Epidemiology, Genetics & Risk factors in Alopecia Androgenetics

The most widespread type of progressive hair loss in both men and women all over the world is known as androgenetic alopecia [AGA]. It is also marked by progressive loss of hair in a specific pattern as a result of genetic factors and because of the actions of androgen hormones, especially dihydrotestosterone [DHT]. The condition causes miniaturization of the hair follicles, reduction of the anagen [growth] phase, and increase of telogen [resting] phase of the hair cycle. AGA does not just impact the physical appearance, but also has a huge psychological and social impact, such as low-self-esteem and quality of life. The pathophysiology of AGA has complex interactions of genetic factors and androgen metabolism and follicular sensitivity. When the enzyme is active as 5-alpha reductase, it leads to more DHT which attaches to androgen receptors on the hair follicles leading to progressive thinning of hair. Recent studies also mention the inflammation, oxidative stress and changes in the microvascular changes in the scalp to be contributory factors. Different methods can be used to treat AGA including pharmacological therapies, minoxidil and finasteride and more recently there are platelet-rich plasma [PRP], low-level laser therapy and transplanting hair. Nevertheless, there is no ultimate curing and most of the therapies are aimed at reducing the pace of the disease development and hair growth. This review will give a detailed insights into the pathophysiology, molecular events, and the existing and emerging therapeutics of androgenetic alopecia.