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Male pattern alopecia (Androgenetic alopecia)


Androgenetic alopecia (male pattern alopecia) is hair loss associated with the male hormone androgens and is characterised by hair loss and thinning in the parietal and frontal areas of the head. This condition progresses gradually with age, the frontal hairline shifts backwards, the hair on the top of the head thins, and the baldness in the parietal area begins to spread further.  

The main causes of androgenic alopecia are heredity and a type of male hormone, androgen. The nature of inheritance of alopecia is not well understood, but it is known that the disease is inherited by the autosomal dominant type with variable expression. It has been noted that the level of androgens in the blood in patients with signs of androgenic alopecia is similar to that in people without signs of hair loss, but in patients suffering from androgenic alopecia, the strongest male androgen hormone is produced in large quantities, leading to atrophy of hair follicles in the area of baldness.


Human hair normally grows for 3-6 years, but in people with a genetic predisposition to alopecia due to the hormone dihydrotestosterone, the period of hair growth is gradually shortened. As a rule, healthy hair as it grows first falls out and then new hair grows in its place, the process repeats. With androgenic alopecia, hair grows, but each time it becomes lighter and thinner. A characteristic feature of male pattern alopecia is that the hair on the frontal part of the head and the top of the head gradually becomes less frequent, thinner and loses colour (downy hair). As hair loss progresses in the frontal area, the hairline gradually recedes backwards, and as the amount and thinning of hair decreases, the sparse hair can no longer cover the scalp and a bald spot forms. It is rarely the case that hair loss occurs at the back of the head.  


The specialist checks the condition of the area of the head where hair loss is occurring and assesses the hereditary factor, as well as examining the history of recent illnesses.  

Treatment and course of the disease 

The primary treatment for androgenic alopecia is drug therapy, which includes the external application of minoxidil and oral administration of finasteride. These two drugs are now widely used as hair growth agents approved by the US Food and Drug Administration/FDA.  

Minoxidil has a strong vasodilatory effect and was originally developed for the treatment of high blood pressure, but due to side effects related to hair growth, it was later approved as an external agent and was used to treat hair loss. The drug cannot create new hair sheaths, but it has an anti-androgenic effect, which affects the sebaceous glands. Finasteride is a 5α-reductase inhibitor that reduces dihydrotestosterone levels. Both drugs have a peculiarity: when you stop taking the drug, the hair begins to fall out again, and the effect of treatment is not immediately apparent. Minoxidil is the only remedy for hair loss for women. Hair transplant surgery may be performed if medication is ineffective.  

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