be brought on by a condition like hypothyroidism or hyperthyroidism. It can also result from trauma, such as severe surgery. Telogen effluvium can be brought on by medicines, a calorie-restricted diet, and inadequate nutrition.

Tinea capitis: Contrary to other kinds of tinea capitis, such as kerion & favus, the typical form (black dots) results in non-scarring loss of hair.

Anagen effluvium: This is hair loss that happens when the cell growth is in the anagen stage. a side effect of chemotherapy that is seen in people with cancer.

There are three main categories for scarring alopecia:

 Alopecia mucinosa: This happens when a mucinous substance builds up in the sebum and hair follicles. The mucinous substance triggers an inflammatory reaction that prevents hair development.

Tinea capitis: Scarring alopecia may be the result of tinea favosa, an inflammatory form of the condition.

 Alopecia neoplastic: This is a metastatic invasion of cancerous cells into hair growth.

Genetics

Prognostic Factors

Approximately 8.5 percent of people with alopecia totalis & universalis, according to research, had a full recovery. Many patients will have partial or complete hair regrowth, at least temporarily.

Healthcare professionals must be aware of the prognostic as well as its impacts to adequately advise the client because the treatment response is frequently unpredictable.

A novel trichoscopy-related evaluation called the Alopecia Areata Forecast Score is used to estimate how well patients with spotty alopecia areata will respond to treatment.

Clinical History

Physical Examination

Age group

Associated comorbidity

Associated activity

Acuity of presentation

Differential Diagnoses

Laboratory Studies

Imaging Studies

Procedures

Histologic Findings

Staging

Treatment Paradigm

by Stage

by Modality

Chemotherapy

Radiation Therapy

Surgical Interventions

Hormone Therapy

Immunotherapy

Hyperthermia

Photodynamic Therapy

Stem Cell Transplant

Targeted Therapy

Palliative Care

Medication

 

finasteride 

For men only
Use Propecia as 1 mg orally each day for a minimum of 3 months



cabbage palm 

Off-label 200mg orally two times a day (or) Topically apply lotion two times a day



 
 

Media Gallary

References

https://www.ncbi.nlm.nih.gov/books/NBK538178/

Androgenetic Alopecia

Updated : February 2, 2024




Regardless matter the reason, hair loss is referred to as alopecia. It can occur everywhere on the body and is not only limited to the scalp. There are millions of hairs on each person’s head at birth. The three phases of the hair cycle are referred to as anagen (the growing phase), catagen (the resting period), and telogen (the shedding phase).

90 percent of hair is in the anagen phase of growth, and the remaining ten percent is in the phases of resting as well as shedding. In the telogen phase, while hair is shedding, it will cycle back into the anagen phase, when it will begin to grow once more. Scarring & non-scarring (non-cicatricial) alopecia can be separated into two basic kinds.

The most typical kind is androgenetic or non-scarring (non-cicatricial) alopecia. Men typically begin losing hair in their 20s; however, women typically don’t start losing hair until their 40s or 50s. An individual will lose hair as they age. The pattern is different between hair loss in men and women.

Women typically lose hair from the center part of the scalp, but men typically lose hair from the front and the temporal region. Additionally, whereas male hair loss might result in full baldness, female hair loss does not always result in that. Because the hair in this part of the scalp is resistant to androgenic hormones, men tend to preserve it there.

Depending on the kind and cause of alopecia, the epidemiology varies. The frequency of alopecia areata is 0.2 percent, and it can afflict people of any race or sexual orientation. A common condition, androgenic alopecia affects 15 percent of women and 50 percent of men, most of whom are postmenopausal.

More white people are affected than people of color. Women typically experience telogen effluvium more than males do. Tinea capitis is more prevalent in children under the age of five and in those with a dark complexion who do not have any sexual preferences. Chemotherapy-treated cancer patients frequently get anagen effluvium.

The type of alopecia determines the pathogenesis. It is unknown what causes alopecia areata, although the most popular theory suggests autoimmune in the nature of a T-cell-mediated route. Both hormonal and hereditary androgens contribute to the etiology of androgenic alopecia.

The hair loss associated with telogen effluvium is influenced by hormones and stress, though the exact cause is occasionally unclear. The dermatophyte disease that causes tinea capitis is the cause of loss of hair.

The shedding of hair in anagen effluvium is influenced by chemotherapeutic drugs. The etiology of alopecia mucinosis is aberrant lymphocyte infiltration of the scalp.

Non-cicatricial alopecia can be divided into six main groups:

Alopecia areata: Every area of the body, including the face, trunk, scalp, and appendages, may be affected by this type of hair loss. Alopecia areata is the term used when it only impacts a small part of the body. Alopecia totalis is the term used when it affects a whole site.

Alopecia Universalis is the term used when it affects the entire body. Although the cause is uncertain, an autoimmune condition may be involved.

Androgenetic alopecia: is a type of loss of hair influenced by hormones and DNA (androgenic)

Traumatic alopecia: This is comparable to traction alopecia, which develops as a result of the hair being pulled on firmly and frequently in toddlers.

Telogen effluvium comes from a transition from the growing (anagen) phase to the shedding (telogen) phase of the hair cycle. It could be brought on by a condition like hypothyroidism or hyperthyroidism. It can also result from trauma, such as severe surgery. Telogen effluvium can be brought on by medicines, a calorie-restricted diet, and inadequate nutrition.

Tinea capitis: Contrary to other kinds of tinea capitis, such as kerion & favus, the typical form (black dots) results in non-scarring loss of hair.

Anagen effluvium: This is hair loss that happens when the cell growth is in the anagen stage. a side effect of chemotherapy that is seen in people with cancer.

There are three main categories for scarring alopecia:

 Alopecia mucinosa: This happens when a mucinous substance builds up in the sebum and hair follicles. The mucinous substance triggers an inflammatory reaction that prevents hair development.

Tinea capitis: Scarring alopecia may be the result of tinea favosa, an inflammatory form of the condition.

 Alopecia neoplastic: This is a metastatic invasion of cancerous cells into hair growth.

Approximately 8.5 percent of people with alopecia totalis & universalis, according to research, had a full recovery. Many patients will have partial or complete hair regrowth, at least temporarily.

Healthcare professionals must be aware of the prognostic as well as its impacts to adequately advise the client because the treatment response is frequently unpredictable.

A novel trichoscopy-related evaluation called the Alopecia Areata Forecast Score is used to estimate how well patients with spotty alopecia areata will respond to treatment.

finasteride 

For men only
Use Propecia as 1 mg orally each day for a minimum of 3 months



cabbage palm 

Off-label 200mg orally two times a day (or) Topically apply lotion two times a day



https://www.ncbi.nlm.nih.gov/books/NBK538178/