Androgenetic Alopecia: Pathogenesis, Evaluation, and Management

Résumé

Androgenetic alopecia (AGA) is a common, non-scarring, alopecia characterized by the progressive transformation of terminal hairs into miniaturized vellus hairs in a patterned distribution. Female AGA—often termed female‑pattern hair loss (FPHL)—and male AGA (often termed male‑pattern hair loss, MPHL) share similar underlying pathophysiologic, histopathologic, and trichoscopic features; however, they differ in their clinical presentation and patterns of scalp distribution.

AGA represents the most prevalent cause of hair loss in both men and women and can have a significant impact on quality of life. Evidence from a large meta-analysis demonstrates a moderate impairment in health-related quality of life and emotional well-being, underscoring the meaningful psychosocial burden of AGA.

Although patients are often referred for dermatologic evaluation, AGA may also have important endocrine implications. In selected cases—particularly in women or in atypical presentations—it may reflect underlying endocrinologic abnormalities, warranting targeted screening and management.