Pattern Hair Loss (Androgenetic Alopecia)

What it is

Androgenetic alopecia, also called male pattern baldness or female pattern hair loss, is a common form of hair loss in both men and women. [1] In men, the hairline recedes above the temples, often in an "M" shape, and hair thins at the crown. [1] In women, hair thins at the top of the head and the part widens, while the hairline does not typically recede and total baldness is rare. [1] MedlinePlus estimates it affects about 50 million men and 30 million women in the United States, and risk rises with age. [1]

Causes

Genes and environment likely play roles. In men, hair loss is related to androgen hormones, especially dihydrotestosterone (DHT), which can shorten the growth phase of hair so strands become shorter and thinner. [1] In women, androgens play a role but other factors are not yet known. [1] The NHS says it usually runs in families. [2]

MedlinePlus notes associations with other conditions: in men with heart disease and prostate enlargement, and in women with polycystic ovary syndrome. [1] Associations are not proof that one causes the other. For hormone context see PCOS and Testosterone.

Established care

The NHS says finasteride and minoxidil are the main treatments for male pattern baldness, minoxidil can also be used for female pattern baldness, and women should not use finasteride. [2] They do not work for everyone, only work for as long as they are used, and may need to be paid for. [2] A meta-analysis of randomized trials found minoxidil, finasteride (1 mg) and low-level laser light therapy were superior to placebo for hair growth in men, and 2% minoxidil was effective in women, with high heterogeneity among studies. [3] This is an established recommendation with realistic limits. Oral low-dose minoxidil has been reviewed in 17 studies (634 patients) and was described as effective and well tolerated in healthy patients, but larger randomized comparisons are needed. [4] Prescription decisions, pregnancy risks and side effects belong with a clinician.

Hair transplant and other procedures are listed by the NHS; not all are available on the NHS. [2]

Supplements and natural products

Proper evidence not found in the sources checked for herbal or supplement treatments of pattern hair loss. A vitamin and mineral review concluded that large placebo-controlled trials are needed. [5] Read Saw palmetto for the herb often marketed for hair and Collagen, biotin and beauty supplements. Before any supplement see medication interactions.