Androgenic alopecia is hair loss due to the increased formation of male hormones (androgens). This phenomenon is more common in the stronger sex. However, women suffer from baldness against the background of endocrine disorders. It is important to remember that this is not just a cosmetic defect, in this case the loss of hair is associated with hormonal disorders. If in men, baldness is manifested only in hair loss, then in young women, other signs of an excess of androgens are also found. Therefore, hair loss requires not only treatment by a trichologist, but also an endocrinologist’s consultation.
What is androgenic alopecia
Androgenic alopecia is the loss of hair on the top of the head and forehead; in women, the parting line also thins. This pathology is associated with the action of hormones. Otherwise, this disease is called male pattern baldness. In rare cases, the hair falls out completely.
Distinguish between the concepts of androgenetic alopecia and androgenic. With androgenetic alopecia, the main role is played by heredity. Early hair loss is genetically transmitted. Due to the excessive sensitivity of the receptors to the hormone dihydrotestosterone, the hair follicles in a person become too weak. As a result, strong hair is replaced by thin hair. Then they look like fluff and fall out.
Androgenic alopecia is associated with increased levels of dihydrotestosterone. It arises during the course of a person’s life and is not inherited. Its cause is endocrine illness or hormonal medication. Under the influence of androgens, a failure of the hair life cycle occurs. There are 3 periods of hairline growth:
The anagen period lasts from 2 to 8 years. At this time, hair growth is noted. In the catagen stage (2-4 weeks), the follicle undergoes reverse development, its nutrition is disturbed. Telogen is a resting state that lasts 2-4 months. At this time, the hair falls out. Then again comes the anogen. In place of old hair, new ones grow. Normally, a person in a telogen state is about 10% of the hair.
Hair follicles are equipped with receptors that are sensitive to androgens. With an excess of dihydrotestosterone, the anagen phase becomes shorter. Degenerative processes occur in the follicles. Because of this, old hair falls out intensively, and new ones do not grow in their place. A photo of androgenetic alopecia can be seen below.
Why does a person most often lose hair on the top of his head and on his forehead? These areas are subject to the action of the enzyme 5-alpha reductase. It turns the hormone testosterone into dihydrotestosterone, under the influence of which the hair growth period is shortened.
This disease occurs at any age. But most often, androgenic alopecia in women appears after 50 years. This is due to increased levels of steroid hormones before menopause. In men, such baldness usually occurs after 35 years.
Is there a cure androgenetic alopecia? Doctors believe that in most cases, the process of hair loss is reversible. It is only necessary to establish the correct growth cycle. But sometimes there is a serious lesion of the follicles, in which hair growth is not restored. More often this phenomenon is observed in men.
Causes of baldness
As already mentioned, the main cause of androgenetic alopecia is an excessive level of testosterone, which is then converted to dihydrotestosterone. The following categories of people are at risk:
- Male. Testosterone levels in men are much higher than in women.
- Over the age of 50. In mature people, due to hormonal changes, testosterone levels increase, which leads to baldness.
- Patients taking anabolic steroids and corticosteroids. These drugs increase testosterone production.
- People taking antipsychotics, antidepressants, as well as drugs "Reserpine", "Ketoconazole", "Cimitidine", "Arginine", "Penicillamine." These drugs increase the activity of the 5-alpha reductase enzyme, which is responsible for the conversion of testosterone to dihydrotestosterone.
- Women during menopause and pregnancy. Hormonal changes in such periods can trigger an increase in the level of androgens in the body.
- Patients with dysfunction of the pituitary gland, adrenal glands, as well as female and male sex glands. These pathologies are accompanied by increased testosterone production.
Symptoms in men
Androgenic alopecia in men is manifested in increased hair loss and thinning. This is the main manifestation of the disease. The following signs of pathology are noted:
- Hair loses quality, becomes thinner, becomes dull.
- Bald patches form.
- On the head you can see the fluff.
- Hair grows slowly.
The hormone testosterone is natural for the male body. Therefore, there are no visible signs of endocrine disorders with androgenetic alopecia in men.
Symptoms in women
In women, baldness of androgenic origin leads to hair loss and thinning in the crown of the head and forehead. In the postmenopausal period, this does not cause any symptoms from the endocrine system. At a young age, androgenic alopecia in women can be accompanied by the following manifestations:
- violation of the regularity of menstruation;
- the appearance of hair on the chin, upper lip, cheeks, chest, back;
- oily skin;
- the occurrence of acne (acne).
These are signs of excess production of male hormones.
Diagnostic Methods
Trichologist is involved in the treatment of baldness. Consultation of an endocrinologist is usually always recommended, and for a gynecologist, for women.
In the diagnosis of androgenetic alopecia, the following examinations are prescribed:
- blood test for testosterone and dihydrotestosterone (in patients, these indicators always exceed the norm);
- analysis for hormones of the thyroid gland, pituitary and adrenal glands;
- immunological examination for lymphocytes B and T;
- Wasserman reaction (to exclude syphilis).
In addition, it is recommended to undergo ultrasound of the ovaries and adrenal glands, as well as MRI and CT of the brain. These methods help determine the cause of the excess of androgens in the body.
Special tests are also used to assess the condition of hair on the head:
- traction test with hair stretching;
- analysis for fungal infection of the hair;
- study of the hairline for the concentration of chemical elements;
- trichogram - examination for the presence of non-growing hair;
- microscopic examination of the hair shaft.
Differential diagnosis
When diagnosing, it is important to distinguish between androgenic alopecia from androgenetic alopecia. These two forms of alopecia have a different developmental mechanism. Androgenetic alopecia is characterized by an increase in the sensitivity of follicular receptors to dihydrotestosterone. At the same time, the level of hormone in the body remains normal. A trichogram helps to distinguish between these two forms of alopecia. With androgenetic alopecia, this examination shows a decrease in hair follicles and dysplastic changes in them.
Androgenic baldness should be distinguished from diffuse alopecia. These pathologies are associated with various reasons. With diffuse baldness, hair falls evenly on different areas of the head. This is not associated with an excess of dihydrotestosterone. With androgenic alopecia, hair is lost in areas that depend on the level of male hormones.
Drug treatment
How to treat androgenetic alopecia? This disease is always a consequence of hormonal imbalance. Therefore, it is necessary to eliminate the cause of the disease - an excess of testosterone and dihydrotestosterone.
In the treatment of androgenetic alopecia in women, drugs are prescribed that reduce the level of male sex hormones:
- Diane 35
- Androkur;
- "Flutafarm Femina";
- Klimen
- Cyproterone.
Also used estrogen drugs:
- "Janine";
- "Yarina";
- "Microfollin".
Antiandrogens lower the levels of testosterone and dihydrotestosterone in the female body. This effect is enhanced by the use of female hormones.
In the treatment of androgenetic alopecia in men do not prescribe medications that lower testosterone levels. This hormone is necessary for the body of the stronger sex. For the treatment of men, drugs that inhibit the activity of 5-alpha reductase are used:
- "Final";
- Penester
- "Prosteride";
- Zerlon
- Finasteride
- Finprost.
The patient needs to take such drugs for a long time - from 1 year to 2 years. In this case, the hair is restored in the vast majority of cases. However, there are side effects in drugs for androgenetic alopecia. The reviews of men contain information about a decrease in potency and the appearance of gynecomastia after taking the drugs. These drugs are used only under medical supervision, as they affect the level of testosterone. It is necessary to strictly follow the recommended dosages, and sometimes take medications together to regulate potency.
Outwardly prescribed drugs based on minoxidil. They are released in the form of ointments, shampoos, sprays, lotions. They improve the blood supply to the follicles and promote hair growth. The drugs are effective for a short period of alopecia (up to 3 to 5 years). Minoxidil reduces the effect of dihydrotestosterone and accelerates the transition of follicles from the resting stage to the growth phase. The result of treatment is noticeable after 4-6 months.
If drugs based on minoxidil are used to treat female alopecia, then a solution of no more than 2% should be used. An overdose of the drug can cause facial hair growth in patients.
Spirinolactone preparations are also prescribed. This is a diuretic with antiandrogenic action. In the form of tablets, this medicine is undesirable to take, since in large doses it often causes side effects. Small dosages usually do not help. With alopecia, ointments and creams with spirinolactone are useful, but they are more effective in treating women.
In addition to antiandrogen drugs, sprays with dietary supplements and vitamins are prescribed to improve hair growth:
- Alerana
- "Selenzin";
- "Chevylux";
- Kerastaz;
- Kerium
- Aminexil.
It is useful to use vitamin-mineral complexes inside to improve the quality of hair: Pantovigar, Merz, Zinkteral, Revalid.
The natural means of reducing the activity of 5-alpha reductase are the fruits of the dwarf palm. You can use the finished pharmacy drug "Rinfoltil", which contains an extract of this plant.
Often patients ask the question: how to treat androgenetic alopecia with folk remedies? It is impossible to get rid of this disease only with the help of herbs and decoctions, since it is based on hormonal disorders. But drug treatment can be supplemented with the use of herbal remedies containing natural estrogens. These are hop cones, clover leaves, sage, pomegranates, apples, carrots. From them you can prepare hair masks and decoctions for rinsing hair.
Among the reviews of folk remedies, a successful experience in treating baldness with linseed oil is mentioned. It contains many vitamins that nourish and strengthen hair. It is better to purchase cold-pressed oil, sold in pharmacies. However, the use of this folk remedy should be combined with the use of hormonal drugs.
Physiotherapy
There are different opinions of experts on the effectiveness of the treatment of androgenetic alopecia with physiotherapeutic methods. Some trichologists believe that such procedures are ineffective, since after their cancellation, baldness returns. However, many doctors prescribe physiotherapy:
- Galvanization. This effect on areas of baldness with a weak electric current. It helps to improve blood supply to the follicle and normalize the endocrine background.
- Electrophoresis Under the influence of current, drugs are introduced into the skin. Apply drugs with magnesium, zinc, euphyllin. They stimulate blood flow and prevent hair loss.
- Electrical stimulation. This method is the effect of a constant pulsed current on the nervous system. The procedure stimulates the production of enzymes and biologically active substances that normalize the function of the endocrine system and positively affect the trophism of the scalp.
- Laser Therapy Infrared and ultraviolet radiation contributes to the formation of new cells and improves blood circulation in areas of baldness. As a result, old hair stops falling out, and new ones grow back.
- Darsonvalization. A special electrode (in the form of a comb) is carried out on problem areas of the head. Exposure to alternating current improves hair follicle nutrition and blood circulation in bald areas.
Reviews of the treatment of androgenetic alopecia with darsonvalization indicate the effectiveness of this method. After a course of therapy for 10-20 days, the hair stops falling out and begins to grow faster. However, all physiotherapeutic methods should be supplemented with medical treatment.
Beauty treatments
Cosmetic procedures for hair restoration are part of a comprehensive treatment for baldness. The use of mesotherapy for androgenetic alopecia in women is very popular. Reviews indicate the high efficiency of this method. Injections of medicinal mixtures are injected into the scalp. They have a vasodilating effect, resulting in improved nutrition of the follicle and blood microcirculation. After a series of such procedures, a normal hair life cycle is established.
Mesotherapy is also done using a special scooter. It is a roller with thin needles. This device is carried out on problem areas of the head, and then drugs are applied to the dermis. Microscopic punctures remain on the skin through which drugs penetrate.
One of the new treatments is plasmotherapy. The patient’s blood plasma is injected subcutaneously. This method helps to improve the condition of the hair follicles, and extend their service life by about 2 years.
Botox for hair is also used to combat baldness. This drug is a tool that delivers beneficial substances to the root of the hair. Vitamins and proteins are retained in the follicle even when washed. In addition, Botox reduces the effects of androgens on hair growth zones. However, not all cosmetologists consider this method quite effective. After the end of the course of therapy, baldness may return.
Surgical methods
In severe cases of baldness, when it is impossible to restore natural hair growth, surgical treatment is used. In this case, the hair follicles are transplanted from other parts of the head or body to the baldness zone. The operations are carried out in the following ways:
- Strip method. A skin flap is taken from the donor area. It is divided into several parts, each of which contains 1-3 hair follicles. These sites are transplanted to the zone of baldness. The operation is done on an outpatient basis under local anesthesia.
- FUE machine method. A site with follicles is taken from donor zones. It is cut into pieces for transplantation. In the baldness zone, punctures and incisions are made through which transplants are introduced. This operation is also done under local anesthesia.
- HFE method. This is the least traumatic and painless way. Hair follicles are removed from the donor area using special needles. At the same time, no incisions are made on the skin. Then the follicles are injected with another needle into the areas of baldness. To date, this method is considered the most advanced hair transplantation technique .
After transplantation, the follicles fully retain their functions, and new hair grows in the patient. Surgical methods help patients restore hair even in the most hopeless cases.