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What is it androgenetic or hereditary alopecia?

Androgenetic or hereditary alopecia is hair loss due to genetic factors that cause the follicles of the scalp to respond anomalously to the action of testosterone, resulting in a process of miniaturization of the follicle. It’s the most common type of alopecia in men. Usually appears, especially, from the age of 17-18 years in both men and women.

Who does it affect?

Androgenetic or hereditary alopecia implies both men and women, although mostly affects the male sex and less to female for the protection of female hormones. It affects in a more or less important way in 7 of every 10 men older than 21 years and in 4 of every 10 women from the menopause.


We can differentiate between:

  • Male androgenetic alopecia: is characterized by the gradual fall of hair that usually begins by the temples and the crown.
  • Female androgenetic alopecia: It doesn’t manifest as a fall, but in the loss of density and in the appearance of clear areas, particularly in the upper part of the head and mostly after entry into childbearing age.


In men, the first symptom that is detected is the appearance of so-called “receding hairline”. This loss can be maintained for years either advancing in the form of M at the front or starting at the top, especially after 40 years. The Hamilton-Norwood scale is used to classify and determine the intensity of this type of alopecia in men.


Evolution of male hereditary androgenetic hair loss. Dr. López Gil, Barcelona dermatology clinic, Teknon.

In female androgenetic alopecia no hair loss is detected but a loss of density and appearance of thin areas especially in the upper part of the head. Female baldness is not frequent since in this case the hair follicles continue to grow the hair although in less quantity and thinner. In this case the Ludwig scale is used to determine in which stage the patient is and decide the most appropriate treatment for the patient.


Evolution of female hereditary androgenetic hair loss. Dr. López Gil, Barcelona dermatology clinic, Teknon.


Both men and women share the causes that give rise to hereditary alopecia:

  • Genetic factors : especially in men
  • Hormones:
    • Mens: The enzyme 5a-reductase converts testosterone to dihydrotestosterone which is responsible for decreasing the number of hair follicles, making hair thinner and lighter until it disappears.
    • Women: the loss of hair density in the area is caused by the degradation of the hair follicles, particularly after the advent of menopause as a consequence of a higher presence of certain male hormones, such as testosterone, androsterone and dihydrotestosterone.
  • Aging: The fact of fulfill years, also affects the growth and health of the hair and particularly the hair follicles.

Treatment androgenetic or hereditary alopecia

For many years, there are standards for the treatment of alopecia.

  • Minoxidyl: Is a vasodilator substance used in the treatment of arterial hypertension and that incidentally, it was seen that produced as a side effect a hair growth in bald persons. It’s often used alone or in combination with other hair-active substances.
  • Finasteride: is a drug that is used for the treatment of prostate hypertrophy and has a very satisfactory result to stop or slow androgenic alopecia. Young men who take the medication in the early years of hair loss avoid being bald like their predecessors.
  • PRP: one of the newer therapies to induce the appearance of new hair is local administration by injections of tissue growth factors from platelets. It’s a simple method, which consists in the extraction of blood from the individual himself. Once extracted it’s centrifuged to obtain the serum containing highly active substances for the growth of the hair mass.
  • Hair Implant: consists in the extraction of roots or follicles of perpetual characteristics as they are those of the part of the nape of the people. These hair follicles are very carefully placed in the hairless areas providing an increase in the volume of hair mass.


In certain cases, it can cause psychological problems and of self-esteem, especially in women.