Understanding Androgenic Alopecia
by Trichologist, Dr. Kari Williams
If your grandmother, grandfather, mother or father experienced hair loss, this may be an ominous prediction that you will also experience the same kind of hair loss. This hereditary condition is most commonly known as Male- or Female patterned baldness (Androgenic Alopecia). In this pattern of hair loss, the hair becomes thinner and thinner, and then ceases to grow establishing baldness. For women, this process does not start until after the age of 20, but in most cases may start only after menopause.
While the main cause of hair loss in androgenic alopecia is testosterone, the main culprit is DHT (dihydrotestosterone). DHT is created through a hormonal process where testosterone binds to enzymes located in the follicle’s oil glands. DHT shrinks follicles making it impossible for hair to grow.
Women have a small fraction of testosterone compared to men, but even small amounts can trigger the affects of DHT, especially if hereditary factors are involved. When the levels of androgen hormones rise in women, DHT becomes a bigger problem. This normally happens after menopause because women’s hormones drop sharply during menopause and beyond. As a result, the female hormones are no longer suppressing androgenic activity and this imbalance causes problems, such as hair loss. Other factors tied to hormones may contribute to this type of hair loss including ovarian cysts and taking a high androgen index birth control pill.
During the first stage of androgenic alopecia, the hair becomes progressively thinner, finer and shorter and there is widespread diffuse thinning of the hair. The second stage of the alopecia produces a patch of hair loss in the crown of the head. After this stage, the area of hair loss will increase until only a fringe of hair remains around the perimeter of the scalp. The second stage of androgenic alopecia is more characteristic of what happens in men, although some women experience this pattern of hair loss as well.
Although there is no known remedy for androgenic alopecia at the present time, the topical application of minoxidil has proven to stimulate hair growth in some patients. This particular treatment must be used continuously to see lasting results. It is important that you confirm the diagnosis of your hair loss before attempting any treatments to remedy the problem. A dermatologist can perform a scalp biopsy to confirm androgenic alopecia. Blood tests will also reveal if there is an imbalance of your hormones.