Rare Hematology News

Disease Profile

Androgenetic alopecia

Prevalence
Prevalence estimates on Rare Medical Network websites are calculated based on data available from numerous sources, including US and European government statistics, the NIH, Orphanet, and published epidemiologic studies. Rare disease population data is recognized to be highly variable, and based on a wide variety of source data and methodologies, so the prevalence data on this site should be assumed to be estimated and cannot be considered to be absolutely correct.

Unknown

Age of onset

#N/A

ICD-10

#N/A

Inheritance

Autosomal dominant A pathogenic variant in only one gene copy in each cell is sufficient to cause an autosomal dominant disease

no.svg

Autosomal recessive Pathogenic variants in both copies of each gene of the chromosome are needed to cause an autosomal recessive disease and observe the mutant phenotype

no.svg

X-linked
dominant X-linked dominant inheritance, sometimes referred to as X-linked dominance, is a mode of genetic inheritance by which a dominant gene is carried on the X chromosome.

no.svg

X-linked
recessive Pathogenic variants in both copies of a gene on the X chromosome cause an X-linked recessive disorder

no.svg

Mitochondrial or multigenic Mitochondrial genetic disorders can be caused by changes (mutations) in either the mitochondrial DNA or nuclear DNA that lead to dysfunction of the mitochondria and inadequate production of energy.

no.svg

Multigenic or multifactor Inheritance involving many factors, of which at least one is genetic but none is of overwhelming importance, as in the causation of a disease by multiple genetic and environmental factors.

no.svg

Not applicable

no.svg

Other names (AKA)

Androgenic alopecia

Summary

Androgenetic alopecia is a common form of hair loss in both men and women. In men, hair is usually lost in a well-defined pattern, beginning above both temples and is usually referred to as male-pattern baldness. Over time, the hairline recedes to form a characteristic 'M' shape. Hair also thins near the top of the head, often progressing to partial or complete baldness. The pattern of hair loss in women differs from men (female pattern hair loss). In women, the hair becomes thinner all over the head, and the hairline does not recede. Androgenetic alopecia in women rarely leads to total baldness. A variety of genetic and environmental factors likely play a role in causing this condition. Mutations in the AR gene have also been associated with androgenetic alopecia.[1]

Symptoms

In addition to male-pattern baldness, androgenetic alopecia in men has been associated with several other medical conditions including coronary heart disease and enlargement of the prostate. Additionally, prostate cancer, disorders of insulin resistance (such as diabetes and obesity), and high blood pressure (hypertension) have been related to androgenetic alopecia in men. In women, androgenetic alopecia is associated with an increased risk of polycystic ovary syndrome (PCOS), which is characterized by a hormonal imbalance that can lead to irregular menstruation, acne, excess body hair (hirsutism), and weight gain.[1]

This table lists symptoms that people with this disease may have. For most diseases, symptoms will vary from person to person. People with the same disease may not have all the symptoms listed. This information comes from a database called the Human Phenotype Ontology (HPO) . The HPO collects information on symptoms that have been described in medical resources. The HPO is updated regularly. Use the HPO ID to access more in-depth information about a symptom.

Medical Terms Other Names
Learn More:
HPO ID
Percent of people who have these symptoms is not available through HPO
Alopecia
Hair loss
0001596
Sex-limited autosomal dominant
0001470

Treatment

Only 2 drugs currently have US Food and Drug Administration (FDA) approved indications for treatment of androgenetic alopecia:[2]

Minoxidil: Appears to lengthen the duration of the anagen phase (the active growth phase of hair follicles), and it may increase the blood supply to the follicle. Regrowth is better at the top of the head than in the front areas and is not noted for at least 4 months. It is used as a 2% or a 5% solution that rubs into the scalp and the 5% solution may work better. However, if the treatment is stopped the baldness returns. It works better in patients who just starting having the alopecia and who have small areas of hair loss.

Finasteride: It can only be used in men and is better for balding at the top of the head. If the treatment is stopped the baldness returns. It cannot be used in women who are still able to have children because it can result in ambiguous genitalia in male babies and it does not seem to be effective in women. The doses are about 1 mg daily by mouth.

Minoxidil use for several months can result in an eye condition known as central chorioretinopathy (an eye disease that lead to temporary visual impairment) , which can go back to normal after 1 months of not using the drug. Finasteride has no known side effects in men, according to several studies, but it cannot be used in women who are still trying to have children because it may produce fetal genital malformations.[2]

Every patient is unique and only the doctor can evaluate and determine the best treatment.

Some drugs that are not approved by the FDA but may be helpful are:[2][3]

Spironalactone: In women with androgenetic alopecia.
Oral contraceptives: In women.
Dutasteride: Is currently in study.
Topical latanoprost 0.1% is currently used to treat glaucoma and using it results in an increase of eyelashes. Some studies have shown that this medication could be useful for stimulating hair follicle activity and treating hair loss.
Follistatin, a human cell derived medication is also in study.

Also, low-level laser light therapy, a red light hairbrush–like device has shown some good results.

Surgical treatment of androgenetic alopecia has good cosmetic results. The main problem is covering the bald area with donor plugs (or follicles) sufficient in number to be effective. Micrografting produces a more natural appearance than the old technique of transplanting plugs.

It is important for the patients with androgenetic alopecia to be evaluated for treatable causes of “telogen effluvium” (diffuse hair shedding, often starting suddenly) like anemia or hypothyroidism, especially in patients who had a rapid progress of their disease or a sudden start of the disease. The following treatment options are recommended for women by some experts:[2]

Spironolactone and cyproterone acetate
Finasteride
Minoxidil.

These treatments are most effective when started early.

Organizations

Support and advocacy groups can help you connect with other patients and families, and they can provide valuable services. Many develop patient-centered information and are the driving force behind research for better treatments and possible cures. They can direct you to research, resources, and services. Many organizations also have experts who serve as medical advisors or provide lists of doctors/clinics. Visit the group’s website or contact them to learn about the services they offer. Inclusion on this list is not an endorsement by GARD.

Organizations Supporting this Disease

    Learn more

    These resources provide more information about this condition or associated symptoms. The in-depth resources contain medical and scientific language that may be hard to understand. You may want to review these resources with a medical professional.

    Where to Start

    • MedlinePlus was designed by the National Library of Medicine to help you research your health questions, and it provides more information about this topic.
    • Genetics Home Reference (GHR) contains information on Androgenetic alopecia. This website is maintained by the National Library of Medicine.
    • The Merck Manuals Online Medical Library provides information on this condition for patients and caregivers.

      In-Depth Information

      • Medscape Reference provides information on this topic. You may need to register to view the medical textbook, but registration is free.
      • Online Mendelian Inheritance in Man (OMIM) is a catalog of human genes and genetic disorders. Each entry has a summary of related medical articles. It is meant for health care professionals and researchers. OMIM is maintained by Johns Hopkins University School of Medicine. 

        References

        1. Androgenetic alopecia. Genetics Home Reference. May 2006; https://ghr.nlm.nih.gov/condition/androgenetic-alopecia. Accessed 8/19/2011.
        2. Schwartz R A. Anagen Effluvium. Medscape Reference. October 6, 2014; https://emedicine.medscape.com/article/1073488-overview. Accessed 4/27/2015.
        3. Harcha G & cols. A randomized, activeand placebo-controlled study of the efficacy and safety of different doses of dutasteride versus placebo and finasteride in the treatment of male subjects with androgenetic alopecia. J Am Acad Dermatol.. March, 2014; 70(3):489-498. https://www.ncbi.nlm.nih.gov/pubmed/24411083. Accessed 4/27/2015.

        Rare Hematology News