Managing androgenic alopecia


Have you felt that you are increasingly losing hair and that your hair has become thin? It is pretty likely that you have androgenic alopecia. Never delay seeking medical help for hair loss, as doctors can help well in the early stages of the disease. However, doctors can do little in later stages due to irreversible loss of hair follicles.

Androgenic alopecia also called androgenetic alopecia, is the leading cause of hair thinning and hair loss in men and women, affecting about half of the global population.

It is a condition that run-in families. However, it appears that the main cause of the condition is higher amounts of 5-alpha-reductase in hair follicles in susceptible individuals due to genetic reasons. This causes the increased conversion of testosterone to dihydrotestosterone (DHT) in hair follicles, causing hair loss.

Managing androgenic alopecia

There are many topical solutions and oral drugs used to manage androgenic alopecia.

When it comes to topical solutions, it is worth understanding that there is only one medication that is US FDA approved and globally tested to date. 5% Minoxidil is the only effective topical medication that can help in most cases of androgenic alopecia, especially if the treatment is started early enough. Of course, other hair oils and vitamins may also promote hair growth, but they are not as effective as minoxidil.

Systemic reviews show that minoxidil can boost hair growth significantly compared to placebo. However, although topical minoxidil results are excellent, its prolonged use is essential to see any visible difference. Thus, researchers think that there are significant issues regarding compliance.

When it comes to oral drugs, they might be used alone or in combination with topical minoxidil. Among the most commonly used and clinically effective drug is finasteride. It is a 5-alpha reductase inhibitor.

A systemic review published in the journal JAMA found that there is strong evidence that finasteride can help improve hair count in those diagnosed with androgenic alopecia. However, it appears to increase the risk of sexual dysfunction in men.

Interestingly enough, there is also increasing interest in the use of topical finasteride. Early studies use that it may help. The benefit of using topical finasteride is that it is less likely to cause sexual dysfunction in men.

Another finasteride analog called dutasteride has also been approved in many countries in the last few years. It is several times more potent than finasteride in blocking 5-alpha-reductase in the hair follicle. It is generally prescribed to those in whom finasteride failed to help.

Doctors generally avoid prescribing antiandrogens like finasteride to women due to the higher risk of side effects. Thus, in women, they prefer spironolactone. Spironolactone is a mild antihypertensive that can block androgens at a lower dosage.

Researchers have also started exploring non-pharmacological means for stimulating hair growth in recent years. For example, some studies suggest that red light therapy may help prevent hair loss. Moreover, this therapy is highly safe and available without a doctor’s prescription.

Those who fail to respond to these treatments may ultimately require a hair transplant.

Androgenic alopecia and comorbidities

Since the condition is about altered sensitivity to androgens, some researchers think that those living with androgenic alopecia might be at a greater risk of benign prostate hypertrophy (BPH). However, the results of studies are mixed, with some studies confirming this theory while others found no such link. Nevertheless, it is something to know.

Similarly, some studies have proposed that androgenic alopecia is associated with a higher risk of prostate cancer. In addition, some studies also indicate an increased risk of colon cancer in such individuals.


To conclude, androgenic alopecia is challenging to treat. However, it is possible to slow down or prevent hair loss in the condition. But, it would often require prolonged use of topical solutions, oral medicines, and thus issues regarding compliance and higher risk of side effects.

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