Androgenetic alopecia. Current
aspects of a common phenotype
Hautarzt. 2003 Aug
Hanneken S, Ritzmann S, Nothen MM, Kruse R.
Hautklinik der Heinrich-Heine-Universitat Dusseldorf. Hanneken@med.uni-duesseldorf.de
Androgenetic alopecia is the most common type of hair loss in men and women.
The
disorder represents a quantitative phenotype with an underlying genetic
disposition. So far none of the causative genes have been identified. Under the
influence of androgens there is a shortening of the anagen phase as well as a
reduction of the cellular hair matrix volume in the involved scalp area.
This
results in the transformation of thick terminal hair follicles into thin vellus-like
hair follicles.
Clinically, patients present with an alopecia that follows a
defined pattern (pattern baldness) and progresses continuously but in varying
degrees. In advanced cases, men may develop baldness with remaining hair
exclusively in the temporal and occipital regions.
Women are prone to exhibit a
more diffuse type of hair loss with pronounced thinning in the parietal region.
Whereas the diagnosis of androgenetic alopecia is easy, its treatment is often
difficult.
The physician is commonly confronted with high patients' expectations
regarding hair regrowth. Today, with minoxidil and finasteride, effective
therapies are available which can lead to cessation of hair loss.
The
identification of underlying genes will make a more specific therapy easier to
achieve.
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