Androgenetic Alopecia (Male and Female Pattern Baldness)

Figure 1

Etiology: Heredity (polygenic); androgen stimulation

Physical: Different pattern for men and women; men—temporal areas affected, progressing to vertex; females—diffuse pattern.

DDx: Alopecia areata, anagen/telogen effluvium

Investigations: ferritin, TSH, androgen profile (if suspicious of virilization).

Management

• Topical minoxidil lotion (Rogaine®; 2% or 5%) use daily to stabilize hair loss and regrowth in some cases.
• Finasteride (Propecia®) 1 mg po qd in men (inhibits synthesis of dihydrotestosterone).
• Spironolactone 100-200 mg po daily in women.
• Hair transplantation (from occipital scalp).
• Hair prosthesis (wig).