review · Nigerian Postgraduate Medical Journal
Androgenetic alopecia is the most widespread form of non-scarring hair loss, defined by a progressive deterioration of scalp hair follicles in characteristic patterns. Although more prevalent in men, the condition can also emerge at younger ages as premature hair loss. Its onset and progression stem from complex interactions involving hormonal influences, genetic predisposition, micronutrient deficiencies, microinflammation, and stress. Beyond hair thinning, androgenetic alopecia carries significant psychosocial impacts and potential links to cardiovascular diseases. Synthesising literature spanning from 1950 to 2024 across medical databases, the findings capture the epidemiology, pathophysiology, diagnosis, and treatment approaches for the disorder. A deeper understanding of these interconnected biological mechanisms and associated comorbidities encourages dermatologists and patients to pursue more comprehensive clinical assessments and patient education, addressing both physical symptoms and broader health considerations.
Hair loss is often viewed purely as a cosmetic concern, but androgenetic alopecia intersects with psychological well-being and systemic health risks such as cardiovascular disorders. Clarifying the biological drivers, from genetics to nutrition and inflammation, helps patients and clinicians recognise the wider health implications of patterned balding, supporting earlier identification and more holistic medical care.
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This study reviewed the current knowledge on the epidemiology, pathophysiology, clinical presentations, diagnosis, treatment, quality-of-life assessment and recent trends in androgenetic alopecia (AGA). Relevant articles on AGA from PubMed, Google Scholar, Medline and Scopus from 1950 to 2024 were obtained and scrutinized.. Key search words included each term like 'androgenetic alopecia', 'androgenic alopecia', 'pattern baldness' and 'pattern hair loss' AND each term like 'epidemiology', 'pathophysiology', 'genetics', 'hormones', 'micronutrient', 'stress and inflammation', 'growth factors', 'clinical features', 'staging', 'cardiovascular associations', 'diagnosis' and 'management' were used in the search. AGA is a non-scarring hair loss that is exemplified by a progressive decline of hair follicles, or non-functional or dead hair follicles in the scalp in a defined pattern. It is the most common hair loss, more common in men but can also present in younger age as premature AGA. Hormones, genetics, micronutrient deficiency, microinflammation and stress have been implicated, while psychosocial distress and cutaneous correlate of cardiovascular diseases have become sources of relentless research. AGA is a patterned hair loss that is more prevalent in Men. It results from the interactions between hormonal, genetic and other factors which determine the extent of hair loss and associated disorders (psychosocial and cardiovascular). As results of more research become available, the extent of AGA, its comorbidities as well as the full spectrum of their manifestations will continue to be sources of health education and more holistic examination by dermatologists and patients.
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DOI: 10.4103/npmj.npmj_47_24
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