Androgenic Alopecia: A Comprehensive Literature Review of Epidemiology, Pathophysiology, Diagnosis, and Management

Authors

Baiq Zaskia Maudina , Reza Rizwandipa Wahyudi , Dhaifatu Dzulilmi , Septy Rianty Salsabila D.P , Devi Shanti Prameswari , Naufal Revaldy Fauzan , Ni Made Saithanya G.D , Rofi Bramantyo , Alifia Sabira Putri , Amanda Suana Rizqi , Ruhaniah Najwa Salsabila

DOI:

10.29303/jbt.v25i4.10182

Published:

2025-10-01

Downloads

Abstract

Androgenetic alopecia (AGA) is the most common form of hair loss in men and women, caused by a complex interaction of genetic and hormonal factors, particularly dihydrotestosterone (DHT). This condition is characterized by the miniaturization of hair follicles and changes in hair growth patterns, which affect the physical and psychological aspects of the sufferers. This article is prepared through a literature review from various recent scientific sources discussing the definition, etiology, epidemiology, pathophysiology, clinical manifestations, diagnosis, management, complications, and prognosis of AGA. Androgenetic alopecia (AGA) is triggered by genetic predisposition, follicle sensitivity to dihydrotestosterone (DHT), and supporting factors such as malnutrition, aging, and vascular disorders. The pattern of baldness differs in men and women, assessed using the Hamilton–Norwood or Ludwig scale. Diagnosis is established through history taking, physical examination, and supportive tests. Management includes topical and systemic therapy, supplements, hair transplantation, and low-level laser therapy (LLLT). AGA is also associated with the risk of actinic keratosis, cardiovascular disease, metabolic disorders, and polycystic ovary syndrome (PCOS) in women. AGA is a progressive chronic condition with multifactorial etiology. Early and appropriate management can slow progression and improve the quality of life of patients. Therapy is individualized, tailored to the degree of severity, gender, and patient response to treatment.

Keywords:

Androgenetic alopecia, dihydrotestosterone, hair loss, hair loss therapy, miniaturization of hair follicles.

References

Abdelkader, A., Y Abdallah, I., Abdeen, A., & E Ibrahim, S. (2024). Androgenetic alopecia: an overview. Benha Journal of Applied Sciences, 9(2), 37-50. 10.21608/bjas.2024.259966.1306

Ahmed, N. E., Shams, G. M., Abdallah, O. E., Elkholy, A. M., Abd Elrazik, M. G., & Abdelrahman, S. M. (2025). Exploring the role of CYP19A1 single nucleotide polymorphisms in the pathogenesis of female pattern hair loss. Egyptian Journal of Dermatology and Venerology, 45(2), 142-147. 10.4103/ejdv.ejdv_32_24

Asfour, L., Blume-Peytavi, U., Bokhari, L., Kasprzak, M., Seise, M., Sicinska, J., & Sinclair, R. D. (2025). You cannot go bald without first, losing your hair: Telogen effluvium is a precursor to, prerequisite for and potentially an incitant to common baldness in men. Clinical and Experimental Dermatology, llaf361. 10.1093/ced/llaf361

Bansod., Shashank., Sharma., Aseem., Mhatre., Madhulika. (2022) Androgenetic Alopecia: Clinical Features and Trichoscopy. Clinical Dermatology Review, 6(2):p 63-68. 10.4103/cdr.cdr_1_22

Darmaningrat, A., Ari, S., Lousiana, S., & Nurhidayati, N. (2022). Alopesia Androgenetik: Mengenali Manifestasi Klinis Hingga Tatalaksana. JUKEJ: Jurnal Kesehatan Jompa, 1(2), 109-117. https://doi.org/10.57218/jkj.Vol1.Iss2.397

Grymowicz, M., Rudnicka, E., Podfigurna, A., Napierala, P., Smolarczyk, R., Smolarczyk, K., & Meczekalski, B. (2020). Hormonal effects on hair follicles. International journal of molecular sciences, 21(15), 5342. 10.3390/ijms21155342

Hariani, E., & NK, J. (2017). Pengobatan alopesia areata berbasis bukti (evidence based treatment of alopecia areata). Berk Ilmu Kesehat Kulit Kelamin, 29(2), 126-34.

He, F., Shen, M., Zhao, Z., Liu, Y., Zhang, S., Tang, Y., Xie, H., Chen, X., & Li, J. (2022). Epidemiology and disease burden of androgenetic alopecia in college freshmen in China: A population-based study. PLoS ONE, 17(2 February), 1–10. https://doi.org/10.1371/journal.pone.0263912

Ho, C. H., Sood, T., & Zito, P. M. (2024). Androgenetic alopecia. In StatPearls. StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK430924/

Kang, S., Amagai, M., Bruckner, A. L., Enk, A. H., Margolis, D. J., McMichael, A. J., & Orringer, J. S. (2019). Fitzpatrick’s dermatology (9th ed., Vols. 1–2). McGraw-Hill Education. https://accessmedicine.mhmedical.com/content.aspx?bookid=2570&sectionid=210413306

Katzer, T. et al. (2019) ‘Physiopathology and current treatments of androgenetic alopecia: Going beyond androgens and anti-androgens’, Dermatologic Therapy, 32(5), pp. 1–10. 10.1111/dth.13059

Koch, S.L. et al. (2020) ‘The biology of human hair: A multidisciplinary review’, American Journal of Human Biology, 32(2), pp. 1–17. 10.1002/ajhb.23316

Lolli, F., Pallotti, F., Rossi, A., Fortuna, M. C., Caro, G., Lenzi, A., ... & Lombardo, F. (2017). Androgenetic alopecia: a review. Endocrine, 57(1), 9-17. 10.1007/s12020-017-1280-y

McMichael, A. J., & Hordinsky, M. K. (2018). Hair and Scalp Diseases: Medical, Surgical, and Cosmetic Treatments (2nd ed). CRC Press.

Park, A. M., Khan, S., & Rawnsley, J. (2018). Hair Biology: Growth and Pigmentation. Facial Plastic Surgery Clinics of North America, 26(4), 415-424. https://doi.org/10.1016/j.fsc.2018.06.003

Piccini, I., Sousa, M., Altendorf, S., Jimenez, F., Rossi, A., Funk, W., ... & Bertolini, M. (2022). Intermediate hair follicles from patients with female pattern hair loss are associated with nutrient insufficiency and a quiescent metabolic phenotype. Nutrients, 14(16), 3357. 10.3390/nu14163357

Pillai, J. K., & Mysore, V. (2021). Role of low-level light therapy (LLLT) in androgenetic alopecia. Journal of Cutaneous and Aesthetic Surgery, 14(4), 385-391. 10.4103/JCAS.JCAS_218_20

Rubin, A., Shah, R. R., Khan, S., Haroon, A., & Rao, B. (2023). Imaging Tools for Noninvasive Hair Assessment. Cutis, 112(1). 10.12788/cutis.0834

Rui, W., Sheng, Y., Hu, R., Miao, Y., Han, Y., Guo, X., ... & Yang, Q. (2015). Association of single nucleotide polymorphisms in the CYP19A1 gene with female pattern hair loss in a Chinese population. Dermatology, 231(3), 239-244. 10.1159/000433597

Santhosh, P. (2022). Pathogenesis of androgenetic alopecia. Clinical Dermatology Review, 6(2), 69–74. https://doi.org/10.4103/cdr.cdr_29_21

Stephanie, A. (2018). Tatalaksana Alopesia Androgenetik. Cermin Dunia Kedokteran, 45(8), 401179. https://doi.org/10.55175/cdk.v45i8.735

Sukarjati, S., & Nugroho, G. A. (2021). Potensi Ekstrak Daun Afrika (Vernonia amygdalina), Daun Pepaya (Carica papaya L) Serta Kombinasi Kedua Ekstrak Terhadap Jumlah Folikel Primer, Sekunder dan Tersier Pada Mencit (Mus musculus). Wahana: Tridarma Perguruan Tinggi, 73(2), 39-57. https://doi.org/10.36456/wahana.v73i2.4513

Swerdloff, R. S., Dudley, R. E., Page, S. T., Wang, C., & Salameh, W. A. (2017). Dihydrotestosterone: biochemistry, physiology, and clinical implications of elevated blood levels. Endocrine reviews, 38(3), 220-254. 10.1210/er.2016-1067

Trüeb, R. M. (2020). Nutrition Basics. In Nutrition for Healthy Hair: Guide to Understanding and Proper Practice (pp. 17-35). Cham: Springer International Publishing.

Vila-Vecilla, L., Russo, V., & de Souza, G. T. (2024). Genomic markers and personalized medicine in androgenetic alopecia: a comprehensive review. Cosmetics, 11(5), 148. https://doi.org/10.3390/cosmetics11050148

Yang, H. S., Liu, W. T., Yang, C. C., Plewig, G., Danarti, R., & Chen, W. (2024). Vellus hair follicle diseases. Dermatologica Sinica, 42(2), 89-97. https://researchoutput.ncku.edu.tw/en/publications/vellus-hair-follicle-diseases

Zhang, Y., Huang, J., Fu, D., Liu, Z., Wang, H., Wang, J., ... & Miao, Y. (2021). Transcriptome analysis reveals an inhibitory effect of dihydrotestosterone-treated 2D-and 3D-cultured dermal papilla cells on hair follicle growth. Frontiers in Cell and Developmental Biology, 9, 724310. 10.3389/fcell.2021.724310

Author Biographies

Baiq Zaskia Maudina, Universitas Mataram

Author Origin : Indonesia

Reza Rizwandipa Wahyudi, Universitas Mataram

Author Origin : Indonesia

Dhaifatu Dzulilmi, Universitas Mataram

Author Origin : Indonesia

Septy Rianty Salsabila D.P, Universitas Mataram

Author Origin : Indonesia

Devi Shanti Prameswari, Universitas Mataram

Author Origin : Indonesia

Naufal Revaldy Fauzan, Universitas Mataram

Author Origin : Indonesia

Ni Made Saithanya G.D, Universitas Mataram

Author Origin : Indonesia

Rofi Bramantyo, Universitas Mataram

Author Origin : Indonesia

Alifia Sabira Putri, Universitas Mataram

Author Origin : Indonesia

Amanda Suana Rizqi, Universitas Mataram

Author Origin : Indonesia

Ruhaniah Najwa Salsabila, Universitas Mataram

Author Origin : Indonesia

Downloads

Download data is not yet available.

How to Cite

Maudina, B. Z., Wahyudi, R. R., Dzulilmi, D., Salsabila D.P, S. R., Prameswari, D. S., Fauzan, N. R., … Salsabila, R. N. (2025). Androgenic Alopecia: A Comprehensive Literature Review of Epidemiology, Pathophysiology, Diagnosis, and Management. Jurnal Biologi Tropis, 25(4), 4860–4868. https://doi.org/10.29303/jbt.v25i4.10182

Most read articles by the same author(s)

Similar Articles

1 2 3 4 5 6 7 8 9 10 > >> 

You may also start an advanced similarity search for this article.