Causes and Risk Factors for Androgenetic Alopecia

Androgenic-Alopecia
Genetics, age, stress, and even certain health conditions may affect risk for male or female pattern hair loss.Adobe Stock

Thinning, a widening part, or a growing bald patch can be distressing. You may have androgenetic alopecia. “Androgenetic alopecia, also known as male or female pattern baldness, is the most common type of hair loss,” says Shoshana Marmon, MD, PhD, assistant professor and director of clinical research in the department of dermatology at New York Medical College in New York City.

Androgenetic alopecia is a progressive type of hair loss, meaning the loss happens slowly over time, notes StatPearls. Although you may hear this type of alopecia referred to as androgenic alopecia, that’s a common misspelling. The correct term is androgenetic alopecia. This condition affects as many as half of women and men, so if you’re struggling with seeing more of your scalp in the mirror, there are millions of people who know exactly what you’re going through.

Causes of Androgenetic Alopecia

People who have male or female pattern hair loss have something in common: their genes. Individual hairs sprout from hair follicles, and there’s a specific gene that causes the hair follicles on certain places on your head to shrink, according to the American Academy of Dermatology (AAD). “This shrunken follicle produces a thinner, smaller hair shaft — a process known as ‘miniaturization.’ Over time, as more follicles are miniaturized, the hair coverage of the scalp decreases,” says Dr. Marmon.

As these hair follicles shrink, you’ll notice thinning and finer hairs. If left untreated, eventually those follicles will stop growing hair altogether, according to the AAD.

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Risk Factors for Androgenetic Alopecia

There are two main risk factors for androgenetic alopecia: genetics and age. Other risk factors can contribute, too.

Genetics

Variation of the androgen receptor (AR) gene (though there may be other genes involved, as well) is the known gene that sets the stage for hair loss, according to the National Library of Medicine.

One of the biggest driving factors in hair loss is DHT, which stands for dihydrotestosterone. DHT is converted into testosterone in the body. Hair follicles in genetically prone people are especially sensitive to DHT, which makes them more likely to experience hair loss. But this loss doesn’t happen all over the scalp. “Only certain hairs are susceptible to the effects of DHT,” says John Browning, MD, a dermatologist with Texas Dermatology and Laser Specialists in San Antonio. “These are the hairs in front and top of the scalp, while the hair on the sides and back of the head are not,” he says.

If you have a close family member with male or female pattern hair loss, you’re likely to be at risk for it as well. For men, their risk is five to six times higher that they will begin to bald if their fathers did, per StatPearls. However, “You can’t always predict it. Among siblings, one can have severe androgenetic alopecia, while the other sibling is completely unaffected. It can also skip a generation completely where there’s no hair loss,” says Dr. Browning. The development of male or female pattern hair loss is due to a mix of factors,” he says.

Age

Hair growth itself slows as you age, says the AAD, which can also contribute to hair loss. In Caucasian men, 30 percent have androgenetic alopecia at age 30, a rate that increases to 50 percent at age 50 and 80 percent by age 70, notes research. For women, female pattern hair loss typically occurs during and after menopause as hair follicles shrink, according to the Cleveland Clinic.

Race

When it comes to race, Caucasian people are more likely to experience this type of hair loss compared to those who are Asian or African American.

Stress

A move, having a baby, and psychological stress can all cause a different type of hair loss, called telogen effluvium (TE), notes research. This hair loss is actually hair shedding that occurs all over your head. And while stress is not a cause of androgenetic alopecia, TE can unmask male or female pattern baldness, bringing it to light for the first time. This can prompt people to seek help, says Browning.

Certain Health Conditions

Marmom notes that conditions associated with androgenetic alopecia include coronary artery disease and prostate cancer in men and polycystic ovary syndrome (PCOS) in women.

For example, among 162 young men with androgenetic alopecia, 29 percent had markers for increased arterial stiffness, a risk factor for coronary artery disease, while only 10 percent of the group without hair loss had evidence of arterial stiffness, one study found. “The onset of androgenetic alopecia, especially at an earlier age, can be a signal to screen for the presence of other more serious medical issues,” Marmon says.

If you are dealing with androgenetic alopecia at an early age, be sure to discuss your concerns and treatment options with your primary care doctor and dermatologist.

Prevention of Androgenetic Alopecia

Unfortunately, some of the main factors associated with male and female pattern hair loss — genetics, age, race — cannot be changed.

The good news is that certain lifestyle factors can support healthy hair growth, such as consuming a nutritious diet that contains the calories, protein, and iron your body requires, as well as managing stress, per the Cleveland Clinic.

Smoking has also been shown in some studies to be linked to male androgenic alopecia, as the habit may decrease blood flow to hair follicles, create DNA damage, and increase inflammation. Keeping your hair may be another perk to quitting smoking.

You can also practice healthy hair habits, such as avoiding tight hairstyles, limiting the use of hot hair tools, and gently cleansing hair, advises the AAD. This won’t stop genetic hair loss, but it can prevent damage to your hair or the hair follicle that leads to more shedding. In other words, show your hair some TLC.

It’s also important to see a board-certified dermatologist if you’re worried that you’re losing your hair. Treatments for androgenetic alopecia, which include both topical and oral medications that stimulate hair growth and slow hair loss, are often most effective when started early, according to the AAD. What’s more, because of the range of treatments available, you can work with a dermatologist to find what’s right for you.

Summary

Androgenetic alopecia, also called male or female pattern hair loss, is the most common cause of hair loss. Genetics and age are both risk factors for this type of hair loss, and the condition may also be a sign of more serious health issues. There are effective treatments that can help regrow hair and stop further hair loss.

Common Questions & Answers

What is androgenetic alopecia?
Androgenetic alopecia, also known as male or female pattern baldness, is the most common type of hair loss. It is a progressive type of hair loss.
What causes androgenetic alopecia?
Androgenetic alopecia is caused by a specific gene that causes hair follicles on certain areas of the head to shrink, leading to thinning and finer hairs.
What are the risk factors for androgenetic alopecia?
The main risk factors for androgenetic alopecia are genetics and age. Other factors such as race, stress, and certain health conditions can also contribute.
Can androgenetic alopecia be prevented?
While factors like genetics and age cannot be changed, certain lifestyle factors, such as a nutritious diet, managing stress, and avoiding damaging hair habits, can support healthy hair growth.
Are there treatments available for androgenetic alopecia?
Yes, there are topical and oral medications that can stimulate hair growth and slow down hair loss. These treatments are often most effective when started early.
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Resources

  • Types of Hair Loss. NYU Langone Health.
  • Interview: Shoshana Marmon, MD, PhD, FAAD, assistant professor and director of clinical research, department of dermatology, at New York Medical College in New York City.
  • Ho CH, Sood T, Zito PM. Androgenetic Alopecia. StatPearls. August 25, 2022.
  • Hair Loss: Who Gets and Causes. American Academy of Dermatology.
  • Androgenetic Alopecia. MedlinePlus. August 1, 2015.
  • Lolli F, Pallotti F, Rossi A, et al. Androgenetic Alopecia: A Review. Endocrine. March 28, 2017.
  • Interview: John Browning, MD, FAAD, dermatologist with Texas Dermatology and Laser Specialists in San Antonio.
  • Kash N, Leavitt M, Leavitt A, et al. Clinical Patterns of Hair Loss in Men: Is Dihydrotestosterone the Only Culprit? Dermatologic Clinics. July 2021.
  • Hair Loss in Women. Cleveland Clinic. February 10, 2021.
  • Agac MT, Bektas H, Korkmaz L, et al. Androgenetic Alopecia Is Associated With Increased Arterial Stiffness in Asymptomatic Young Adults. Journal of the European Academy of Dermatology & Venereology. January 2015.
  • Hair Loss. Cleveland Clinic. August 26, 2021.
  • Hair Loss: Tips for Managing. American Academy of Dermatology.
  • Hair Loss: Diagnosis and Treatment. American Academy of Dermatology.
  • Asghar F, Shamim N, Farooque U, et al. Telogen Effluvium: A Review of the Literature. Cureus. May 2020.
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