1. Androgenetic alopecia
Done by : Rina Karborani

2. Cause?
familial
linked to high levels of dihyrotestosterone (DHT) levels
Increased levels of androgens in hair follicles can lead to a shorter cycle of hair growth and the growth of shorter and thinner strands of hair. Additionally, there is a delay in the growth of new hair to replace strands that are shed.
In female-pattern hair loss, there may be an increased sensitivity to circulating androgen, as androgen levels are usually within normal limits.

3. Patient presentation and clinical course
Temples then crown ( can be quickly or slowly) following a family pattern
Diffuse hair loss , particularly over crown area
( slow progression)

4. complications
great anxiety that rarely progress to a monosymptomatic hypochondriasis ( even in minor hair loss)
Sun burn to the scalp and may develop to multiple actinic keratoses.
Some studies suggested that bald men are more likely to have a heart attack and prostate cancer than those with a full head of hair.

5. investigations
hormonal testing is usually not needed unless symptoms or signs of androgen excess are present such as hirsutism, severe unresponsive acne or virilization.

6. Treatment Scalp surgery, hair transplants and wigs
Topical application of minoxidil lotion or foam ( antihypertensive formula) may slow early hair loss and even stimulate new growth of hair
Some females benefit from using oral antiandrogens ( spironolactone)
Finasteride ; human type II 5α-reductase inhibitor { reduces serum and skin DHT levels }
not indicated for women and children
Side effects are rare, but
include decreased libido, erectile dysfunction and altered
prostate-specific antigen levels.

7. References: 1) book 2) https://ghr.nlm.nih.gov/
Thank you
References: 1) book 2)