Androgenetic Alopecia

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Androgenetic Alopecia is commonly referred to as Male Pattern Baldness (MPB) although women can suffer from it as well.  Sometimes it is simply referred to as Pattern Baldness when general characteristics are spoken of that can affect either men or women.  Androgenetic Alopecia is the inherited or genetic form of hair loss and it is the most common form.  While it is more common among men than women, either gender can inherit this genetic trait.

Statistical Background of Androgenetic Alopecia

In men it most usually begins by the age of 21 with a receding hairline and progresses from there.  Actually, MPB can commence even as young as 12 and it may not be evidenced until a man reaches the age of 40.  It accounts for at least 95% of all cases of hair loss and it is felt that by the age of 35 as many as two-thirds of the male population in the United States will have evidenced it to some degree.  Statistics further indicate that approximately 85% of American males will have some degree of visible hair loss by the time they reach the age of 50.  Androgenetic Alopecia accounts for greater than 95% of all cases of hair loss in men.  The statistics in women are significantly different.  While 50% of women over the age of 40 may have evidenced some amount of hair loss due to Androgenetic Alopecia, it is believed that only 13% of women in premenopausal years will show appreciable loss.  According to some sources, postmenopausal women are much more likely to develop some degree of Pattern Baldness and as many as 75% of them will have some degree by the age of 65.

The Progression of Pattern Baldness

The reason why Androgenetic Alopecia is referred to as “Pattern Baldness” is because it usually follows a specific pattern as it progresses.  In males it usually begins at the hairline while women tend to gradually lose hair throughout the entire scalp.  In men the hairline will begin receding, usually at the temples and over time the loss will form a pattern resembling the letter ‘M’.  As it progresses, the hairline further recedes upwards and back until, quit often, the entire top and crown of the head are bald.  It is not uncommon to end with hair that circles the head from above the ears and around the back of the head with the entire top being bare.  In some cases it progresses to total baldness.  Although the ‘pattern’ is not as obvious in women since they tend to lose hair throughout the entire scalp, it is still referred to as Pattern Baldness to differentiate between other forms of hair loss.  In many women with Androgenetic Alopecia, by the time they reach 65 their hair will be extremely sparse.

The X-Factor

Until quite recently the actual gene that was responsible for this disorder had not been identified.  In 2008 a study was conducted and it was determined that this particular genetic disorder is linked to a specific gene on the X chromosome.  This was an amazing breakthrough and can significantly alter treatment for genetic hair loss in the future as even more becomes understood about this particular gene that causes the disorder.  In order to fully understand just how phenomenal this breakthrough really is, consider the fact that the X chromosome is comprised of more than 153 million base pairs (opposite complimentary strands of RNA and DNA).  While it would take a molecular biologist to fully comprehend this information, it is sufficient to say that a single gene is extremely complex and the segment of that gene that is a tiny segment of a strand of the X chromosome is responsible for Pattern Baldness.  The reason why both men and women can ‘inherit’ this genetic disorder is because it is tied to the X chromosome.  Men have an X (from their mother) and a Y (from their father) while women have an X and an X (one from her mother and one from her father’s mother, paternal grandmother.)  The site on the gene that has been found to be responsible for MPB has been named 3q26 and it can reside on either of the X chromosomes in women while the man retained that specific X chromosome from his mother.

This inherited gene is far reaching.

The specific gene that is the cause of MPB is actually responsible for the male hormone testosterone which in turn is responsible for a metabolite, Dihydrotestosterone (DHT) that is secreted from one of four locations.  It is manufactured in the prostate gland, the testes, adrenal glands or in hair follicles.  It is an overabundance of DHT that causes the hair follicle to shrink and at some point the hairs produced become short and thin.  Eventually the follicle dies and hair is no longer produced.  This is the ultimate cause for genetic baldness.  What is interesting about this is the fact that DHT is also responsible for Benign Prostatic Hyperplasia (BHP) which is an enlarged prostate that is not thought, at this time, to be a precursor to prostate cancer.  There is a tendency for males with Androgenetic Alopecia to also suffer from an enlarged prostate.  The two are genetically linked so finding a ‘cure’ for Male Pattern Baldness also has broad and significant implications for curing and/or preventing BHP.

Current pharmaceutical treatments give hope for the future.

At the moment there are two pharmaceutical medications that are able to effectively treat Androgenetic Alopecia with a decent rate of success.  Both Rogaine (Minoxidil), Propecia (Finasteride) have proven to be effective in inhibiting the amount of DHT that is secreted, thereby reducing damage to hair follicles.  The interesting thing about Propecia is that it was originally developed to treat BHP and is now approved for hair loss as well.  Since the gene responsible for these genetic disorders has been identified, there is much excitement in the scientific and medical communities.   There is a great deal of hope that genetic engineering can one day soon eliminate both MPB and BHP by manipulating the gene that causes both disorders.  And from there the possibilities are endless.

Remember, every cure came about by first identifying the ‘cause’ of the disease or disorder.  Now that the cause has been found, the cure is just around the corner.

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