Androgenetic alopecia

What it is

The most common cause of hair loss worldwide. Genetics and sensitivity to hormones called androgens (mainly DHT) make follicles gradually shrink, so hairs grow finer and shorter over years.

Who gets it

Up to half of men by age 50 and a large share of women, especially after menopause. It often runs in families on either side.

Signs to look for

• Men: receding temples and/or thinning at the crown (Norwood pattern)
• Women: widening part and thinning on top with the front hairline kept (Ludwig pattern)
• Hairs of mixed thickness — some fine, some normal
• Slow change over months and years, not sudden patches

Common causes and triggers

• Inherited follicle sensitivity to DHT
• Age
• Hormonal shifts (menopause, PCOS in some women)

How it is diagnosed

• Usually diagnosed by pattern and history
• Dermatoscope view of the scalp showing miniaturized hairs
• Blood tests in women to rule out iron, thyroid or hormone issues

Treatment and care options

These are the options commonly discussed. What suits you depends on your diagnosis — a dermatologist can help you choose.

• Topical Minoxidil (FDA-approved OTC for men and women)
• Finasteride or dutasteride (prescription, mainly men)
• Oral Minoxidil or spironolactone (prescription, off-label)
• Low-level laser, microneedling, PRP
• Hair transplant for stable, well-defined loss
• Cosmetic support: volumizing products, styling, scalp care

Outlook

It is progressive but very treatable, especially when started early. Treatment usually needs to be ongoing to keep results.

When to see a doctor

See a dermatologist if loss is fast, patchy, itchy or painful, or if you are unsure it follows the typical pattern.