MALE-TYPE LOSS IN WOMEN AND MEN (ANDROGENETIC ALOPEPE)
Androgenetic alopecia, popularly called baldness, is a genetic hair loss seen in both men and women. The type seen in men is called male-type shedding, and the type seen in women is called female-type shedding. However, in daily speech, it is called male type shedding, regardless of male or female. It is a genetic form of shedding and it manifests itself as thick dark hair turns into thin, quince hair over time. The spill in this form has a typical appearance:
Male type (Hamilton-Norwood)
In male patients, it starts with thinning of the hair on the sides of the anterior line of the scalp. Accordingly, the front hairline is pulled back from the sides without error. The front part of the hair takes the form of a triangle with the peak located on the forehead. Then it continues with shedding at the peak.
female type (Ludwig)
In this type, the front line of the hair remains in its usual state, while the middle part of the peak is opened.
In women, a Christmas tree-type shedding can also be seen. In the Christmas tree type shedding, the top part of the hair is opened again, but the front hairline has disappeared.
Androgenetic alopecia occurs in roughly 50% of men. Symptoms begin to appear in the puberty period in men. There are 2 different ages of onset of androgenetic alopecia in women: One is the puberty period and the glutton is post-menopausal. While it affects approximately 13% of premenopausal women, its incidence obviously increases after menopause. It is seen in 80% of men and 42% of women after the age of 70.
What is the cause of androgenetic alopecia?
It shows an androgen-dependent feature in men. The hair root becomes sensitive to dihydrotestosterone, which is stronger than testosterone. Dihydrotestosterone shortens the growth phase of the hair and causes the thick hair called terminal hair to become quince hair. Androgenetic alopecia in men is mostly genetic. In the analysis of androgenetic alopecia in men, the risk of androgenetic alopecia in boys was found to be high if the father has baldness.
In women, less is known about the cause. Its link with androgens (testosterone) is unknown. Probably other factors are also involved. However, in a cluster of patients with androgenetic alopecia, androgenetic alopecia and hormonal disorder are in the middle. Therefore, hormonal tests should be performed in necessary patients.
Androgenetic alopecia is basically a cosmetic problem. Due to the dilution of the other hair due to its spiritual influence, the sun’s rays reach the scalp and cause sun-related damage. There may be an increased risk of heart attack in male androgenetic alopecia. This type of shedding has also been associated with prostate enlargement.
Androgenetic alopecia is diagnosed by clinical examination. Sometimes it can be confused with different types of hair loss. In this case, the diagnosis is confirmed by scalp biopsy.
How is androgenetic alopecia treated?
Treatment in androgenetic alopecia has 2 purposes: To stop the progression and to allow new hair to grow.
Minoxidil: Minoxidil is marketed as a blood pressure medication. Hair growth has been observed as a side effect. It is the first book approved by the FDA for the treatment of androgentic alopecia in men and women. It is used in the form of a drug. It is available in spray and foam form.
Finasteride: It is a drug in tablet form that is approved for use in men. Its effect can be evaluated after 6 months.
Hormonal therapies: Scientific data on their benefit are insufficient.
Mesotherapy: In this treatment, vasodilating agents such as vitamins, minerals and minoxidil are injected into the scalp. Hair loss stops and existing hair thickens. There are no studies related to mesotherapy.
Hair transplantation: Its effectiveness has been proven by clinical studies. The results were found to be quite successful with appropriate patient selection.
Other options:
1. Amino acids: In particular, cysteine is thought to cause an increase in growth factors.
2. Trace elements: Zinc and copper have been suggested to increase the nourishment of the hair. Conflicting results have been found regarding the reduction of iron stores in patients with androgenic alopecia. There is no adequate evidence for iron supplementation without iron deficiency.
3. Vitamins: In particular, the effects of biotin and niacin on hair growth have been suggested and have positive effects on hair nutrition.
4. Proanthocyanidins: Procyanidin B is also included in this cluster. Procyanidin B is one of the flavonoids with antioxidant properties. Procyanidin B has been shown to cause a significant increase in hair count in men after 6 months of use.
5. Millet seed: Millet seeds are a natural product containing silicic acid, amino acids, minerals and vitamins. An oral medication containing millet seed extract, cysteine, and calcium pantothenate has been shown to increase growth stage rates.
6. There is no study on ginko bloba, aloe vera, ginseng, bergamot, hibiscus or sorphora.
7. Caffeine: It is found in some hair care products and has been suggested to stop the progression of androgenetic alopecia and grow hair. However, there is no study that proves this.
8. Melatonin: In a study, it was shown that melatonin applied in the form of a smear for 6 months is beneficial in female patients with androgenic alopecia or diffuse hair loss.
9. Low level laser comb: Few studies have been done. It has been suggested that it may be useful.
10. Black snake root: It has positive effects on estrogen levels. It is used for post-menopausal complaints in female patients. It may be useful in androgenic alopecia, but this issue has not been studied.
11. Other spies that act by blocking dihydrotestosterone are saw palmetto, beta sitosterol, green tea or polysorbate 60. In a study on saw palmetto in androgenetic alopecia, a significant change in hair count was observed.
12. Aminexil. It has a system similar to minoxidil, but there is no study that it is effective.
13. Prostaglandin analogues: It is thought that it may be effective by dilating the vessels.