What is AGA Hair Loss? and Treatment

The other day, I had someone email me and ask: “you reference AGA hair loss often in your articles. What exactly is this type of hair loss? What causes it? What are some of the symptoms of it? And, how is it treated?” While I’m certainly not a doctor or specialist, I will try to answer these questions as completely as I can (based on experience and research) in the following article.

Who Has AGA? What Is It? What Causes It?:

The scientific term for AGA is androgenic alopecia. Many dermatologist will tell you that, despite what people who have hair loss would like to believe, androgenic alopecia is the most common culprit for this loss. It’s estimated that over 90% of all cases of loss can be attributed to androgens (or the sensitivity to them) in some way. It’s also said that 50% of men and 40% of women will suffer some form of hair loss before they reach 50 years of age. Of course, the severity of this will differ from person to person.

There are many factors that are contributory to the causes of AGA. The most common is thought to be genetics and heredity. But, increasingly, specialists are seeing more and more cases of people presenting with loss that resembles this type of hair loss without a family history. In short, testosterone is converted to dihydrotestosterone (known as DHT) by an enzyme called 5-alpha-reductase. And this DHT in turn affects the follicles.

Some Symptoms Of Androgenic Alopecia:

This process can seriously affect and compromise the hair growing from those follicles. The result is typically gradual hair loss (although more aggressive or rapid hair loss and shedding is sometimes also seen) with miniaturization. To put it plainly, this miniaturization is really what defines AGA hair loss and is what makes the hair loss as noticeable and pronounced as it is. Think about it. With seasonal shedding or hair loss caused by conditions like telogen effluvium (TE) that don’t include miniaturization, what has been lost is eventually successfully replaced. Normal textured hair replaces the shed hair so that there is eventually no loss in volume or coverage.

But, with androgenic alopecia, the hair comes back in thinner, finer, and with more of fly away or cotton candy texture. Over time, you may have slightly less hair strands, but the fact that what you do have is compromised and much more fine in texture means that the volume and coverage are severely compromised. This very much affects the appearance of your hair. Over many cycles, the hair gets finer each time until you can eventually get peach fuzz and then balding or nothing at all.

Now, this presents differently for women. For men, you’ll typically get balding spots or noticeable thinning in the temples and on the top of the head or at the back crown area. What starts out as thinning might become a small bald spot that expand and become bigger over time. For women, you’ll more typically see diffuse thinning and loss of volume or a widening at the part line. That’s not to say that you don’t see thinning in specific areas in women. You can. This sometimes happens at the crown, temples, or bang line. It really just depends upon the person and the hand that genetics has dealt them.

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Treatment:

AGA hair loss is treated in a variety of ways. Some people try drugs to get the androgens under control. Success rates vary. But what you’re typically up against here is that there’s often no feasible way to eliminate all DHT or to totally stop this process and the conversion from happening. So, you’re dealing with a continuously moving target. And, in my opinion and experience, it’s usually not that you have too much testosterone, DHT, or 5-alpha-reductase, it’s that you’re sensitive to what you do have. People (women especially) will often tell me things like “but my testosterone is low, not high. So why is this happening?” It’s not usually the levels that you are trying to control, it’s the sensitivity.

That’s why I think that addressing sensitivity, inflammation, and regrowth can be a better plan. This is more realistic and focuses on controlling what you actually can. Regrowth is, to me, the most important part of the equation. To get a cosmetically decent result, you’ll need to effective regrow, and then maintain, what has been lost.

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