Androgenic alopecia has a pattern, that is, something that characterizes it, defines it and differentiates it from the rest, and that is the fact that it only affects the top of the head.
It always respects the side and back hair (nape of the neck). This hair never falls, because the roots of these hairs that we call follicles are genetically prepared not to respond to male hormonal action (androgens), which are the real responsible for the fall. That is, they are like plants that are genetically prepared not to die, therefore, when we talk about performing a hair micrografting, the basis of this procedure is to take these roots genetically prepared not to die and transplant them to the depopulated areas of the head, because it is not about the area, but the genetic code of the root.
Those on the top of the head are ready to fall out, while those on the sides and back of the head are ready to never die.
Is androgenic alopecia in women reversible with any treatment?
Androgenic alopecia, both in women and men, has no cure. It is a chronic progressive disease. In the case of women, it appears with greater relevance in the post-menopause, caused by the sudden drop in estrogen production. Therefore, as the years go by, the disorder will worsen.
Nowadays, we can stabilize the degree of female baldness with very effective medical treatments and, in the case of absence of hair, combine it with a hair microtransplant.
What causes androgenic alopecia and is it only caused by genetic factors?
Androgenic alopecia, as its name suggests, is a hair loss of hormonal and hereditary origin. That is, it is produced by male hormonal action (androgens, of which the best known is testosterone) in a genetically predisposed patient. It is important to say that it is not merely a hormonal issue, but in those who have a hereditary predisposition, because following the first criterion all men would be bald.
Is there a difference between men and women?
In 70% of men, androgenic alopecia follows a pattern established in Hamilton Norwood’s classification of the sixties, which establishes 7 degrees or stages based on the evolutionary form of this type of baldness, independent of age. This can occur at 20, 30, 40 or 50 years of age; it is simply evolution.
Baldness begins with pronounced receding hairline at the front of the head until the middle evolutionary stage when an islet begins to appear at the crown of the head. From the swirl (which we all have), it begins to open like a flower and has a centrifugal growth (from the center outward), so the crown begins to enlarge until there is a bridge of hair that separates two unpopulated islands. This bridge is then broken, leaving a high horseshoe shape, which continues to descend until it reaches the terminal stages (6 and 7) where there is always lateral and posterior hair.
In women, although baldness affects only the upper part of the head, as in men, it has a different evolution, since women do not have receding hairline or crown, but lose it in a diffuse form (diffuse androgenic alopecia), according to Ludwig’s classification with 3 degrees: mild requiring medical treatment, moderate requiring both treatments and severe with almost total lack of hair in the upper part and requiring a hair microtransplant.
Can this type of alopecia be prevented?
As I said before, it is a baldness that combines two factors: hormonal and hereditary.
In the case of men, it usually appears incipiently at an early age, around 20 years old, so if there are hereditary antecedents, it would be convenient to consult with a specialist and start with a medical treatment to stop the baldness advance.
In the case of women, although some signs may appear in the fertile age of life, it becomes more evident or worsens after menopause, so, if there is a hereditary background, it would be advisable to start with medical treatment to achieve a stabilization of baldness and, in some cases, put hair where it is missing from a hair micro-graft.
What is the most effective treatment for androgenic alopecia?
In the initial processes of baldness or in young people, where surgery is not yet indicated, a treatment with finasteride, minoxidil and hair mesotherapy, provides very satisfactory results.
In more advanced cases and middle-aged people may require a combined treatment, that is to say, to put hair by means of a hair transplant in depopulated areas of the head and to maintain the persistent hair with medical treatment.
In the elderly or in terminal cases, the only solution is surgery, because the process will no longer progress, because age means that hormone production has already decreased or, because it is a maximum degree of baldness, it does not make sense to perform medical treatment.