HEREDITARY HAIR LOSS

Androgenetic alopecia

Androgenetic alopecia is hereditary hair loss in which the hair gradually thins.

Read how to recognize this form in men and women and what role hereditary predisposition and sensitivity to DHT play.

Written by the TRIX Basic team

Medically reviewed by Prof. dr. Sherief Janmohamed · Dermatologist

Photo: Androgenetic alopecia

Briefly summarized

  • Androgenetic alopecia is the most common form of hereditary hair loss.
  • Hereditary predisposition and sensitivity to DHT cause hair to gradually become thinner and shorter.
  • In men, receding hairline and thinning on the crown often occur; in women, the parting usually widens.
  • The process is generally gradual and may increase further over time.
Illustration: What happens with androgenetic alopecia?

MEDICALLY EXPLAINED

What happens with androgenetic alopecia?

In androgenetic alopecia, hair follicles in certain areas of the scalp are genetically sensitive to dihydrotestosterone (DHT). As a result, the hair growth phase gradually becomes shorter.

New hairs grow back increasingly thinner and shorter. This process is called miniaturisation and causes hair density to slowly decrease. The hair follicles initially remain present, but produce fewer and fewer visible hairs.

 Read about follicular miniaturisation

RECOGNIZABLE PATTERNS

How does androgenetic alopecia differ in men and women?

  • In men: the hairline often recedes at the temples, creating a receding hairline. Later, the crown may also become thinner. The areas may gradually spread toward each other.
  • In women: the centre part usually becomes wider, and the hair on top of the head gradually loses density. The front hairline is often largely preserved.
Photo: How does androgenetic alopecia differ in men and women?
Illustration: What role do genetic predisposition and DHT play?

CAUSE AND MECHANISM

What role do genetic predisposition and DHT play?

DHT is produced when the enzyme 5-alpha-reductase converts testosterone into dihydrotestosterone. DHT occurs naturally in the body and does not cause hair loss in everyone.

In people with a hereditary sensitivity, certain hair follicles react more strongly to DHT. This shortens the growth phase and accelerates miniaturisation. A family history of hair loss increases the likelihood of AGA, but does not accurately predict when it will develop or how severe it will be.

 Read about 5-alpha-reductase

GRADUAL PROGRESSION

How does hereditary hair loss progress?

Androgenetic alopecia usually develops slowly. There is not always a sudden increase in hair loss; often, the hair gradually becomes finer and the visible hair density decreases.

The first changes may include deeper receding temples, a thinner crown, or a widening part. The rate varies from person to person. The process may appear stable for a while and later become more noticeable again.
Photo: How does hereditary hair loss progress?
What support is available for androgenetic alopecia?

POSSIBLE APPROACH

What support is available for androgenetic alopecia?

The right approach depends on the pattern, progression and your personal situation. Minoxidil may support hair growth in some people and help slow further thinning. It must be used consistently to maintain the effect.

For men, a doctor may also discuss medication that reduces the influence of DHT. These medicines are not suitable for everyone and may have side effects. Food supplements do not treat the hereditary cause, but may support the normal condition of the hair when relevant nutrients are insufficient.

If you are unsure, first have an assessment to establish whether it is androgenetic alopecia.

Do you use minoxidil? Read about temporary initial shedding with minoxidil and possible side effects of minoxidil.

Important to know

Androgenetic alopecia usually progresses gradually. Sudden, patchy, or rapidly increasing hair loss may be consistent with another cause. Have the hair loss professionally assessed if the pattern is unclear or if you also experience itching, redness, flakes, or a burning sensation.

Read more about hair loss

Illustration: What is DHT?

HORMONES AND HAIR LOSS

What is DHT?

Learn how DHT is produced, why certain hair follicles are sensitive to it, and what role the hormone plays in hereditary hair loss.

 Read more →
Photo: Hair loss in men

Hair loss in men

Hair loss in men

Learn which types of hair loss occur in men, how to distinguish recognizable patterns, and when professional assessment is advisable.

 Read more →
Photo: Hair loss in women

Hair loss in women

Hair loss in women

Learn which forms of hair loss occur in women, how to recognise changes in your parting and hair density, and which causes may play a role.

 Read more →

Questions about androgenetic alopecia

Is androgenetic alopecia always hereditary?

Genetic predisposition plays an important role, but the pattern is not determined by a single gene. Predisposition can be inherited from both the father and the mother. Hair loss in the family increases the likelihood of androgenetic alopecia, but does not precisely predict when it will develop or how severe it will become.
Does androgenetic alopecia also occur in women?

Yes. In women, the central parting usually gradually widens, and hair density decreases on top of the head. The front hairline often remains largely intact. In men, receding temples and thinning at the crown are more common.
Is androgenetic alopecia permanent?

Androgenetic alopecia is a chronic process that usually progresses gradually without treatment. Early recognition can be important, as support generally has a better chance of helping while the hair follicles are still present. The outcome and progression vary from person to person.
What role does DHT play in androgenetic alopecia?

DHT is a hormone produced from testosterone. In people with an inherited sensitivity, certain hair follicles react more strongly to DHT. As a result, the hair’s growth phase becomes shorter, and new hairs gradually grow back thinner and shorter.
Can minoxidil help with androgenetic alopecia?

Minoxidil may support hair growth in some people and help slow further thinning. The effect varies from person to person and usually only becomes visible after several months. To maintain the results achieved, minoxidil must be used consistently and long term.
When is a professional assessment advisable?

Have hair loss assessed when it develops quickly, clearly increases, occurs in patches, or is accompanied by itching, redness, flaking, or a burning sensation. Assessment is also advisable when the pattern is unclear or before starting treatment. For a medical assessment, you can request a hair consultation at Intermedica Hair Clinic.

Sources and medical background

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