Pattern Hair Loss: Causes, Treatments, and Solutions for Androgenetic Alopecia in NYC
Androgenetic Alopecia affects up to 50% of men and women. However, some people may not be familiar with the diagnosis, causes, and available treatment options.
What Is Androgenetic Alopecia?
Androgenetic alopecia is a hair loss condition in men and women that gradually worsens. Many patients have parents with similar condition, but it is not always a case. The primary symptoms are hair loss, thinning, or balding on the scalp.
Androgenetic alopecia in women, also known as female pattern hair loss, often begins with thinning hair at the crown. Women may begin noticing that the hairline at the top of their heads is becoming wider.
Most women notice thinning hair in their 40s or 50s. They usually do not see big changes in their frontal hairline. However, the thinning may slowly spread to all areas of the scalp.
Male pattern hair loss presents differently and can start earlier, around their 20s or 30s. Most men notice a slowly receding frontal hairline or a growing bald spot on the crown. Thinning may begin around the temple areas, and the hairline may develop an “M” shape. Eventually, the frontal hairline moves further up the scalp. In other men, a bald spot grows to encompass most or the entire top of the head. The exact pattern and severity of hair loss vary.
Androgenetic alopecia is not the same as temporary hair loss (telogen effluvium). Stress, various diseases and disorders, certain medications like blood thinners, and medical treatments like chemotherapy can cause temporary hair loss. However, hair growth returns to normal after these medications and treatments in most of these cases. A dermatologist can accurately diagnose between temporary hair loss diagnosis and androgenetic alopecia with a physical exam and medical history questions.
What Causes Androgenetic Alopecia?
People with androgenetic alopecia produce higher levels of Dihydrotestosterone (DHT), an active male sex hormone (androgen) formed from testosterone. DHT shrinks hair follicles, limiting the ability to grow new hair. Eventually, this prevents the body from replacing lost hair.
Androgenetic Alopecia is not a male-specific diagnosis as both men and women have testosterone, just at different levels. Therefore, an excess response to higher levels of DHT can lead to this hair loss disorder in men and women.
How Is Androgenetic Alopecia Diagnosed?
Dermatologists diagnose androgenetic alopecia by conducting a physical exam while taking a thorough family and medical history. Typical questions may include:
When did you start noticing the hair loss?
Does anyone in your family have hair loss?
Did the hair loss happen suddenly or gradually?
Are you currently taking any medications or supplements?
Dermatologists may order blood tests or biopsies to rule out temporary hair loss diagnoses. They may also use a noninvasive method of imaging the scalp and hair known as trichoscopy to help confirm a diagnosis.
Are There Available Treatments for Androgenetic Alopecia?
Dermatology Circle offers many safe and painless treatment options for androgenetic alopecia. Medications and in-office procedures can limit hair loss, boost hair health, and encourage new growth.
Minoxidil
Commonly known as Rogaine, minoxidil is a topical treatment with a long record of safety and success. The medication comes as a foam that patients apply directly to their balding area. It works by stimulating hair follicles to encourage new growth and prolong the growing phase of the hair (anagen phase). Food and Drug Administration (FDA) approved topical Minoxidil for male and female pattern hair loss.
Minoxidil generally takes three to six months before hair growth is noticed. After that, patients must continue to use it every day to deter further hair loss.
Studies show that minoxidil rarely causes side effects, but it can lead to irritant dermatitis with itching or scaling. Newer data suggested that low dosages of Minoxidil can be taken orally.
Finasteride
Also known as Proscar or Propecia, finasteride is a pill that patients take daily and works by lowering DHT levels in the body. The FDA approves it for male pattern alopecia, but doctors may use it in females in certain situations. Most patients report improved hair growth after about four months of use. Patients must continue taking finasteride to maintain the results.
Side effects rarely occur while using finasteride. The medication may cause a loss of libido, gynecomastia (swelling of breast tissue in men), and orthostatic hypotension (low blood pressure when standing after sitting or lying down).
Dutasteride
Dutasteride (also known as Avodart) is approved for men and works by lowering DHT levels. Studies have shown that it produces slightly better results than finasteride with comparable side effects.
Spironolactone
For women with pattern hair loss, especially those with polycystic ovary syndrome (PCOS), spironolactone can be an effective treatment. PCOS is a hormonal disorder. It often causes an imbalance in androgens, which are male hormones. This imbalance can lead to symptoms like hair thinning and loss.
Spironolactone is a diuretic that is primarily used to treat conditions such as high blood pressure and fluid retention. However, it also possesses anti-androgenic properties, meaning it can inhibit the effects of androgens like testosterone. High levels of testosterone in women can cause more hair loss on the scalp. It can also lead to other issues like acne and unwanted hair growth, known as hirsutism.
By blocking the action of testosterone, spironolactone helps to prevent the miniaturization of hair follicles, a process that is often accelerated by androgens. This can lead to a stabilization of hair loss and, in some cases, even promote regrowth in areas where hair has thinned.
Platelet-Rich Plasma Injections
Platelet-rich plasma (PRP) injections are a safe and effective treatment option for androgenetic alopecia in both men and women. Treatment generally requires monthly injections at first. After the initial phase, patients switch to a lighter schedule of several injections per year.
PRP injections use patients’ blood cells for treatment. Dermatologists order the removal of a small amount of blood, using a centrifuge to separate blood elements and concentrate the platelets.
Patients then receive platelet injections into their scalps. The platelets release multiple growth factors that increase the production of hair follicles.
Laser Therapy and Low-Level Lasers
Laser therapy shows great potential as a treatment for patterned hair loss. This method works by stimulating the scalp and hair follicles using laser light, which promotes regeneration. Following this, different serums containing growth factors or exosomes can be applied. At present, fractional lasers, which lightly ablate the skin, are commonly utilized for stimulating the scalp and hair, including types such as erbium and thulium lasers.
For a long time, dermatologists have used low-intensity lasers. These lasers help hair follicles and weak cells grow new hair. This method is non-intrusive, devoid of pain, and has no recognized adverse effects. There are both home-use caps and helmets, as well as in-clinic procedures available.
Microneedling
Microneedling encourages collagen formation and growth factor production in the treated areas. Studies show it works best when combined with other treatments like minoxidil or PRP injections. After applying a topical anesthetic, dermatologists use fine needles to puncture the scalp’s outer layer gently. Side effects can include bruising or swelling of the treated areas, but this usually subsides within a few days.
Hair Transplant
Hair transplants can serve as a viable solution for androgenetic alopecia. Hair follicles are harvested from the rear of the scalp (donor area) and relocated to the balding regions. While some of the relocated hairs may shed within a few months, the remaining follicles start to sprout new hair soon after. Using hair transplant methods with treatments like minoxidil can lead to better results.
How Do You Approach Pattern Hair Loss?
At our clinic, we dedicate time to address the concerns of our patients and offer comprehensive clinical consultations and scalp analysis. During these consultations, we evaluate your overall health, and current medications, and identify potential causes of hair loss. We utilize digital trichoscopy and conduct a scalp analysis as part of our clinical examination.
If required, we can perform a scalp biopsy, although this test is not necessary for all patients. We provide a variety of treatments for different types of hair loss, ensuring the best possible results.
In our approach, we always start with FDA-approved medications first. These medications follow international care standards and are known to produce excellent results.
For patients seeking an integrative approach, we offer a range of methods to stimulate hair growth. These include PRP injections, microneedling with growth factors and exosomes, or Keralase fractional laser treatment.
Pattern Hair Loss FAQ
No, pattern hair loss cannot be fully reversed or completely stopped. However, the progression of hair loss can often be slowed down with medications. Treatments like minoxidil (topical) and finasteride (oral) are commonly prescribed to help reduce hair loss and promote some regrowth. Minoxidil increases blood flow to hair follicles, while finasteride reduces a hormone responsible for shrinking hair follicles.
While these treatments can slow the hair loss process, they require consistent use and take time to show results. Early intervention is crucial because once hair follicles are dormant or inactive, they cannot be restored. Keep in mind that these treatments are meant to manage, rather than cure, pattern hair loss.
Yes and no. Stress itself doesn’t directly cause pattern hair loss, but it can contribute to a temporary condition called telogen effluvium (TE), which leads to increased shedding. TE occurs when a stressful event or period pushes more hair follicles into the resting phase, leading to noticeable shedding. This type of hair loss is typically temporary and resolves once the stressor is removed.
However, for individuals with pattern hair loss, TE can worsen the appearance of thinning or shedding, as it adds to the existing loss. In these cases, it may look like pattern hair loss is rapidly progressing, but the TE shedding is usually reversible once the stress is managed.
Yes, pattern hair loss can indeed cause shedding. This chronic condition typically follows a progressive pattern, which means that hair shedding can fluctuate over time. People with pattern hair loss may experience periods when the shedding seems more noticeable, followed by times when the shedding lessens or even stabilizes. TE episodes should be ruled out if shedding dramatically worsens.
Such fluctuations are typical with pattern hair loss, and external factors like stress, changes in diet, or other health conditions can influence the amount of shedding as well. Effective management with the right treatments can help minimize the shedding and prolong the health of existing hair.
Pattern hair loss and alopecia areata are two distinct types of hair loss with different characteristics. Pattern hair loss (androgenetic alopecia) typically results in gradual thinning at the top of the head or a receding hairline, and it progresses over time.
In contrast, alopecia areata is an autoimmune disorder that leads to sudden, patchy hair loss in small circular areas. There is also a rare, diffuse form of alopecia areata that can cause generalized shedding across the scalp. This form of alopecia areata can sometimes be difficult to differentiate from pattern hair loss due to similar symptoms, but it’s uncommon. Diagnosis of alopecia areata may involve a careful examination and, in some cases, a biopsy to confirm.
While both pattern hair loss and TE can involve shedding, they have key differences. Pattern hair loss is a chronic condition associated with genetics and hormones that progressively worsen over time. TE, on the other hand, is usually a temporary condition triggered by stress, illness, or a major life change, and it can lead to increased shedding across the scalp.
In cases of TE, the hair typically regrows once the underlying cause is resolved. Chronic TE, while rarer, can occur and may require further investigation. Blood work, a comprehensive history, and a scalp examination are important to accurately differentiate these conditions and to rule out any underlying factors.
It is still possible to have pattern hair loss even if there is no clear family history. Although pattern hair loss is often hereditary, other factors, such as lifestyle, health conditions, or hormonal changes, can play a role. For instance, in women, hormonal imbalances related to conditions like polycystic ovary syndrome (PCOS) can contribute to pattern hair loss.
Genetic predispositions can vary widely, and sometimes traits skip generations. Each individual’s genetics are unique, which means that even if family members don’t exhibit hair loss, it may still manifest in others.
Natural remedies can complement the treatment of pattern hair loss, but it’s important to understand that they are generally not a replacement for medical treatments, especially in moderate to severe cases. Supplements like saw palmetto or regenerative treatments such as lasers, microneedling, or PRP injections, can promote scalp health. There are many new treatments with peptides, amino acids, growth factors, and exosomes are currently under development.
While these natural options may help to support overall hair and scalp health, they are unlikely to halt the progression of pattern hair loss entirely. A comprehensive approach, often including medical treatments alongside lifestyle and natural remedies, is generally the most effective.
Yes, because pattern hair loss is a progressive condition, continued treatment is usually necessary to maintain the results. Hair loss can progress with age, and any break from treatment (such as during pregnancy, breastfeeding, or illness) may result in the resumption of hair loss.
That said, temporary pauses in treatment are sometimes needed due to specific life events (pregnancy, breastfeeding, etc) or medical conditions, but ideally, treatment should be resumed afterward to continue managing the condition effectively.
No, stopping medications will not directly make your hair worse than before, but you will lose the benefits of treatment. Since pattern hair loss is a progressive condition, hair thinning will continue naturally, and with age, you may notice more thinning than you had before treatment.
It’s also important to understand that the progression of pattern hair loss varies from person to person, and the natural aging process can make hair appear thinner over time regardless.
A hair transplant can help by redistributing healthy hair follicles to areas with noticeable thinning. However, it’s important to recognize that hair transplantation addresses existing bald areas and doesn’t stop the progression of pattern hair loss in other parts of the scalp.
Since pattern hair loss is a chronic and ongoing condition, it’s often advisable to develop a long-term plan that includes both medical and surgical treatments. Combining these approaches can help maintain results and manage future thinning.
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