Androgenetic Alopecia
Androgenetic Alopecia
Androgenetic Alopecia (AGA) is the most common cause of hair loss in men, with 98% of men experiencing hair loss suffering from AGA.
The hallmark of hair loss due to Androgenetic Alopecia is the gradual miniaturization of hair follicles in specific areas of the scalp: the frontal hairline, the crown, and the top of the head. These regions are hormone-sensitive, meaning that the normal androgens produced by the body during puberty trigger the progressive shrinking of the follicles in these scalp areas.
As a result of this follicle miniaturization, the affected follicles produce thinner, finer, and colorless hairs. The hair growth rate decreases dramatically, and hairs remain for shorter periods on the scalp. Consequently, the scalp skin becomes increasingly visible between the thinning hairs, leading first to hair thinning and eventually to baldness.
Classification of Androgenetic Alopecia
In men, androgenetic alopecia is classified using the Norwood-Hamilton scale, which describes the progressive stages of male pattern baldness.
In women, the Ludwig scale is used, which specifically illustrates the thinning of hair on the crown and the central part of the scalp.
Stages of Androgenetic Alopecia
In the table below, you can see the different stages of hair loss. The chart also calculates the approximate number of hair follicles required to be transplanted in order to restore natural hair density in each specific area.
Androgenetic alopecia is a form of hair loss that develops gradually and is mainly caused by the action of androgens on the hair follicles, as well as by genetic predisposition. It is the most common cause of hair thinning in both men and women, significantly affecting appearance and quality of life.
Causes of Androgenetic Alopecia
Genetic Predisposition
Androgenetic alopecia has a strong genetic basis. A family history of hair loss significantly increases the likelihood of developing the condition at an earlier age—both in men and women.
The underlying causes are genetic, meaning they are linked to specific genes inherited from one’s parents. It is important to note that men with hair loss do not have higher levels of androgens than those without hair loss—the difference lies in the hair follicles, which are simply more sensitive to normal levels of androgens.
Other Contributing Factors
Additional factors that are often blamed—such as scalp sebum, microbes, stress, poor diet, smoking, etc.—have minimal impact on their own. However, they may slightly accelerate the onset of hair loss in genetically predisposed individuals.
Androgenetic Alopecia: Heredity
King Charles’s two sons have not inherited their father’s hair loss pattern in the same way—one shows more advanced androgenetic alopecia than their father, while the other has a full head of thick hair.
A man with a family history of hair loss is generally more likely to experience it himself. However, in some families, the genetic predisposition may skip a generation—remaining dormant in the parents and reappearing in the next generation.
In other cases, a young man may begin to show signs of thinning hair even if no close relatives are affected. Conversely, a man with dense hair may have multiple relatives with significant hair loss. Genetics often holds surprises!
Androgenetic Alopecia in Men
Androgenetic alopecia in men typically begins between the ages of 20 and 30 and progresses gradually over time. It is most commonly observed as thinning at the temples and the crown of the scalp.
Hair loss doesn’t stop at a certain age—you will lose all the hair you are genetically predisposed to lose, unless you take action. Hair thinning due to androgenetic alopecia doesn’t happen overnight, and it doesn’t begin at the same time for everyone.
Men experiencing hair loss often go through alternating phases—periods of slow or rapid shedding followed by periods of stability, where no visible hair loss occurs. One thing is certain: if no treatment is initiated, hair loss will continue to progress.
A common misconception is that hair loss stops after a certain age. Just look at photos of well-known actors over the years—you’ll notice that those who showed early signs of hair thinning in their youth often end up with very little hair later in life.
In other words, hair loss won’t stop on its own as time goes by—unless you do something about it. Fortunately, there are several effective solutions available today to restore your appearance, including hair transplantation.
Androgenetic Alopecia in Women
Although it occurs at a lower rate, female hair loss affects approximately 10% of the female population. It is well known that women tend to place greater importance on the appearance and health of their hair.
Women may experience androgenetic alopecia due to hormonal imbalances, menopause, or genetic predisposition. Hair loss is typically not complete but is characterized by a reduction in hair diameter and density, primarily presenting as thinning hair on the crown of the scalp.
Symptoms of Androgenetic Alopecia: When Hair Thinning Begins
Nine out of ten men first notice their hair loss when they see clogged drains filled with shed hairs in the bathroom or sink, or when they find an excessive amount of hair on their pillow or brush. Many men change their hairstyle to conceal thinning, abandoning styles that comb hair backward in favor of side-parted looks.
Some men comb their hair forward to hide thinning along the hairline, while others opt for very short haircuts to minimize the contrast with the denser hair on the sides. However, it is important to take action to stop hair loss rather than merely trying to hide it.
Diagnosis of Androgenetic Alopecia
The diagnosis of androgenetic alopecia is based on a clinical examination of the scalp, hair root analysis (trichogram), dermoscopy, and laboratory tests to rule out other causes of hair loss. Often, androgen levels and other hormonal disorders are also evaluated.
Treatment and Therapeutic Options for Androgenetic Alopecia
The management of androgenetic alopecia includes both pharmacological treatments and invasive procedures. The main therapeutic options are:
Pharmacological Treatment with Minoxidil and Finasteride
Only two medications have been scientifically proven to provide real results in the fight against hair loss: Minoxidil and Finasteride. Despite the numerous treatments that frequently appear on the market, often promising quick results, these two remain the cornerstone of effective therapy.
Minoxidil is one of the most well-established and scientifically approved treatments for androgenetic alopecia. It was the first therapy to deliver indisputable results for hair loss management.
Although the exact mechanism of action of Minoxidil is not yet fully understood, it is known to dilate blood vessels and prolong the life cycle of hair follicles. This leads to improved hair quality and extended retention of hairs on the scalp.
Male pattern hair loss is the number one concern affecting increasingly younger men every day. With topical Minoxidil application, patients can now achieve the full, desired results with absolute safety.
Minoxidil and Finasteride are the only pharmaceutical agents supported by extensive research and large-scale clinical studies that demonstrate their efficacy, safety, and effectiveness. These two compounds form the foundation of every scientifically supported hair loss treatment.
Duration of Treatment
Treatment requires time and consistency. The period needed to see visible results varies by individual, but generally, since effects do not appear immediately, patience is essential—typically for at least 6 to 12 months.
If your treatment delivers satisfactory results, it is important to continue it daily. Discontinuing the treatment will reverse the benefits within a short period of time.
Hair Transplantation
Some men with hair loss are not satisfied with the results of pharmacological treatments and wish to restore their lost hair through hair transplantation. At Anastasakis Hair Clinic, the hair transplantation we offer delivers permanent results with 100% natural appearance and density.
Treatment of Androgenetic Alopecia in Women
Treatment in women differs, as hormonal imbalances often play a significant role. Besides Minoxidil—which guarantees a natural and dense result, especially when combined with hair transplantation methods—women may also benefit from hormonal regulation. This can include the use of anti-androgens or autologous mesotherapy for hair, particularly in cases with a genetic predisposition.
Results of Androgenetic Alopecia Treatments: What to Expect
The results depend on the stage of androgenetic alopecia, the condition of the hair follicles, the chosen treatment, and patient compliance. FUE hair transplantation provides a natural and permanent result, especially when combined with autologous hair mesotherapy and appropriate pharmacological therapy.
Androgenetic alopecia, whether in men or women, is a manageable condition with proper education, timely diagnosis, and targeted treatment. Modern medicine offers numerous therapies that can slow progression and restore lost hair density.
Scalp Condition & Complications from Androgenetic Alopecia Treatments
The condition of the scalp significantly affects treatment outcomes. Inflammations, seborrheic dermatitis, or poor blood supply to the hair follicles can worsen hair loss and reduce the effectiveness of therapies.
Tips for Effective Management of Androgenetic Alopecia
Effective and timely management of androgenetic alopecia relies on targeted actions:
- Do not delay diagnosis
- Use products suitable for your scalp condition
- Follow the instructions for your medication carefully
- Maintain a good quality of life and reduce stress
Choosing a Clinic for Effective Management of Androgenetic Alopecia
Selecting the right hair transplant clinic is crucial. Look for specialized physicians, extensive experience in FUE hair transplantation, and the ability to provide personalized treatment plans. A comprehensive scalp evaluation should always precede any intervention.
