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Androgenic alopecia

Androgenic alopecia is the most frequent cause of hair loss in men (around 70-80%), which is connected with the sensitivity of hair follicles to androgens, therefore, it has a hormonal and genetic background.The first symptoms usually appear at the age of around 20–30 — hairline recession in men usually occurs at the temples and on the top of the head. Left uncured, it may lead to complete baldness; therefore, it is worth seeing a doctor as soon as you notice the first alarming symptoms.

The main factor causing androgenic alopecia is the hypersensitivity of hair follicles to dihydrotestosterone (DHT). This is a derivative of testosterone arising under the influence of the 5α reductase enzyme, a catalyst which has its highest concentration on the scalp in the sebaceous glands near the hair follicles. Dihydrotestosterone causes hair follicles to shrink, which in turn leads to their weakening and to thinning hair. Research has shown that men with androgenic alopecia have a higher concentration of 5α reductase. What is interesting is that androgenic alopecia doesn’t cause hair in the occipital section of the head to fall out, because the hair follicles located there are resistant to dihydrotestosterone (DHT).

The hair growth cycle consists of 3 phases:

  • anagen (the growth phase) — the growth of the hair follicle
  • catagen (the transition phase) — metabolic processes slow down and the hair thins; this period can last several weeks
  • telogen (the resting phase) — further thinning is completed by the hair falling out; this process occurs over several months.

In humans, these phases are not synchronous.In a healthy person, approximately 85% of hair is in the growth phase, roughly 15% in the resting phase, and about 1% in the transition phase. In people with androgenetic alopecia, a prolapse phase and shortening of the growth phase occur.

It is believed that susceptibility to androgenetic alopecia is genetically determined, although recent reports also indicate an environmental impact on the condition. Stress and a diet low in vitamins and nutrients weaken the hair, contributing to the faster development of androgenetic alopecia. Therefore, when planning a therapy to inhibit hair loss, it is worth considering all these factors, recommending  appropriate supplements to patients, for example.

Diagnosis of androgenetic alopecia in men is relatively simple and does not require conducting additional tests.The doctor conducts a thorough interview with the patient to learn the history and duration of the hair loss and asks about similar cases occurring in the family. A trichoscopy test can also be conducted. In the case of androgenetic alopecia in women, it is also necessary to check the levels of testosterone, TSH, and ferritin to be able to make an accurate diagnosis.

Effective therapy includes comprehensive treatment following an individually formulated plan. The treatments used at i-Hairmed — e.g., scalp mesotherapy with special cocktails (e.g., peptide or platelet-rich plasma), stem cell micrografts, carboxytherapy, and LED light therapy — support hair regrowth and stimulate hair follicles into activity.

Sometimes treatment of androgenetic alopecia in men is supported  with drugs. Orally-administered finasteride inhibits the conversion of testosterone into DHT, which damages the hair follicles and causes their shrinkage. Use of this drug causes the balding process to slow down or to be inhibited. Minoxidyl is a second commonly-used drug (applied to the scalp), which extends the hair growth cycle and leads to its strengthening.

In the case of significant hair loss and complete destruction of hair follicles, stimulant treatments and medications may not be effective. In such case, the only method of hair restoration is hair transplantation. In our clinic, we use the modern FUE method employing the innovative SmartGraft device, which leaves no scars at the site of collection. The result is safe and painless transplant surgery under local anesthesia on an outpatient basis.