Understanding androgenetic alopecia: Causes, symptoms, and treatment options

Are you losing a lot of hair? You may be suffering from androgenetic alopecia—more commonly known as pattern baldness. 

Here we’ll explore the causes and symptoms of this condition and the latest treatment options available. Whether you’re personally experiencing androgenetic alopecia or just curious about this prevalent condition, join us as we navigate its complexities.

What is androgenetic alopecia?

Androgenetic alopecia (AGA) is the most common type of hair loss.¹ For men, it usually starts with hairline receding at the front and might even progress to the top of the head. Women tend to experience it as a more general thinning of hair between the front and the top of the scalp, but typically, their frontal hairline isn't affected as much.² 

AGA is often linked to menopause for women.³ To diagnose it, doctors do a clinical check-up, looking for signs like miniaturization of hair follicles. This hair loss can affect how you feel about yourself, your self-esteem, and your overall well-being, especially for women. Since it’s a chronic condition, it needs thoughtful, evidence-based treatment plans that consider your personal needs, your budget, how much hair you’ve lost, and what you want to achieve with your hair.⁴

What causes androgenetic alopecia?

Androgenetic alopecia, the type of hair loss that affects up to half of all men and women, is mainly due to how your scalp is genetically programmed to react to androgens, which are hormones.⁵ 

If you’re genetically predisposed to this condition, these hormones can kickstart hair loss any time after puberty.⁶ What happens is that androgens shorten the hair growth phase, making the hair follicles smaller and the hair thinner and shorter. It tends to ramp up in women after menopause.⁷ If you’re suffering from this condition, speak to a medical professional. They can assess your situation and give you the support and expert treatment advice you need.

The best treatments for androgenetic alopecia

The good news is that even though it’s a chronic condition, there are treatment options available to help you reduce your hair loss and promote hair growth.  

Some of the best research-backed treatments for androgenic alopecia include the following:

Topical minoxidil

You can start with topical minoxidil, a well-known treatment. It’s available over-the-counter in different strengths, including a 5% solution.⁸ If your hair loss is more severe, you can consult a healthcare professional for a stronger prescription. Just be aware that some people may experience itching or irritation as a side effect.⁹

Topical and oral finasteride

Topical finasteride is another treatment option. In one study, those who used it for 24 weeks saw a significant increase in hair count compared to a placebo. It’s less likely than oral finasteride to cause side effects since it has lower drug levels in your bloodstream.¹⁰ Oral finasteride is also an FDA-approved option for helping improve hair growth. As with most medications, it has a few potential side effects, so always speak with a medical provider before using it.¹¹

Topical ketoconazole

Ketoconazole is a medication commonly used to treat and manage fungal infections, but research shows that its ability to help treat androgenetic alopecia is promising.¹² It is an antifungal that treats dandruff, while also stimulating hair regrowth.

Topical caffeine

Caffeine isn’t just an excellent way to wake yourself up in the morning! Applied topically, it can help you manage hair loss. 

Studies have found topical caffeine in a 0.2% solution is nearly as effective as minoxidil for promoting hair growth in men with pattern baldness.¹³ Caffeine acts as a phosphodiesterase inhibitor, which means it boosts cell metabolism and hair follicle health. Research shows it’s a viable and effective option for managing hair loss.¹⁴

Melatonin

You might be surprised to hear that melatonin, often associated with sleep, may also be a solution for hair loss. Recent studies have shown that topical melatonin, when applied directly to the scalp, can effectively treat hair loss in both men and women.¹⁵ 

Research on people experiencing pattern hair loss has shown positive outcomes, such as more hair growth, less severe hair loss, and better hair health, with melatonin treatment.¹⁶ While the exact mechanism of action is still being determined, it is likely the positive effects on hair growth are due to antiandrogen and antioxidant effects, as demonstrated in 5 separate studies. It’s a safe option, so consider talking to a healthcare professional about it as a possible treatment option.¹⁷

Topical and oral spironolactone

For a targeted approach, think about using topical spironolactone. It’s effective against hair thinning and loss, especially androgenetic alopecia.¹⁸ This treatment involves formulations like 1% gels or 5% solutions, applied twice daily. It blocks the action of androgens known to shrink hair follicles, with minimal side effects compared to oral spironolactone.¹⁹

Other proposed treatments

Aside from these topical treatments, one effective and cosmetically satisfactory choice is a hair transplant, where the donor’s hair is used to cover bald areas. Advances in techniques have improved the results of this procedure.²⁰ Another option is red light or laser therapy, which has demonstrated efficacy for hair loss. This therapy utilizes a red light with a wavelength of 660 nm and is available without a prescription for those dealing with pattern baldness.²¹

There are also alternative treatments to explore, including the use of saw palmetto extract, prostaglandin analogs like latanoprost and bimatoprost (though these may be costly), and therapies that involve multiple growth factors such as platelet-rich plasma and stem cells.²²

Keep in mind that the effectiveness of these treatments can vary from person to person. To determine the best approach for your specific needs, it’s important to consult with a healthcare professional who can provide personalized guidance. Maintaining consistency with these treatments is crucial, as many require ongoing use to achieve and sustain positive results.

Expert hair care tips

If you’re aiming to keep your hair in top shape, follow these expert-approved hair care tips:

Select the right shampoo

First, when it comes to shampoo, make sure you pick the right one for your hair type and specific concerns.²³ For instance, if your hair tends to get oily, go for a shampoo that’s designed to control excess sebum. Take a moment to understand the ingredients in your shampoo. It’s essential to look for detergents that match your hair’s needs. This way, you can avoid harsh chemicals that might not be suitable for your hair type. 

Additionally, keep an eye on the pH levels of your shampoo, especially if you’ve treated your hair chemically. Opting for a shampoo with a neutral pH is crucial to prevent hair shaft swelling, which can lead to damage and frizz.²⁴ 

And remember, the amount of foam a shampoo produces doesn’t necessarily indicate how well it cleans your hair. Some shampoos may not foam much during the first wash, especially if your hair is dirty, but that doesn’t mean they’re not doing their job.²⁵

Consider a conditioner

You should also consider using a conditioner. Shampoo’s primary role is to cleanse, but over-cleansing can make your hair dry and hard to manage. If you have dry, damaged, or chemically treated hair, using a shampoo with a built-in conditioner can help maintain manageability and shine.²⁶

Avoid harsh soaps

One thing to avoid is using bar soap on your hair. While some can work well for the body, they’re not the best choice for cleansing your hair. Bar soaps can leave behind a stubborn residue that’s hard to rinse out and could contribute to issues like seborrheic dermatitis.²⁷

Opt for natural ingredients

Lastly, consider embracing natural ingredients. Hair needs an adequate amount of elements like iron, oxygen, hydrogen, nitrogen, and sulfur for healthy growth.²⁸ Vitamins, minerals, and herbal products play vital roles in this process. Supplements containing nutrients like niacin (vitamin B3), the vitamin B complex, ascorbic acid (vitamin C), tocopherol (vitamin E), grape seed extract, and rosemary oil can promote hair growth. However, consult with your healthcare provider before adding supplements to your routine to ensure they’re safe and suitable for you.²⁹

By selecting the right products and establishing a hair care routine tailored to your hair type and needs, you can keep your hair healthy and looking its best.

Restore your hair with the right treatments

You can explore a range of topical treatments for androgenetic alopecia, from minoxidil and finasteride to caffeine and melatonin. These solutions offer hope for healthier, thicker hair. 

Remember, consulting a healthcare professional is crucial for personalized guidance. With Curology, you can even get a personalized hair loss treatment with our Hair Formulaᴿˣ . Your medical provider will determine the active ingredients to best help you achieve your hair goals, and they’ll be there to support you along your hair growth journey. Sign up today to see if Hair Formulaᴿˣ is a fit for you.

We’re here to tell you what we know. That’s why our information is evidence-based and fact-checked by medical experts. Still, everyone’s skin is unique—the best way to get advice is to talk to your healthcare provider.

*Cancel anytime. Subject to consultation. Results may vary. Restrictions apply. See website for full details and important safety information.

Ingredients subject to medical consultation. Do not use them if pregnant, breastfeeding, or trying to conceive.

P.S. We did the homework so you don’t have to:

1. Nestor, M.S., et al. Treatment options for androgenetic alopecia: Efficacy, side effects, compliance, financial considerations, and ethics. J Cosmet Dermatol. (December 2021).

2. Nestor, M.S., et al. Treatment options for androgenetic alopecia: Efficacy, side effects, compliance, financial considerations, and ethics. J Cosmet Dermatol. Ibid.

3. Nestor, M.S., et al. Treatment options for androgenetic alopecia: Efficacy, side effects, compliance, financial considerations, and ethics. J Cosmet Dermatol. Ibid.

4. Nestor, M.S., et al. Treatment options for androgenetic alopecia: Efficacy, side effects, compliance, financial considerations, and ethics. J Cosmet Dermatol. Ibid.

5. Ho, C.H., et al. Androgenetic Alopecia. StatPearls. (2022, October 16).

6. Ho, C.H., et al. Androgenetic Alopecia. StatPearls. Ibid.

7. Ho, C.H., et al. Androgenetic Alopecia. StatPearls. Ibid.

8. Suchonwanit, P., et al. Minoxidil and its use in hair disorders: a review. Drug Des Devel Ther. (2019, August 9).

9. Suchonwanit, P., et al. Minoxidil and its use in hair disorders: a review. Drug Des Devel Ther. Ibid.

10. Piraccini, B.M., et al. Efficacy and safety of topical finasteride spray solution for male androgenetic alopecia: a phase III, randomized, controlled clinical trial. J Eur Acad Dermatol Venereol. (February 2022).

11. Nestor, M.S., et al. Treatment options for androgenetic alopecia: Efficacy, side effects, compliance, financial considerations, and ethics. J Cosmet Dermatol. Ibid.

12. Fields, J.R., et al. Topical ketoconazole for the treatment of androgenetic alopecia: A systematic review. Dermatol Ther. (2020, January 2).

13. Dhurat, R., et al. An Open-Label Randomized Multicenter Study Assessing the Noninferiority of a Caffeine-Based Topical Liquid 0.2% versus Minoxidil 5% Solution in Male Androgenetic Alopecia. Skin Pharmacol Physiol. (2017, October 21).

14. Dhurat, R., et al. An Open-Label Randomized Multicenter Study Assessing the Noninferiority of a Caffeine-Based Topical Liquid 0.2% versus Minoxidil 5% Solution in Male Androgenetic Alopecia. Skin Pharmacol Physiol. Ibid.

15. Fischer, T.W., et al. Topical Melatonin for Treatment of Androgenetic Alopecia. Int J Trichology. (October-December 2012).

16. Fischer, T.W., et al. Topical Melatonin for Treatment of Androgenetic Alopecia. Int J Trichology. Ibid.

17. Fischer, T.W., et al. Topical Melatonin for Treatment of Androgenetic Alopecia. Int J Trichology. Ibid.

18. Wang, C., et al. The Efficacy and Safety of Oral and Topical Spironolactone in Androgenetic Alopecia Treatment: A Systematic Review. Clin Cosmet Investig Dermatol. (2023, March 9).

19. Wang, C., et al. The Efficacy and Safety of Oral and Topical Spironolactone in Androgenetic Alopecia Treatment: A Systematic Review. Clin Cosmet Investig Dermatol. Ibid.

20. Ho, C.H., et al. Androgenetic Alopecia. StatPearls. Ibid.

21. Ho, C.H., et al. Androgenetic Alopecia. StatPearls. Ibid.

22. Ho, C.H., et al. Androgenetic Alopecia. StatPearls. Ibid.

23. Draelos, Z.D. Essentials of Hair Care often Neglected: Hair Cleansing. Int J Trichology. (January-June 2010).

24. Draelos, Z.D. Essentials of Hair Care often Neglected: Hair Cleansing. Int J Trichology. Ibid.

25. Draelos, Z.D. Essentials of Hair Care often Neglected: Hair Cleansing. Int J Trichology. Ibid.

26. Draelos, Z.D. Essentials of Hair Care often Neglected: Hair Cleansing. Int J Trichology. Ibid.

27. Draelos, Z.D. Essentials of Hair Care often Neglected: Hair Cleansing. Int J Trichology. Ibid.

28. Wall, D., et al. Advances in hair growth. Fac Rev. (2022, January 12).

29. Wall, D., et al. Advances in hair growth. Fac Rev. Ibid.

30. Nestor, M.S., et al. Treatment options for androgenetic alopecia: Efficacy, side effects, compliance, financial considerations, and ethics. J Cosmet Dermatol. Ibid.

31. Ho, C.H., et al. Androgenetic Alopecia. StatPearls. Ibid.

32. Nestor, M.S., et al. Treatment options for androgenetic alopecia: Efficacy, side effects, compliance, financial considerations, and ethics. J Cosmet Dermatol. Ibid.

33. Suchonwanit, P., et al. Minoxidil and its use in hair disorders: a review. Drug Des Devel Ther. Ibid.

34. Nestor, M.S., et al. Treatment options for androgenetic alopecia: Efficacy, side effects, compliance, financial considerations, and ethics. J Cosmet Dermatol. Ibid.

35. Peters, E.M.J., et al. Hair and stress: A pilot study of hair and cytokine balance alteration in healthy young women under major exam stress. PLoS One. (2017, April 19).

36. American Academy of Dermatology Association. Hair Loss: Tips for Managing. (n.d.).

Kristen Jokela is a certified Family Nurse Practitioner at Curology. She obtained her Master of Science in Nursing at the University of South Florida in Tampa, FL.

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** Restrictions apply. See website for full details and important safety information.

Written by

Curology Team

Medically reviewed by

Kristen Jokela, NP-C