Back To Search Results

Androgenetic Alopecia

Editor: Patrick M. Zito Updated: 1/7/2024 1:51:36 PM


Pattern or androgenetic alopecia is a genetically predetermined disorder due to excessive response to androgens, impacting approximately 50% of males and females.[1] This condition is characterized by progressive loss of terminal hair of the scalp, typically occurring following puberty, with a distinctive pattern in both males and females. In males, hair loss is most prominent in the vertex and frontotemporal regions, whereas females tend to retain their frontal hairline while experiencing diffuse apical hair thinning, causing a broader appearance of the anterior part of the hair.[2][3][4]


Register For Free And Read The Full Article
Get the answers you need instantly with the StatPearls Clinical Decision Support tool. StatPearls spent the last decade developing the largest and most updated Point-of Care resource ever developed. Earn CME/CE by searching and reading articles.
  • Dropdown arrow Search engine and full access to all medical articles
  • Dropdown arrow 10 free questions in your specialty
  • Dropdown arrow Free CME/CE Activities
  • Dropdown arrow Free daily question in your email
  • Dropdown arrow Save favorite articles to your dashboard
  • Dropdown arrow Emails offering discounts

Learn more about a Subscription to StatPearls Point-of-Care


Androgenetic alopecia, as indicated by its name, possesses a distinct genetic predisposition and is predominantly due to an excessive response to androgen.[5][6] This condition is characterized by a polygenic nature with varying penetrance degrees, influenced by maternal and paternal genes. A familial predisposition towards androgenetic alopecia exists, with sons having 5 to 6 times higher relative risk if their fathers experienced balding. 

The onset of pattern alopecia is contingent upon androgen receptor activation and is typically observed after puberty. Prepubertal castration and individuals with androgen insensitivity syndrome do not exhibit pattern baldness. Both hormone metabolism and androgen receptors play a key role in developing pattern alopecia.[7]


Caucasian individuals are most notably more affected, followed by Asians and African Americans, and subsequently by Native American and Inuit populations. The incidence aligns closely with age in Caucasian males, as approximately 50% are affected by 50 and approximately 80% by age 70. The disorder is quite common in females, with its incidence showing a notable rise after menopause.[8][9]


The androgen receptor activation shortens the anagen, or growth phase, within the normal hair growth cycle, which instigates follicular miniaturization by progressively shortening the anagen phase in androgenetic alopecia. Consequently, hair follicles become thinner and shorter, potentially failing not even to penetrate the epidermal layer. Pathological samples reveal a decreased 5:0 ratio of anagen to telogen hair, whereas the standard ratio is 12:1.[10][11]

Individuals with androgenetic alopecia exhibit elevated dihydrotestosterone (DHT) production, heightened levels of 5 alpha-reductase, and an increased abundance of androgen receptors in the areas of the scalp affected by balding. This heightened androgenic milieu in the scalp contributes to the progressive miniaturization of hair follicles, leading to the characteristic pattern of hair thinning and eventual hair loss seen in androgenetic alopecia (see Image. Androgenetic Alopecia in Male).

Important Background Information

Two primary isoforms of the 5 alpha-reductase enzyme exist. This enzyme converts testosterone to DHT, a compound with a higher affinity for the androgen receptor. The Type 2 isoform of the 5 alpha-reductase enzyme plays a more significant role in androgenetic alopecia.   

The Type 1 isoform of 5 alpha-reductase enzymes are distributed within sebaceous glands, keratinocytes, and sweat glands. On the other hand, Type 2 5 alpha-reductase enzymes predominately reside in the outer root sheath of hair follicles, epididymis, vas deferens, seminal vesicles, and prostate.

The average hair growth cycle consists of 4 phases:

  1. Anagen (growth)
  2. Catagen (involution)
  3. Telogen (resting)
  4. Exogen (hair shedding)

Approximately 80% to 90% of the hair is in the anagen phase, which spans from 2 to 6 years, ultimately determining hair length. Less than 5% of the hair is in the catagen phase, while the rest are in the telogen phase. The natural exogen phase entails the shedding of around 100 hairs per day.

History and Physical

Androgenetic alopecia manifests as a gradual and predictable hair loss pattern after puberty. In men, it typically begins with bitemporal thinning of the frontal scalp followed by involvement of the vertex (see Image. Male-Pattern Androgenetic Alopecia). In women, the hair thinning is more diffuse, often concentrated on the crown of the scalp while retaining the frontal hairline.

The physical examination of a person with androgenetic alopecia involves assessing the pattern and extent of hair loss. The Norwood-Hamilton scale is commonly used to classify male-pattern baldness, while the Ludwig scale is used for female-pattern baldness. These scales help categorize the severity of hair loss and guide treatment decisions.[12]

During a physical examination, a healthcare provider might also look for signs of increased hair shedding, miniaturized hair follicles, and the overall condition of the scalp. Dermoscopy, a noninvasive technique involving a unique magnifying tool, can aid in visualizing the hair follicles and diagnosing androgenetic alopecia.

It's important to note that while androgenetic alopecia is the most common cause of hair loss, other factors such as medical conditions, medications, and stress can also contribute to hair thinning and loss. For example, in women, pattern baldness is often unmasked by telogen effluvium, which occurs 1 to 6 months after a stressor causes a larger portion of the hair to shift from the anagen phase to the telogen phase, leading to an increasing number of hair follicles in the exogen phase. Another example is that in men, early androgenetic alopecia is defined as occurring before 30 years and is seen as the male phenotypic equivalent to polycystic ovarian syndrome. 


Androgenetic alopecia is usually diagnosed through clinical evaluation, involving a history of gradual onset after puberty and often, but not necessarily, a familial history of baldness. Biopsy is usually not necessary unless the diagnosis remains unclear. Dermoscopy can reveal miniaturized hair and brown perihilar casts, aiding in distinguishing it from diffuse alopecia areata that resembles male pattern baldness. Diffuse alopecia areata will exhibit tapered fractures such as exclamation point hairs.[8][10]

Conducting a comprehensive review of systems, medical history, and current medication regimen is important to rule out alternative causes for hair loss and to identify potential triggers for the manifestation of androgenetic alopecia. Additional studies might include thyroid studies, a complete blood count, and screening for iron deficiency through assessments of serum iron levels, total iron binding capacity, and serum ferritin levels.[13][14] If there is suspicion, screening for syphilis could also be considered.[15] Furthermore, performing a brief psychiatric assessment to identify signs of depressive symptoms and other psychiatric disorders may also be warranted for all patients seeking dermatological evaluation for hair loss.[16]

Treatment / Management

Two FDA-approved treatments are available for pattern baldness: topical minoxidil and finasteride. These treatments require at least 4 to 6 months of consistent application before noticeable improvements become apparent, and they require ongoing, indefinite usage to sustain results.[17] Due to this perpetual requirement, maintaining consistent medication adherence can be challenging. Additionally, initiation of these medications may trigger an initial shedding phase. Notably, the combined usage of these treatments often yields more favorable outcomes.[18][19][20](A1)

Topical minoxidil is available over the counter (OTC) and is offered in various strengths, with formulations extending up to 5% solution. Higher strengths are more effective. The most common adverse effects are pruritus and local irritation, leading to flaking.[21] The flaking issue is usually due to propylene glycol or alcohol within the drug's formulation. Minoxidil functions as a potassium channel blocker, facilitating the dilation of blood vessels. This theoretical enhancement of vascular access is postulated to enable heightened oxygen, blood, and nutrient delivery to hair follicles, stimulating the anagen growth phase. (B3)

Finasteride is a 5 alpha-reductase type 2 inhibitor rather than functioning as an antiandrogen agent.[22] Typically prescribed at a daily dose of 1 mg, it displays greater effectiveness in promoting hair regrowth at the vertex region of the scalp compared to the frontal area. The efficacy of finasteride in addressing female pattern baldness remains uncertain, and it is contraindicated for women of reproductive potential (Category X) due to the risk of inducing ambiguous genitalia development in male fetuses.[23] Potential adverse effects include sexual dysfunction, which usually improves with time, an increased risk of high-grade prostate cancer due to masking of PSA levels and delayed detection, and case reports of persistent diminished libido with or without erectile dysfunction.[24][25](A1)

Other drugs used in the management of pattern baldness lack FDA approval. Dutasteride, in particular, is noteworthy as it is approximately 3 times more potent against type II 5 alpha-reductase enzyme and 100 times more potent against the type 1 enzyme. It is often used for patients who have not experienced satisfactory results with finasteride.[26] The adverse effect profile of dutasteride is similar to that of finasteride.[27]

In women, oral antiandrogens like spironolactone are often used to treat pattern baldness. Spironolactone exhibits a very weak partial agonist toward the androgen receptor. Its primary mode of action involves blocking the more potent DHT and free testosterone from binding to the androgen receptor, physiologically behaving like a direct antagonist. Additionally, spironolactone inhibits androgen synthesis and enhances the conversion of testosterone to estradiol.

Although there haven't been documented cases of serious adverse effects associated with spironolactone use, there are some noteworthy side effects. Oral spironolactone's most commonly reported side effects include menstrual irregularities, dizziness or headache, facial hypertrichosis, rash, and hyperkalemia.[28][29] Research suggests that these side effects are usually self-resolving and manageable, with less than 5% of patients discontinuing spironolactone due to these reasons.[29] (A1)

In contrast, men using spironolactone may experience side effects like gynecomastia, decreased libido, and mild impotence.[30] These potential side effects should be discussed with a healthcare professional when considering spironolactone therapy for pattern baldness in either gender.(A1)

A similar drug, Cyproterone acetate, is used for similar purposes internationally but is not accessible in the United States.[31] Antiandrogens tend to be more effective when other signs of virilization are present, which can make them a less favorable choice to treat alopecia solely.[32](A1)

Red light or laser at 660 nm has effectively addressed hair loss and is available OTC for managing pattern baldness. Low-level laser therapy has emerged as a superior nonsurgical treatment option for androgenetic alopecia.[33](A1)

Hair transplantation can be effective and cosmetically satisfactory for specific patients.[34] However, patients must possess an adequate volume of donor hair, typically greater than 40 follicular units/cm²) to adequately cover the bald area. Advances in techniques have significantly improved the cosmetic outcomes of hair transplantation, resulting in more natural and pleasing results.

Other proposed treatments for androgenetic alopecia include saw palmetto extract (Serenoa Repens), prostaglandin analogs like latanoprost and bimatoprost (which may be cost-prohibitive), and multiple growth factors. Platelet-rich plasma and adipose-derived stem cells are also considered in some cases, theoretically, for their potential to enhance hair growth. It is important to note that these treatments are typically not used as standalone modalities but as adjunctive therapies in combination with other established treatments for androgenetic alopecia. 

Differential Diagnosis

Differential diagnoses of androgenetic alopecia encompass other hair loss disorders such as:

  • Alopecia areata
  • Anagen effluvium
  • Syphilis
  • Systemic diseases
  • Telogen effluvium


Androgenetic alopecia, as a standalone condition, is not considered life-threatening and does not directly result in mortality. However, in some instances, this condition can be associated with other underlying severe pathologies that may coexist in a patient and potentially contribute to adverse health outcomes.

Several factors, including early onset, gender, surface area involvement, family history, treatment choices, compliance with treatment, and lifestyle factors, can influence the prognosis of androgenetic alopecia.[35] The prognosis for androgenetic alopecia is highly individualized, with outcomes varying from person to person. Although androgenetic alopecia is a chronic and progressive condition, early intervention and appropriate management strategies can help decrease hair loss over time, potentially leading to improved outcomes for the patient.


While some men may experience rapid progress to complete baldness within a few years, others may present with a patterned thinning of the scalp. In contrast, women often encounter hair loss at the crown of the head and rarely develop complete baldness. Once hair is lost, the scalp becomes exposed to the sun's UV rays, and evidence suggests that this exposure may heighten the risk of developing actinic keratosis.[36] 

Extensive research has consistently demonstrated a strong relationship between pattern baldness, especially when it manifests early or involves vertex hair loss, and cardiovascular diseases, especially in males. These cardiovascular conditions include hypertension, myocardial infarction, insulin resistance, mortality resulting from diabetes or heart diseases, abnormal lipid profiles, obesity, and infertility.[37][38]

In females, androgenetic alopecia has been linked to conditions like polycystic ovarian disease. This highlights the need for comprehensive health assessments in these cases as well. 

The data on the connection between androgenetic alopecia and benign prostate hypertrophy is inconclusive, with mixed findings. However, evidence suggests a 2-fold increased risk of prostate cancer and a higher incidence of mortality associated with prostate cancer in individuals with androgenetic alopecia.[39] Additionally, there is a modestly elevated risk of colon cancer and urolithiasis among patients with androgenetic alopecia.[40][41]

Enhancing Healthcare Team Outcomes

Androgenetic alopecia is a prevalent condition that can significantly impact the appearance and self-esteem of both males and females. Alopecia is a common issue encountered in dermatology clinics, yet many patients feel embarrassed to seek medical assistance, often resorting to online solutions. Essential to addressing this disorder is patient education.

Treating androgenetic alopecia often involves an interprofessional team of healthcare practitioners working together to provide comprehensive care. An interprofessional team can collaborate to treat androgenetic alopecia in the following ways:

  • Dermatologist: The primary healthcare provider responsible for diagnosing and managing androgenetic alopecia. They can perform a thorough evaluation, recommend appropriate treatments, and monitor the condition's progress.
  • Primary care physician: PCPs, including physicians and advanced practitioners, can be critical in identifying risk factors for androgenetic alopecia during routine check-ups. They may refer patients to dermatologists for specialized care and coordinate overall healthcare. 
  • Pharmacist: The pharmacist is valuable in educating patients about medications used to treat androgenetic alopecia, such as minoxidil and finasteride. They can provide information on proper usage, potential side effects, and drug interactions, ensuring patients adhere to their treatment plans.
  • Endocrinologist: In cases where hormonal imbalances are suspected, an endocrinologist may be consulted to assess and manage hormonal issues contributing to androgenetic alopecia.
  • Plastic surgeon: Patients may consider hair transplant surgery in advanced cases of androgenetic alopecia where medical treatments have not yielded satisfactory results. Plastic surgeons can perform these procedures.
  • Nutritionist/Dietitian: Dietary factors can influence hair health. Nutritionists or dietitians can guide dietary changes and nutritional supplements that may promote hair growth and overall hair health.
  • Psychologist: Hair loss can have a significant psychological impact on individuals. Psychologists or counselors can help patients cope with the emotional and psychological effects of hair loss, offering strategies to improve self-esteem and body image.

Despite the availability of various medications and hair transplant procedures, the outcomes of treatments for androgenetic alopecia remain unpredictable. Providing simple reassurance that this is a benign disorder may suffice for patients not significantly distressed by hair thinning. Clinicians and pharmacists must collaborate in educating patients about this emotionally challenging issue, ensuring they are well-informed about available options, potential risks, and expected outcomes.[4][42][43]


(Click Image to Enlarge)
<p>Male-Pattern Androgenetic Alopecia. Photo of typical hair loss in males with androgenetic alopecia.</p>

Male-Pattern Androgenetic Alopecia. Photo of typical hair loss in males with androgenetic alopecia.

Contributed by Ahmad Al Aboud, MD

(Click Image to Enlarge)
<p>Male-Pattern Androgenetic Alopecia. Hair loss from frontal, temporal, and central scalp areas.</p>

Male-Pattern Androgenetic Alopecia. Hair loss from frontal, temporal, and central scalp areas.

Contributed by Ahmad Al Aboud, MD



Lolli F, Pallotti F, Rossi A, Fortuna MC, Caro G, Lenzi A, Sansone A, Lombardo F. Androgenetic alopecia: a review. Endocrine. 2017 Jul:57(1):9-17. doi: 10.1007/s12020-017-1280-y. Epub 2017 Mar 28     [PubMed PMID: 28349362]


Sasaki GH. Review of Human Hair Follicle Biology: Dynamics of Niches and Stem Cell Regulation for Possible Therapeutic Hair Stimulation for Plastic Surgeons. Aesthetic plastic surgery. 2019 Feb:43(1):253-266. doi: 10.1007/s00266-018-1248-1. Epub 2018 Oct 15     [PubMed PMID: 30324295]


Neuhaus K, Schiestl C, Adelsberger R, Weibel L, Meuli M, Böttcher-Haberzeth S. Bold to do - bald to be? Outcomes decades after harvesting the scalp in burned children. Burns : journal of the International Society for Burn Injuries. 2019 May:45(3):543-553. doi: 10.1016/j.burns.2018.09.023. Epub 2018 Oct 15     [PubMed PMID: 30337156]


Almohanna HM, Perper M, Tosti A. Safety concerns when using novel medications to treat alopecia. Expert opinion on drug safety. 2018 Nov:17(11):1115-1128. doi: 10.1080/14740338.2018.1533549. Epub 2018 Oct 25     [PubMed PMID: 30318935]

Level 3 (low-level) evidence


Chan L, Cook DK. Female pattern hair loss. Australian journal of general practice. 2018 Jul:47(7):459-464. doi: 10.31128/AJGP-02-18-4498. Epub     [PubMed PMID: 30114864]


Tanaka Y, Aso T, Ono J, Hosoi R, Kaneko T. Androgenetic Alopecia Treatment in Asian Men. The Journal of clinical and aesthetic dermatology. 2018 Jul:11(7):32-35     [PubMed PMID: 30057663]


Hoffmann R, Happle R. Current understanding of androgenetic alopecia. Part II: clinical aspects and treatment. European journal of dermatology : EJD. 2000 Jul-Aug:10(5):410-7     [PubMed PMID: 10882953]

Level 3 (low-level) evidence


Mahmoudi H, Salehi M, Moghadas S, Ghandi N, Teimourpour A, Daneshpazhooh M. Dermoscopic Findings in 126 Patients with Alopecia Areata: A Cross-Sectional Study. International journal of trichology. 2018 May-Jun:10(3):118-123. doi: 10.4103/ijt.ijt_102_17. Epub     [PubMed PMID: 30034191]

Level 2 (mid-level) evidence


He H, Xie B, Xie L. Male pattern baldness and incidence of prostate cancer: A systematic review and meta-analysis. Medicine. 2018 Jul:97(28):e11379. doi: 10.1097/MD.0000000000011379. Epub     [PubMed PMID: 29995779]

Level 1 (high-level) evidence


Bienenfeld A, Azarchi S, Lo Sicco K, Marchbein S, Shapiro J, Nagler AR. Androgens in women: Androgen-mediated skin disease and patient evaluation. Journal of the American Academy of Dermatology. 2019 Jun:80(6):1497-1506. doi: 10.1016/j.jaad.2018.08.062. Epub 2018 Oct 10     [PubMed PMID: 30312644]


Sadick NS, Callender VD, Kircik LH, Kogan S. New Insight Into the Pathophysiology of Hair Loss Trigger a Paradigm Shift in the Treatment Approach. Journal of drugs in dermatology : JDD. 2017 Nov 1:16(11):s135-s140     [PubMed PMID: 29141068]


Gupta M, Mysore V. Classifications of Patterned Hair Loss: A Review. Journal of cutaneous and aesthetic surgery. 2016 Jan-Mar:9(1):3-12. doi: 10.4103/0974-2077.178536. Epub     [PubMed PMID: 27081243]


Naik PP, Farrukh SN. Association between alopecia areata and thyroid dysfunction. Postgraduate medicine. 2021 Nov:133(8):895-898. doi: 10.1080/00325481.2021.1974689. Epub 2021 Sep 6     [PubMed PMID: 34455910]


Treister-Goltzman Y, Yarza S, Peleg R. Iron Deficiency and Nonscarring Alopecia in Women: Systematic Review and Meta-Analysis. Skin appendage disorders. 2022 Mar:8(2):83-92. doi: 10.1159/000519952. Epub 2021 Nov 19     [PubMed PMID: 35415182]

Level 1 (high-level) evidence


Cavazos A, Deb A, Pawar D, Sharma U, Pertuz GDR, Pham M, Gutal AG, Winn R. Secondary syphilis presenting with "crown of Venus" alopecia. Proceedings (Baylor University. Medical Center). 2022:35(4):548-549. doi: 10.1080/08998280.2022.2065074. Epub 2022 Apr 27     [PubMed PMID: 35754574]


Grant JE, Chamberlain SR. Trichotillomania. The American journal of psychiatry. 2016 Sep 1:173(9):868-74. doi: 10.1176/appi.ajp.2016.15111432. Epub     [PubMed PMID: 27581696]


Adil A, Godwin M. The effectiveness of treatments for androgenetic alopecia: A systematic review and meta-analysis. Journal of the American Academy of Dermatology. 2017 Jul:77(1):136-141.e5. doi: 10.1016/j.jaad.2017.02.054. Epub 2017 Apr 7     [PubMed PMID: 28396101]

Level 1 (high-level) evidence


Nast A, Gaskins M, Eisert L, Werner RN, Borradori L, Marinovic B, Paul C, Dressler C. Prioritizing topics in guideline development: results of a two-phase online survey of dermatologist members of the EADV. Journal of the European Academy of Dermatology and Venereology : JEADV. 2019 Jan:33(1):227-233. doi: 10.1111/jdv.15282. Epub 2018 Nov 13     [PubMed PMID: 30317678]

Level 3 (low-level) evidence


Manabe M, Tsuboi R, Itami S, Osada SI, Amoh Y, Ito T, Inui S, Ueki R, Ohyama M, Kurata S, Kono T, Saito N, Sato A, Shimomura Y, Nakamura M, Narusawa H, Yamazaki M, Drafting Committee for the Guidelines for the Diagnosis and Treatment of Male- and Female-Pattern Hair Loss. Guidelines for the diagnosis and treatment of male-pattern and female-pattern hair loss, 2017 version. The Journal of dermatology. 2018 Sep:45(9):1031-1043. doi: 10.1111/1346-8138.14470. Epub 2018 Jun 4     [PubMed PMID: 29863806]


Hu R, Xu F, Sheng Y, Qi S, Han Y, Miao Y, Rui W, Yang Q. Combined treatment with oral finasteride and topical minoxidil in male androgenetic alopecia: a randomized and comparative study in Chinese patients. Dermatologic therapy. 2015 Sep-Oct:28(5):303-8. doi: 10.1111/dth.12246. Epub 2015 Jun 2     [PubMed PMID: 26031764]

Level 1 (high-level) evidence


York K, Meah N, Bhoyrul B, Sinclair R. A review of the treatment of male pattern hair loss. Expert opinion on pharmacotherapy. 2020 Apr:21(5):603-612. doi: 10.1080/14656566.2020.1721463. Epub 2020 Feb 17     [PubMed PMID: 32066284]

Level 3 (low-level) evidence


Zito PM, Bistas KG, Syed K. Finasteride. StatPearls. 2023 Jan:():     [PubMed PMID: 30020701]


Hirshburg JM, Kelsey PA, Therrien CA, Gavino AC, Reichenberg JS. Adverse Effects and Safety of 5-alpha Reductase Inhibitors (Finasteride, Dutasteride): A Systematic Review. The Journal of clinical and aesthetic dermatology. 2016 Jul:9(7):56-62     [PubMed PMID: 27672412]

Level 1 (high-level) evidence


Andy G, John M, Mirna S, Rachita D, Michael K, Maja K, Aseem S, Zeljana B. Controversies in the treatment of androgenetic alopecia: The history of finasteride. Dermatologic therapy. 2019 Mar:32(2):e12647. doi: 10.1111/dth.12647. Epub 2018 Sep 25     [PubMed PMID: 30253001]


Mysore V. Finasteride and sexual side effects. Indian dermatology online journal. 2012 Jan:3(1):62-5. doi: 10.4103/2229-5178.93496. Epub     [PubMed PMID: 23130269]


Arif T, Dorjay K, Adil M, Sami M. Dutasteride in Androgenetic Alopecia: An Update. Current clinical pharmacology. 2017:12(1):31-35. doi: 10.2174/1574884712666170310111125. Epub     [PubMed PMID: 28294070]


Fertig RM, Gamret AC, Darwin E, Gaudi S. Sexual side effects of 5-α-reductase inhibitors finasteride and dutasteride: A comprehensive review. Dermatology online journal. 2017 Nov 11:23(11):. pii: 13030/qt24k8q743. Epub 2017 Nov 11     [PubMed PMID: 29447628]


Nestor MS, Ablon G, Gade A, Han H, Fischer DL. Treatment options for androgenetic alopecia: Efficacy, side effects, compliance, financial considerations, and ethics. Journal of cosmetic dermatology. 2021 Dec:20(12):3759-3781. doi: 10.1111/jocd.14537. Epub 2021 Nov 6     [PubMed PMID: 34741573]


Wang C, Du Y, Bi L, Lin X, Zhao M, Fan W. The Efficacy and Safety of Oral and Topical Spironolactone in Androgenetic Alopecia Treatment: A Systematic Review. Clinical, cosmetic and investigational dermatology. 2023:16():603-612. doi: 10.2147/CCID.S398950. Epub 2023 Mar 9     [PubMed PMID: 36923692]

Level 1 (high-level) evidence


Trinchieri A, Perletti G, Magri V, Stamatiou K, Trinchieri M, Montanari E. Drug-induced gynecomastia: A systematic review and meta-analysis of randomized clinical trials. Archivio italiano di urologia, andrologia : organo ufficiale [di] Societa italiana di ecografia urologica e nefrologica. 2021 Dec 21:93(4):489-496. doi: 10.4081/aiua.2021.4.489. Epub 2021 Dec 21     [PubMed PMID: 34933535]

Level 1 (high-level) evidence


Fabbrocini G, Cantelli M, Masarà A, Annunziata MC, Marasca C, Cacciapuoti S. Female pattern hair loss: A clinical, pathophysiologic, and therapeutic review. International journal of women's dermatology. 2018 Dec:4(4):203-211. doi: 10.1016/j.ijwd.2018.05.001. Epub 2018 Jun 19     [PubMed PMID: 30627618]


Vexiau P, Chaspoux C, Boudou P, Fiet J, Jouanique C, Hardy N, Reygagne P. Effects of minoxidil 2% vs. cyproterone acetate treatment on female androgenetic alopecia: a controlled, 12-month randomized trial. The British journal of dermatology. 2002 Jun:146(6):992-9     [PubMed PMID: 12072067]

Level 1 (high-level) evidence


Gupta AK, Mays RR, Dotzert MS, Versteeg SG, Shear NH, Piguet V. Efficacy of non-surgical treatments for androgenetic alopecia: a systematic review and network meta-analysis. Journal of the European Academy of Dermatology and Venereology : JEADV. 2018 Dec:32(12):2112-2125. doi: 10.1111/jdv.15081. Epub 2018 Jul 11     [PubMed PMID: 29797431]

Level 1 (high-level) evidence


Bater KL, Ishii M, Joseph A, Su P, Nellis J, Ishii LE. Perception of Hair Transplant for Androgenetic Alopecia. JAMA facial plastic surgery. 2016 Dec 1:18(6):413-418. doi: 10.1001/jamafacial.2016.0546. Epub     [PubMed PMID: 27560098]


Katzer T, Leite Junior A, Beck R, da Silva C. Physiopathology and current treatments of androgenetic alopecia: Going beyond androgens and anti-androgens. Dermatologic therapy. 2019 Sep:32(5):e13059. doi: 10.1111/dth.13059. Epub 2019 Aug 26     [PubMed PMID: 31400254]


Stollery N. Scalp problems. The Practitioner. 2010 Feb:254(1726):36-7     [PubMed PMID: 20307029]


Abdel Fattah NS, Darwish YW. Androgenetic alopecia and insulin resistance: are they truly associated? International journal of dermatology. 2011 Apr:50(4):417-22. doi: 10.1111/j.1365-4632.2010.04677.x. Epub     [PubMed PMID: 21413951]

Level 2 (mid-level) evidence


Sadgrove NJ. The new paradigm for androgenetic alopecia and plant-based folk remedies: 5α-reductase inhibition, reversal of secondary microinflammation and improving insulin resistance. Journal of ethnopharmacology. 2018 Dec 5:227():206-236. doi: 10.1016/j.jep.2018.09.009. Epub 2018 Sep 6     [PubMed PMID: 30195058]


Amoretti A, Laydner H, Bergfeld W. Androgenetic alopecia and risk of prostate cancer: a systematic review and meta-analysis. Journal of the American Academy of Dermatology. 2013 Jun:68(6):937-43. doi: 10.1016/j.jaad.2012.11.034. Epub 2013 Feb 8     [PubMed PMID: 23395589]

Level 2 (mid-level) evidence


Gül U, Kiliç A, Akbaş A, Aslan E, Demiriz M. Alopecia neoplastica due to metastatic colon adenocarcinoma. Acta dermato-venereologica. 2007:87(1):93-4     [PubMed PMID: 17225030]

Level 3 (low-level) evidence


Resorlu M, Sancak EB, Uysal F, Arslan M, Diri A, Adam G, Akbas A, Sariyildirim A, Gulpinar MT, Resorlu B. The association of urolithiasis and androgenetic alopecia. Renal failure. 2016:38(1):84-8. doi: 10.3109/0886022X.2015.1096729. Epub 2015 Oct 13     [PubMed PMID: 26460579]


Lee S, Kim BJ, Lee YB, Lee WS. Hair Regrowth Outcomes of Contact Immunotherapy for Patients With Alopecia Areata: A Systematic Review and Meta-analysis. JAMA dermatology. 2018 Oct 1:154(10):1145-1151. doi: 10.1001/jamadermatol.2018.2312. Epub     [PubMed PMID: 30073292]

Level 1 (high-level) evidence


Giordano S, Romeo M, di Summa P, Salval A, Lankinen P. A Meta-analysis On Evidence Of Platelet-rich Plasma for Androgenetic Alopecia. International journal of trichology. 2018 Jan-Feb:10(1):1-10. doi: 10.4103/ijt.ijt_74_16. Epub     [PubMed PMID: 29440850]

Level 1 (high-level) evidence