[Click! Health] "M-shaped Hairline on Forehead, Visit a Dermatologist"

As the number of patients visiting hospitals for hair loss steadily increases, experts advise that appropriate treatment is necessary according to the symptoms and progression of androgenetic alopecia.

Among types of hair loss, androgenetic alopecia is the most common and is particularly prominent in middle-aged and older adults. We explored various questions about androgenetic alopecia with Professor Park Rin Yoo from the Department of Dermatology at Gangdong Kyung Hee University Hospital.

Androgenetic alopecia is the most common form of hair loss in both men and women and is characterized by its continuous progression. It can occur in both genders after puberty, but in men, the incidence sharply increases after their 30s, making it more noticeable in middle-aged and older men.

The symptoms differ slightly between men and women. In men, the hairline at the forehead, especially the frontal area, gradually recedes in an M-shaped pattern, and hair thinning occurs at the crown. As it progresses, the front hairline recedes further and hair loss at the crown continues. In women, the forehead hairline is usually maintained, but hair becomes thinner and sparser from the front to the crown. Although rare, severe cases in women can lead to extreme hair loss, leaving only the frontal hairline and occipital area.

The main causes are genetic factors and the male hormone androgen. Additionally, aging of hair follicles and environmental factors are known to play some role. Genetic predisposition is the most important factor; if there is a genetic tendency, hair loss progresses with age under the influence of androgens. Professor Yoo explained, "Even if the parents do not have severe hair loss, children can experience severe or early onset hair loss, and it can be inherited from either the paternal or maternal side." It is also possible for children not to have hair loss even if their parents do. Generally, 50% of hair loss patients have a family history, and the younger the age of onset, the more likely the family history is present and the progression is more severe.

Early treatment is the most important aspect of managing hair loss. It is difficult to fully recover from hair loss that has already progressed, even with medication. In the early stages, topical hair growth agents (such as topical minoxidil and topical estrogen) are recommended. These topical treatments can be used safely by both men and women without significant risk of side effects. However, sensitive scalps may experience itching or flaking. Generally, hair regrowth can be observed after applying topical agents for more than three months.

If hair loss has progressed further, oral hair growth medications are additionally prescribed. For men, finasteride and dutasteride, which inhibit DHT?a type of androgen responsible for androgenetic alopecia?are used. After taking these medications for more than three months, most patients experience hair regrowth, with steady improvement over one to two years.

These medications inhibit androgens only at the hair follicle level and have minimal effect on blood androgen levels, so sexual dysfunction, a known side effect, is uncommon. However, about 2-3% of men over 50 may experience decreased sexual function, but this usually occurs only in the early stages of treatment. For women, oral minoxidil can be used as a hair growth medication. It is safe as it does not affect hormones and shows effectiveness with consistent use. Some may experience dizziness or swelling of the hands and feet initially, but these side effects are rare and typically resolve on their own.

In cases of severe hair loss, hair transplantation may be considered alongside medication. Hair transplantation involves moving healthy hair from the back of the head to the frontal hairline or crown areas affected by hair loss. Since the transplanted hair from the back of the head is permanently healthy, it does not fall out over time. However, hair loss continues in surrounding areas, so ongoing medication treatment is essential.

Professor Yoo explained that stopping medication leads to progression of hair loss, but discontinuing treatment does not worsen the condition beyond its original state. He said, "With treatment, hair regenerates and improves, but if treatment is stopped, the condition returns to the pre-treatment state and hair loss slowly progresses again." He advised, "Consistent medication treatment is the key to managing hair loss."