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 Table of Contents  
Year : 2022  |  Volume : 6  |  Issue : 2  |  Page : 61-62

Androgenetic alopecia

Department of Dermatology, Government Medical College, Thrissur, Kerala, India

Date of Submission14-Apr-2021
Date of Decision12-Jul-2021
Date of Acceptance04-Oct-2021
Date of Web Publication26-Aug-2022

Correspondence Address:
Ajithkumar Kidangazhiathmana
Department of Dermatology, Government Medical College, Thrissur, Kerala
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/cdr.cdr_30_21

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How to cite this article:
Kidangazhiathmana A. Androgenetic alopecia. Clin Dermatol Rev 2022;6:61-2

How to cite this URL:
Kidangazhiathmana A. Androgenetic alopecia. Clin Dermatol Rev [serial online] 2022 [cited 2022 Dec 3];6:61-2. Available from: https://www.cdriadvlkn.org/text.asp?2022/6/2/61/354751

Androgenetic alopecia (AGA) is a common (physiological) condition manifested in men across the globe. Even though it has affected many world-famous and successful personalities including Socrates, Aristotle, Hippocrates, Julius Caesar, Napoleon, Shakespeare, Darwin, Churchill, Mahatma Gandhi, Vladimir Lenin, and Rupert Murdoch among numerous others, it continues to affect the self-image and quality of life of affected individuals significantly. From time immemorial to the new age, there is growing emphasis on looking good by having scalp full of hair and resultant self-esteem of the person. The proportion of men with hair loss increases with increasing age, ranging from 30% of men of 25 years of age to 53% of men 40–49.[1],[2] The incidence and severity of AGA are higher in Caucasian men, and it occurs later in them than Mongolian men. Oriental, Native American and African-American men manifest less extensive and later-onset baldness than Caucasians.[3] Despite this high incidence, it is considered a “disease” by most.

General and specialist dermatologists like trichologists, cosmetologists, and cosmetic surgeons regularly encounter patients with this condition. Hair is an essential part of an individual's self-image, and it is significantly related to socialization.[3]

Although the negative impact of AGA is often trivialized by unaffected people, studies show that balding men are underrepresented even in high elective offices.[4],[5] A study has shown high psychological morbidity in the form of anxiety and depression in patients with androgenetic alopecia, who often adopt avoidant coping strategies in many.[6] At the same time, it is important to note that majority of affected men cope well with AGA, without significant impact on their psychosocial functioning.[3]

Although various studies have suggested an association between AGA and cardiovascular diseases, benign prostatic hypertrophy, and prostatic malignancy, the only association that has been proven by meta-analysis is between prostate cancer and vertex baldness.[7],[8],[9],[10],[11] There appears to be no clear evidence of a link between cardiovascular diseases and AGA.

There are only a few reviews on AGA from India in recent years, and in this issue of the journal, we have included four articles on AGA. We have attempted to provide an update on various aspects of this common condition.

The etiology and pathogenesis of AGA are being investigated for many centuries. Aristotle considered that it was caused by sex. Ancient Romans blamed the heavy metal helmets worn by soldiers to cause baldness. Later, theories included even dryness of the brain and microbial infection. Now, we have clearer ideas about the cause and pathogenesis of this disease. Ajithkumar and Parvathy Santhosh discuss the pathogenesis of AGA in this issue.

Although a common condition, AGA manifests and behaves differently in different people. Research and management of AGA demands an objective description of the condition. Aseem Sarma writes about the clinical features of AGA, and the different classifications of this condition. An Old Malayalam proverb says there is no treatment for baldness and jealousy. The search for curing baldness dates back to 5000 years when Egyptians tried a concoction of burned prickles of a hedgehog immersed in oil with honey, alabaster, red ochre, and fingernail scrapings.[12] AGA continues to attract a great deal of research on treatment. Over the years, men have used various agents to grow hair. It is said that the money spent yearly all over the world on AGA is more than that spent on malaria and the budget of some countries.[13] Currently, evidence-based modalities like antiandrogens, minoxidil, platelet-rich plasma, and surgical measures like hair transplant are commonly available, though a reversal of this condition remains a distant dream. Feroz Kalliadan and Muhammed Razmi are giving a detailed update on the current treatment modalities for AGA in the current issue of the journal.

We hope this symposium will be of help for the readers to update themselves with the current knowledge on AGA.

  References Top

Rhodes T, Girman CJ, Savin RC, Kaufman KD, Guo S, Lilly FR, et al. Prevalence of male pattern hair loss in 18-49 year old men. Dermatol Surg 1998;24:1330-2.  Back to cited text no. 1
Avital YS, Morvay M, Gaaland M, Kemény L. Study of the international epidemiology of androgenetic alopecia in young Caucasian men using photographs from the internet. Indian J Dermatol 2015;60:419.  Back to cited text no. 2
[PUBMED]  [Full text]  
Male Androgenetic Alopecia-Endotext-NCBI Bookshelf. Available from: https://www.ncbi.nlm.nih.gov/books/NBK278957/. [Last accessed on 2021 Apr 03].  Back to cited text no. 3
Passchier J. Quality of life issues in male pattern hair loss. Dermatology 1998;197:217-8.  Back to cited text no. 4
Sigelman L, Dawson E, Nitz M, Whicker ML. Hair loss and electability: The bald truth. J Nonverbal Behav 1990;14:269-83.  Back to cited text no. 5
Tabolli S, Sampogna F, Di Pietro C, Mannooranparampil TJ, Ribuffo M, Abeni D. Health status, coping strategies, and alexithymia in subjects with androgenetic alopecia: A questionnaire study. Am J Clin Dermatol 2013;14:139-45.  Back to cited text no. 6
Demark-Wahnefried W, Schildkraut JM, Thompson D, Lesko SM, McIntyre L, Schwingl P, et al. Early onset baldness and prostate cancer risk. Cancer Epidemiol Biomarkers Prev 2000;9:325-8.  Back to cited text no. 7
Ramsamy K, Subramaniyan R, Patra AK. An observational study of the association between androgenetic alopecia and size of the prostate. Int J Trichol 2016;8:62-6.  Back to cited text no. 8
[PUBMED]  [Full text]  
Liang W, Song L, Peng Z, et al. Possible association between androgenic alopecia and risk of prostate cancer and testicular germ cell tumor: a systematic review and meta-analysis. BMC Cancer 18, 279 (2018). https://doi.org/10.1186/s12885-018-4194-z.  Back to cited text no. 9
Androgenetic Alopecia and Prostate Cancer: Findings from an Australian Case-Control Study-PubMed. Available from: https://pubmed.ncbi.nlm.nih.gov/12050096/. [Last accessed on 2021 Apr 03].  Back to cited text no. 10
He H, Xie B, Xie L. Male pattern baldness and incidence of prostate cancer A systematic review and meta-analysis. In: Medicine. Vol. 97. United States: Lippincott Williams and Wilkins; 2018.  Back to cited text no. 11
The Benefits of Going Bald-BBC Future. Available from: https://www.bbc.com/future/article/20160921-the-benefits-of-going-bald. [Last accessed on 2021 Mar 31].  Back to cited text no. 12
Bill Gates: Why do We Care More about Baldness than Malaria? | The Independent | The Independent. Available from: https://www.independent.co.uk/news/world/americas/bill-gates-why-do-we-care-more-about-baldness-malaria-8536988.html. [Last accessed on 2021 Apr 02].  Back to cited text no. 13


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