Androgenetic alopecia is hair loss due to increased production of male hormones (androgens). This phenomenon is more common in the stronger sex. However, women also suffer from baldness due to 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 androgen excess are also found. Therefore, in case of hair loss, not only treatment by a trichologist is required, but also a consultation with an endocrinologist.
What is androgenic alopecia
Androgenetic alopecia is a hair loss on the crown 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, hair falls out completely.
Distinguish between the concepts of "androgenetic alopecia" and "androgenetic". In androgenetic alopecia, heredity plays a major role. Early hair loss is genetically transmitted. Due to the excessive sensitivity of receptors to the hormone dihydrotestosterone, human hair follicles become too weak. As a result, strong hair is replaced by thin hair. Then they look like fluff and fall out.
Androgenetic alopecia is associated with increased levels of dihydrotestosterone. It occurs during a person's life and is not inherited. Its cause is endocrine diseases or hormonal medications. Under the influence of androgens, the life cycle of the hair fails. There are 3 periods of hair growth:
- anagen;
- catagen;
- telogen.
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 comes the anogen again. New hair grows in place of old hair. Normally, a person in a state of telogen 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 intensely, and new ones do not grow in their place. Photo of androgenetic alopeciacan be seen below.
Why does a person most often lose hair on the crown and on the forehead? These areas are subject to the action of the enzyme 5-alpha reductase. It converts the hormone testosterone into dihydrotestosterone, under the influence of which the period of hair growth is reduced.
This disease occurs at any age. But most often, androgenetic alopecia in women appears after 50 years. This is due to the increase in the level of steroid hormones before menopause. In men, this type of baldness usually occurs after the age of 35.
Can androgenetic alopecia be cured? Doctors believe that in most cases, the process of hair loss is reversible. It is only necessary to establish the right growth cycle. But sometimes there is a serious damage to 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 excess level of testosterone, which is then converted into dihydrotestosterone. The risk group includes the following categories of people:
- Male. Testosterone levels are much higher in men than in women.
- Over the age of 50. In older people, due to hormonal changes, testosterone levels increase, which leads to baldness.
- Patients taking anabolics and corticosteroids. These drugs increase testosterone production.
- People taking neuroleptics, antidepressants, as well as 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 during such periods can trigger an increase in the level of androgens in the body.
- Patients with impaired function of the pituitary gland, adrenal glands, as well as female and male gonads. These pathologies are accompanied by increased testosterone production.
Symptoms in men
Androgenetic 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 are forming.
- You can see fluff on the head.
- Hair grows back slowly.
The hormone testosterone is natural for the male body. Therefore, there are no visible signs of endocrine disorders in androgenetic alopecia in men.
Symptoms in women
In women, baldness of androgenic origin leads to hair loss and thinning in the crown and forehead. In the postmenopausal period, this does not cause any symptoms from the endocrine system. At a young age, androgenetic alopecia in women may be accompanied by the following manifestations:
- violation of the regularity of menstruation;
- appearance of hair on the chin, upper lip, cheeks, chest,back;
- oily skin;
- the occurrence of blackheads (acne).
These are signs of excess production of male hormones.
Diagnostic Methods
Baldness is treated by a trichologist. Usually, a consultation with an endocrinologist is always recommended, and for women, a gynecologist.
When diagnosing androgenetic alopecia, the following examinations are prescribed:
- blood test for testosterone and dihydrotestosterone (in patients, these figures always exceed the norm);
- test for thyroid, pituitary and adrenal hormones;
- immunological test for B and T lymphocytes;
- Wasserman reaction (to rule out 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 excess androgens in the body.
Special tests are also used to assess the condition of the hair on the head:
- traction test with hair stretching;
- analysis for fungal hair infection;
- study of hair 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 androgenic alopecia from androgenetic. These two forms of alopecia have a different mechanism of development. Androgenetic alopecia is characterized by an increase in the sensitivity of receptorsfollicles to dihydrotestosterone. At the same time, the level of the hormone in the body remains normal. The trichogram helps to distinguish these two forms of alopecia. In androgenetic alopecia, this examination shows the reduction of hair follicles and dysplastic changes in them.
Androgenic alopecia should also be distinguished from diffuse. These pathologies are associated with various causes. With diffuse alopecia, hair falls out evenly on different areas of the head. This is not due to an excess of dihydrotestosterone. With androgenetic alopecia, hair is lost in those areas that depend on the level of male hormones.
Medicated 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:
- "Diana-35";
- "Androkur";
- "Flutapharm Femina";
- "Klymen";
- "Cyproterone".
Estrogen drugs are also used:
- "Janine";
- "Yarina";
- "Microfollin".
Antiandrogens reduce the level 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 prescribemedications 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:
- "Alfinal";
- "Penester";
- "Prosterid";
- "Zerlon";
- "Finasteride";
- "Finprost".
The patient needs to take such drugs for a long time - from 1 to 2 years. In this case, the hair is restored in the vast majority of cases. However, there are also side effects of drugs for androgenetic alopecia. The reviews of men contain information about the decrease in potency and the appearance of gynecomastia after taking the drugs. These drugs are used only under medical supervision, as they affect testosterone levels. It is necessary to strictly observe the recommended dosages, and sometimes take medicines together to regulate potency.
Externally prescribed funds based on minoxidil. They are produced 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 3-5 years). Minoxidil reduces the effect of dihydrotestosterone and accelerates the transition of follicles from the resting stage to the growth phase. The result of the treatment is noticeable after 4-6 months.
If minoxidil-based preparations are used to treat female alopecia, then a solution of no more than 2% should be used. An overdose of the drug may causefemale patients facial hair growth.
Prescriptions with spirinolactone are also prescribed. It is a diuretic with an antiandrogenic effect. It is undesirable to take this medicine in the form of tablets, since in large doses it often causes side effects. Small doses usually do not help. Spirinolactone ointments and creams are useful for alopecia, but they are more effective in treating women.
In addition to antiandrogenic drugs, sprays with bioadditives and vitamins are prescribed to improve hair growth:
- "Alerana";
- "Selenzin";
- "Shevelux";
- "Kerastasis";
- "Kerium";
- "Aminexil".
It is useful to use vitamin-mineral complexes inside to improve the quality of hair: "Pantovigar", "Merz", "Zincteral", "Revalid".
A natural remedy that reduces the activity of 5-alpha reductase is the fruits of the dwarf palm. You can use the ready-made pharmaceutical preparation "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 you can supplement drug treatment with the use of herbal remedies containing natural estrogens. These are hop cones, clover leaves, sage leaves, pomegranates, apples, carrots. From them you can prepare masks forhair and decoctions for rinsing hair.
Among the reviews of folk remedies mentions the successful experience of treating baldness with linseed oil. It contains many vitamins that nourish and strengthen the 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 specialists about the effectiveness of the treatment of androgenetic alopecia with physiotherapeutic methods. Some trichologists believe that such procedures are ineffective, because after their cancellation, baldness returns. However, many doctors prescribe physiotherapy:
- Galvanization. This is an impact on areas of baldness with a weak electric current. It improves the blood supply to the follicle and normalizes the endocrine background.
- Electrophoresis. Under the influence of current, drugs are injected into the skin. Apply preparations with magnesium, zinc, aminophylline. They stimulate blood flow and prevent hair loss.
- Electrical stimulation. This method is the effect of direct 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 promotes the formation of new cells and improves blood circulation in areas of baldness. As a result, old hair stops falling out and new hair grows back.
- Darsonvalization. Special electrode (in the formcombs) are carried out on problem areas of the head. Exposure to alternating current improves the nutrition of hair follicles and blood circulation in areas of baldness.
Reviews on the treatment of androgenic alopecia with darsonvalization testify to the effectiveness of this method. After a course of therapy of 10-20 days, the hair stops falling out and begins to grow faster. However, all physiotherapeutic methods should be supplemented with medical treatment.
Cosmetology treatments
Cosmetological hair restoration procedures are part of a comprehensive treatment for baldness. The use of mesotherapy for androgenetic alopecia in women is very popular. Reviews speak of the high efficiency of this method. Injections of medicinal mixtures are injected into the scalp. They have a vasodilating effect, as a result, the nutrition of the follicle and blood microcirculation improves. After a series of such procedures, the normal life cycle of the hair is established.
Mesotherapy is also done with the help of a special roller. It is a roller with thin needles. This device is carried out over problem areas of the head, and then drugs are applied to the dermis. Microscopic punctures remain on the skin, through which medicinal substances penetrate.
One of the new methods of treatment is plasma therapy. The patient's own blood plasma is injected subcutaneously. This method helps to improve the condition of the hair follicles, and extend their life by about 2 years.
Also, Botox is used to combat baldness forhair. This drug is a tool that delivers beneficial substances to the hair root. Vitamins and proteins are retained in the follicle even when washing. In addition, Botox reduces the effect of androgens on the hair growth areas. However, not all cosmetologists consider this method to be effective enough. 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, hair follicles are transplanted from other parts of the head or body to areas of baldness. 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 areas are transplanted into areas of baldness. The operation is done on an outpatient basis under local anesthesia.
- FUE machine. A site with follicles is taken from the donor zones. It is cut into pieces for transplanting. In the area of baldness, punctures and incisions are made through which grafts are inserted. This operation is also done under local anesthesia.
- HFE method. This is the most minimally invasive and painless way. Hair follicles are taken from the donor area using special needles. At the same time, no incisions are made on the skin. The follicles are then injected with another needle into the areas of baldness. Today, this method is considered the most advanced hair transplant technique.
After transplantation, the follicles fully retain their functions, and the patient grows new oneshair. Surgical methods help patients restore their hair even in the most hopeless cases.
