Consensus Recommendations for the Management of Androgenetic Alopecia in Egypt: A Modified Delphi Study

Sara M Mohy,1,2 Mohamed F Abozeid,1,3 Wael M Seoudy,1,2 Ahmed Elshahid,4 Alaa EA Moubasher,5 Ashraf Hassan,6 Eman Elmorsy,7 Eman RM Hofny,5 Essamelden M Mohamed,8 Hanan Mohammed Saleh,9 Hanan Sabry,10 Khaled Gharib,11 Mohamed Abdelwahed Gaber,12 Mohamed Saad Hegazy,13 Mona A Atwa,14 Nayera Moftah,15 Nermeen Ibrahim Bedair,16 Noha Ezzat Mohammed,17 Samia Esmat,18 Tarek Ameen,19 Tarek Hussein,7 Yasser Mostafa Gohary,20 Mahmoud A Rageh1,4 1Venus Research Center, The Egyptian Society for Woman Health (VENUS), Cairo, Egypt; 2Department of Dermatology, Faculty of Medicine, Misr University for Science and Technology, Giza, Egypt; 3Department of Plastic Surgery, Faculty of Medicine, Cairo University, Giza, Egypt; 4Department of Dermatology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt; 5Department of Dermatology, Faculty of Medicine, Assiut University, Assiut, Egypt; 6Department of Dermatology, Faculty of Medicine, Mansoura University, Mansoura, Egypt; 7Department of Dermatology, Faculty of Medicine, Alexandria University, Alexandria, Egypt; 8Department of Dermatology, Faculty of Medicine, Al-Azhar University, Assiut, Egypt; 9Department of Dermatology, Faculty of Medicine, Ain Shams University, Cairo, Egypt; 10Department of Dermatology, Faculty of Medicine, Benha University, Benha, Egypt; 11Department of Dermatology, Faculty of Medicine, Zagazig University, Zagazig, Egypt; 12Department of Dermatology, Faculty of Medicine, Menoufia University, Menoufia, Egypt; 13Department of Dermatology, Military Medical Academy, Cairo, Egypt; 14Department of Dermatology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt; 15Department of Dermatology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt; 16Department of Dermatology, Faculty of Medicine, Helwan University, Cairo, Egypt; 17Department of Dermatology, Faculty of Medicine, Fayoum University, Fayoum, Egypt; 18Department of Dermatology, Faculty of Medicine, Cairo University, Giza, Egypt; 19Department of Dermatology, Faculty of Medicine, Tanta University, Tanta, Egypt; 20Department of Dermatology, Faculty of Medicine, Beni-Suef University, Beni-Suef, EgyptCorrespondence: Mahmoud A Rageh, Department of Dermatology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt, Email [email protected]: Androgenetic alopecia (AGA) is a common dermatologic condition with significant psychological and social impact. Treatment remains challenging due to heterogeneity in patient response and limited long-term efficacy data.Objective: To develop expert consensus guidelines for the diagnosis and management of AGA tailored to the Egyptian population, considering region-specific clinical and systemic factors.Methods: A modified Delphi process was conducted in two rounds. Initially, a structured, evidence-informed questionnaire was distributed to 1,000 practicing dermatologists across Egypt; 723 completed the survey. Responses were analyzed and refined into consensus statements, which were subsequently evaluated by a panel of 20 senior dermatology professors. Statements achieving ≥ 75% agreement were considered consensus.Results: Twenty-seven consensus statements were established and categorized into seven key areas: diagnosis, minoxidil, antiandrogens, low-level laser therapy, adjuvant treatments, hair transplantation, and counseling/hair aids. These recommendations reflect a synthesis of current evidence and national clinical experience.Conclusion: This consensus provides a regionally relevant, evidence-based framework for AGA management in Egypt. It emphasizes individualized care, multidisciplinary strategies, and the integration of emerging therapies, and may serve as a model for practice in similar healthcare settings.Keywords: androgenetic alopecia, modified Delphi, consensus, hair loss