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Vishal Lad*, Chandrakant Suryawanshi, Amit Sinhal, Amol Landge, Vinod Wagh, Namita Jadhav


Androgenetic alopecia (AGA) is the most common form of hair loss in men and women. Determining factors appear to be genetic predisposition coupled with the presence of sufficient circulating androgens. The prevalence of this condition is high and although there are no serious direct health consequences, the loss of scalp hair can be distressing. Knowledge of the pathogenesis of androgenetic alopecia has increased markedly in recent years. Pre-programmed follicles on the scalp undergo a transformation from long growth (anagen) and short rest (telogen) cycles, to long rest and short growth cycles. This process is coupled with progressive miniaturisation of the follicle. These changes are androgen dependent and predominantly due to the binding of dihydrotestosterone (DHT) to the androgen receptor (AR). Of the many treatments available for androgenetic alopecia, only two (finasteride and minoxidil) have been scientifically shown to be useful in the treatment of hair loss. However, these therapies are variable in their effectiveness. Hair transplantation is the only current successful permanent option, and it requires surgical procedures. Several other medical options, such as antiandrogens, ketoconazole, herbal therapy, Laser and light therapies are reported to be beneficial. Management of expectations is crucial and the aim of therapy, given the current therapeutic options, is to slow or stop disease progression with contentment despite patient expectations of permanent hair regrowth.

Keywords: Androgenetic alopecia, Androgen, Androgen receptor, Dihydrotestosterone, Minoxidil, Finasteride.

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