Dermatology - Pattern Hair Loss

Dermatology - Pattern Hair Loss 
The most prevalent kind of progressive baldness, pattern hair loss is brought on by an androgen's activity and genetic predisposition. Men may experience bitemporal recession, frontal and/or vertex thinning, or complete hair loss. The pattern can start at any point after puberty and may fully manifest in the second decade of life. It happens later in life, typically in the sixth decade, in women, where it is far less common.

The majority of individuals arrive with baldness or gradually losing hair. Due to the importance that our society placed on having a "healthy head of hair," many people find the cosmetic look of pattern hair loss to be extremely upsetting. Signs of androgen excess in young women include virilization, irregular menses, acne, and hirsutism. These should be looked for as serious issues. The majority of women who experience pattern hair loss, however, have normal endocrinology.

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Skin findings are rare; scalps with advanced pattern hair loss are glossy and smooth, and follicle orifices are hardly noticeable to the untrained eye. In pattern hair loss areas, the texture of the hair becomes finer (shorter in length, reduced diameter). Hair eventually atrophies totally and turns vellus.

Clinical diagnosis is occasionally confirmed by biopsy. Diffuse nonscarring alopecia, trichotillomania, iron deficiency, hypothyroidism, hyperthyroidism, secondary syphilis, telogen effluvium, and seborrheic dermatitis are among the differential diagnoses.

Administering a daily dosage of 1 mg of oral finasteride can potentially decelerate hair loss within a span of three months. After six months, there is a possibility of regeneration of fully developed hair on the top and front areas of the scalp. It is crucial to maintain the usage of the medicine, as discontinuation may reverse the effects. However, it is important to note that there is a potential danger of experiencing a drop in sexual desire and difficulties in achieving or maintaining an erection.
Minoxidil 2% and 5% solutions administered topically may help slow down the pace of hair loss or partially regrow hair that has been lost. Spironolactone, cyproterone acetate, flutamide, and cimetidine are beneficial in women with increased adrenal androgens; however, they should not be administered in men. Other possibilities include hairpieces and hair replacement surgery.