Male androgenetic alopecia

Abstract

• Male balding is a common androgen-dependent trait in which there is a progressive decline in the activity and size of scalp hair follicles. • Male balding can cause significant adverse effects on psychosocial wellbeing in some men. • The predisposition to male balding is genetically determined and is polygenic in nature. • Dihydrotestosterone, a 5α-reduced metabolite of testosterone, is the androgen responsible for driving hair loss. The primary target of androgens within the hair follicle is probably the follicular dermal papilla. • Topical minoxidil lotion and oral finasteride, an inhibitor of type 2 5α-reductase, are the only medical treatments of proven efficacy in male balding. They help to prevent or delay the progression of hair loss and can stimulate some regrowth of hair in some men. • Redistribution of terminal hair, using surgical techniques such as hair transplantation, can produce effective cosmetic results in selected cases. © 2008 Springer-Verlag.