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Treatment of androgenetic alopecia in men

Authors
Jeff Donovan, MD, PhD
Beth G Goldstein, MD
Adam O Goldstein, MD, MPH
Section Editor
Maria Hordinsky, MD
Deputy Editor
Abena O Ofori, MD

INTRODUCTION

Male androgenetic alopecia (also known as male pattern hair loss and male balding) is a common, progressive form of hair loss distinguished by the reduction of terminal hairs on the scalp in a characteristic distribution (picture 1A-D). The anterior scalp, mid scalp, temporal scalp, and vertex of the scalp are the typical sites of involvement. Hair loss occurs over the course of years.

Although androgenetic alopecia is a benign and asymptomatic disorder, cosmetic concerns lead some patients to seek treatment. The primary pharmacologic therapies for men with androgenetic alopecia are topical minoxidil and oral finasteride. Hair restoration surgery can also result in cosmetic improvement.

The treatment of androgenetic alopecia in men will be reviewed here. The pathogenesis, clinical features, and diagnosis of male androgenetic alopecia are reviewed in greater detail separately. (See "Androgenetic alopecia in men: Pathogenesis, clinical features, and diagnosis".)

FIRST-LINE THERAPIES

Topical minoxidil and oral finasteride are the therapeutic agents that have been most extensively studied for the treatment of androgenetic alopecia in men. Both drugs have demonstrated efficacy and high tolerability in placebo-controlled randomized trials, supporting their status as first-line agents. The response to treatment with finasteride or minoxidil varies. While some men achieve cosmetically significant regrowth, others benefit most from the slowing of additional hair loss. Continuation of these drugs is required to maintain the results of therapy.

Finasteride — Finasteride is an oral inhibitor of dihydrotestosterone (DHT) production that is efficacious for male androgenetic alopecia.

                   

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Literature review current through: Nov 2016. | This topic last updated: Mon Jul 21 00:00:00 GMT+00:00 2014.
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