Androgenic alopecia : understanding it to fight it better

What is androgenic alopecia ?

Androgenic alopecia, also known as hormonal baldness, is a natural phenomenon affecting the hair environment in both men and women. Although this condition mainly affects men, it can also affect women, and its causes are often linked to genetic and hormonal factors.

What causes androgenic alopecia in women ?

In women, androgenic alopecia may be due to physiological factors, but is often exacerbated by underlying illnesses. Hair loss can occur at different stages of a woman’s life, often after major hormonal events such as :

• Menopause
• Pregnancy
• Hormonal treatments

Understanding androgenic alopecia

Definition and prevalence

Androgenic alopecia is characterized by progressive hair loss, mainly on the crown of the head and temples. Unlike uniform hair loss, this condition manifests itself in specific areas of balding. In men, the signs usually appear in their thirties, while in women, symptoms can occur later in life.

Main causes

1. Hormonal factors: Excessive testosterone and other androgenic hormones play a crucial role in hair loss.
2. Genetic predisposition: Androgenetic alopecia is often inherited.
3. Use of hormonal contraceptives: The pill interferes with the body’s hormonal balance.

Differences between men and women

In women, hair loss due to androgenic alopecia is generally more gradual. Hair loss often begins after menopause and can vary with the seasons. Other aggravating factors include oral contraceptives, hormone replacement therapy, stress, and high cholesterol levels.

Biological mechanism of androgenic alopecia

Androgenic alopecia results from a complex interaction between androgen hormones and hair follicles.

Dihydrotestosterone (DHT), derived from testosterone, plays a central role by binding to hair root receptors and causing follicle miniaturization.

Contributing factors

Genetics and predisposition

Family history is a major factor. Genes can be inherited from either side of the family.

Hormonal influences

Male hormones (androgens)—especially DHT—play a key role. Some people have follicles that are overly sensitive to DHT.

What are the symptoms in women?

Initial symptoms

The first signs include thinning hair and a widening central parting. Women may also experience receding hairlines.

Other signs include acne, menstrual disorders, and excess hair growth, often linked to polycystic ovary syndrome.

Progression stages

Doctors use the Norwood-Hamilton scale (men) and the Ludwig pattern (women) to evaluate severity.

Therapeutic approaches

Medical treatments

1. Minoxidil: Stimulates hair growth.
2. Finasteride: Reduces DHT levels.
3. Dutasteride: Similar to finasteride, potentially stronger.

Surgical options

1. Hair transplant: Follicles are relocated from dense to thinning areas.
2. Scalp reduction: Removes bald areas and stretches hair-bearing zones.

Non-medical solutions

1. Wigs and hairpieces
2. Specialized cosmetics: Thickening powders, sprays, etc.
3. Micropigmentation
4. Hair supplements: e.g., DENSITIVE HAIR SERUM

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Psychological impact

Self-esteem and anxiety

Losing your hair can provoke emotional distress, affecting self-confidence and social wellbeing.

Support and adaptation

Support groups, counselling, and open conversations can help patients cope better.

Common myths about androgenic alopecia

Shampoos and hair care

Frequent shampooing does not cause hair loss.

Helmets and hats

Wearing hats or helmets does not cause androgenic alopecia and does not affect DHT.