Androgenic Alopecia

Androgenic alopecia aka “genetic hair loss,” predominantly affects men between the late teenage years and late 40s, and women around age 50 or later; however, can occur in both genders at any time post-puberty. Over time, the conversion of healthy terminal hair follicles into nonpigmented vellus follicles will take place. Eventually, if the cause of the destruction is not identified, and treated diffuse alopecia areata (shiny bald section) will be permanent. Onset is usually gradual and progresses with triggers.

DIAGNOSIS

Patients often have a familial history of baldness, and the severity is highly correlated. Other causes can progress the rate of loss, and a complete history and physical exam along with bloodwork should be conducted if secondary causes are speculated. A biopsy may be indicated if an identifiable cause is not found. For example, the following labs should be drawn if suspected:

• Dehydroepiandrosterone (DHEA)-sulfate and testosterone analysis: In women, if virilization is evident
• Iron, total iron-binding capacity, and transferrin saturation: To test for iron deficiency, if telogen effluvium is present
• Thyrotropin level: If a thyroid disorder is suspected