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Androgenetic alopecia in men

Androgenetic alopecia (AGA) is a condition related to the influence of androgen hormones on hair follicles. Androgens may stimulate a slow transformation and finally the "deactivation" of the hair follicle (the so-called miniaturization). It is observed in people with genetic predispositions and often runs in the family. In the Caucasian population, androgenetic alopecia is observed in 80% of men and approximately 40% of women. In people of Asian descent and African Americans, the prevalence of AGA is lower.

Androgenetic alopecia in men is called by the abbreviation MAGA (male androgenetic alopecia).

Symptoms
The first symptoms of androgenetic alopecia may appear in one's teens. Sometimes, the recession of the hairline in the temporal and frontal areas dominates, whereas in other persons, the thinning of hair in the vertex area may dominate. Most often, the density and thickness of hair in the occipital area remains nearly unchanged, which results from a much lesser sensitivity of these hair follicles to hormonal stimuli. Patients often note a slow gradual replacement of thick, typically colored hair with thinner and softer hair. Some hair is gradually transformed into clinically invisible, very short, nearly transparent hair. In men, the androgenetic alopecia process may cover the whole scalp area.

Course of disease
The condition is progressive. The first symptoms of the androgenetic alopecia may appear before age 20. Male androgenetic alopecia may lead to complete hair loss.

Diagnosis
The diagnosis is made based on the clinical picture. Trichoscopy is used to confirm the diagnosis and rule out other conditions connected with hair loss.

Treatment
Treatment is most efficient with the early application of therapy (hair follicles miniaturization is reversible only to a certain extent). In treatment, 5-α-reductase inhibitors, finasteride and dutasteride are used. Preparations of minoxidil and prostaglandin analogs are used topically. In AGA therapy, injections of autological platelet-rich plasma may also be used. Reconstruction treatment (hair transplantion) also has some importance in the treatment of androgenetic alopecia.