Androgenetic Alopecia: Clinical Treatment

Abstract

Androgenetic alopecia (AGA) affects predisposed men and women and is characterized by nonscarring progressive miniaturization of the hair follicle accompanied by shortening of the anagen phase, leading to a gradual conversion of terminal hairs into vellus hairs with a pattern distribution. The etiology of AGA is multifactorial and polygenetic. Male androgenetic alopecia, also known as male pattern hair loss (MPHL), is clearly an androgen-dependent condition, and although the mode of inheritance is uncertain, a genetic predisposition is observed. In female androgenetic alopecia, also known as female pattern hair loss (FPHL), the role of androgens is still uncertain. It is more frequent in Caucasians than in Asians and Africans, and the prevalence increases with age. AGA is one of the most common causes of hair consultation, affecting quality of life and self-esteem of patients. Frequently, their expectations about therapy results are higher than reality. For this reason, it is important to clarify during the first consultation that the main treatment goal is to stop progression and prevent further thinning, highlighting that improvement and regrowth cannot always be achieved. Although AGA is a very prevalent condition, approved therapeutic options are limited. The aim of this chapter is to review the efficacy and safety of current clinical therapeutic options in a practical manner.