Male pattern baldness - AGA (androgenetic alopecia)

This kind of hair loss is usually noticed first as a widening of the parting. This can be seen in up to 96% of men after puberty and 58% of men have a significant degree of baldness by the age of 50. Some women are also affected, although usually to a much lesser degree. The amount of distress caused by this condition varies from person to person. Women who are severely affected by the condition find it a very difficult thing to cope with. Whilst the condition is more accepted by men, some men hate it and in particular those who are affected at a young age can find it very distressing.

The thinning is associated with a shortening of the anagen phase. The hair becomes shorter, finer and lighter.

Response to treatment can be measured by an increase in the thickness of the hair, or by the fact that hair loss is slowed down or stops. It can be difficult to assess, particularly as response is usually slow.

This topical treatment can be used by men and women, but women use a weaker version. (2% compared with 5% for men). Improvement only takes place while the treatment is being used; hair loss recurs when the treatment is stopped. It is applied directly to the scalp. It costs about 60 for 3 months supply.

This is an anti-androgen treatment, taken orally. It is only available for men. It is probably more effective than minoxidil, but it is more expensive, costing about 167 for 3 months. The effect is temporary and reverses within a year of stopping treatment. Some men have difficulty with their sexual functioning while on the tablets.

Neither minoxidil or finasteride is available on the NHS for the treatment of male pattern baldness.

Cyproterone acetate
This is an androgen receptor antagonist, which can be used by women. It is one of the hormones contained in Dianette which can also be used to treat acne and excess hair in women. Cyproterone can be given at a higher dose under specialist supervision.

Hair transplant
This involves transplanting hair bearing scalp skin to an area of hair loss. Excision of the bald areas has also been tried, both with varying results.

Further information

This article published on
01 August 2005

Next review date 8/1/2013


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