utd_medknow
International Journal of Trichology International Journal of Trichology
 Print this page Email this page Small font sizeDefault font sizeIncrease font size
 
 
  Home | About IJT | Editorial board | Search | Ahead of print | Current Issue | Archives | Instructions | Online submission | Subscribe | Advertise | Contact us | Login   
 


 
ORIGINAL ARTICLE
Year : 2009  |  Volume : 1  |  Issue : 2  |  Page : 131-133 Table of Contents     

Male androgenetic alopecia: Population-based study in 1,005 subjects


Department of Dermatology, Manipal Hospital, Bangalore, India

Date of Web Publication28-Dec-2009

Correspondence Address:
D S Krupa Shankar
Department of Dermatology, Manipal Hospital, 98, Rustom Bagh, Airport Road, Bangalore
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-7753.58556

Rights and Permissions
   Abstract 

Context: Male androgenetic alopecia (AGA) is a common condition. There is limited information on its prevalence and patterns. Aims: (1). To find the prevalence and most common pattern (2). To correlate the age and pattern of alopecia. Settings and Design: Population-based study. Materials and Methods: This is a population-based study from the public. The selection was random. The method involved was asking the age and, if found to between 30 and 50 years, the scalp was examined for alopecia and the pattern was determined using the Hamilton Norwood classification. Results: Of 1,005 subjects, the youngest was 30 years old and the oldest 49 years old, with a mean age of 37.05 6 standard deviation 4.79. 39.2% of the subjects were in the age group of 30-35, 34.4% in the 36-40 year age group, 26.0% in the 41-45 years age group and 0.4% in the 46-50 years age group. Five hundred and eighty-three subjects (58%) had AGA, the most common type being grade II (27.27%) followed by grade I (22.12%) and grade III (21.78%). 47.5% ( P = 0.003) had pattern alopecia in the 30-35 years age group, 58.7% in the 36-40 years age group ( P = 0.8) and 73.2% in the 41-45 years age group ( P ≤ 0.001). In the 30-35 years age group, grade I was 51.18%, grade II was 42.77% and grade VI was 18.52%. In the 41-45 years age group, grade I was 13.38%, grade III was 33.85% and grade VI was 66.67%. Conclusions: Fifty-eight percent of the male population aged 30-50 years had AGA. Its grade increased with increase in age. 12.9% of the male population had grades IV to VI, and would benefit from hair transplantation while 44.1% had grades I to III and are potential candidates for medical treatment

Keywords: Androgenetic alopecia, Hamilton Norwood classification, prevalence


How to cite this article:
Krupa Shankar D S, Chakravarthi M, Shilpakar R. Male androgenetic alopecia: Population-based study in 1,005 subjects. Int J Trichol 2009;1:131-3

How to cite this URL:
Krupa Shankar D S, Chakravarthi M, Shilpakar R. Male androgenetic alopecia: Population-based study in 1,005 subjects. Int J Trichol [serial online] 2009 [cited 2022 Aug 10];1:131-3. Available from: https://www.ijtrichology.com/text.asp?2009/1/2/131/58556


   Introduction Top


Hair loss is a common cosmetically and psychosocially distressing condition. Androgenetic alopecia (AGA) is the most common cause of hair loss among males. [1] Although the age of onset has been documented at 40 years, there are evidences that show that alopecia begins at 30 years of age. [2] But, this condition attracted least attention and there are limited studies on its prevalence and its grade in the Indian subcontinent. It is important to have further knowledge regarding its prevalence, grade of alopecia and its natural course for providing the appropriate management.


   Materials and Methods Top


This is a population-based study from the public within the vicinity of our hospital, involving 1,005 men between 30 and 50 years of age who were willing to be a part of the study. The period of study was 1 week. The selection was random and did not involve dermatology patients. We randomly selected the males who entered our hospital, which included patients, attainders, doctors and other hospital staff.

The age of the person was enquired. If it was found to be between 30 and 50 years, the scalp was examined with his oral consent for AGA and the pattern was determined using the Hamilton and Norwood classification. Photographs have been taken only from our hospital employees with their informed consent.


   Results Top


A total of 1,005 men were included in the study, of which the youngest was 30 years of age and the oldest was 49 years old, with a mean age of 37.05 ± standard deviation 4.79. 39.2% of the subjects were in the age group of 30-35 years, 34.4% in the age group of 36-40 years, 26.0% in the 41-45 years age group and 0.4% in the 46-50 years age group [Table 1].

Five hundred and eighty-three subjects (58%) had AGA while 422 subjects (42%) did not have alopecia [Figure 1]. The prevalence of AGA was 47.5% (P = 0.003) in the 30-35 years age group, 58.7% (P = 0.8) in the 36-40 years age group and 73.2% (P ≤ 0.001) in 41-45 years age group. Thus, the prevalence of AGA was statistically strongly significant and directly proportional to the increase in age [Table 2],[Figure 2].

The most common pattern of alopecia was grade II (27.27%), followed by grade I (22.12%) and then grade III (21.78%) [Figure 3].

The grade of alopecia was noted to increase with increase in age, as in the 30-35 years age group, grade I was 51.18%, grade II was 42.77% and grade VI was 18.52% while in the 41-45 years age group, grade I was 13.38%, grade III was 33.85% and grade VI was 66.67%.


   Discussion Top


AGA is the most common type of hair loss, representing quantitative phenotype with an underlying genetic disposition along with androgen influence. [3] Pre-programmed follicles on the scalp undergo a transformation from long growth (anagen) and short rest (telogen) cycles to long rest and short growth cycles coupled with progressive miniaturization of the follicle. [3],[4] These changes are androgen dependent and require the inheritance of several genes. The gene that encodes the androgen receptor has been identified. [4] Recently, the EDA2R gene that encodes the androgen receptor has been proposed to be associated with AGA. [5]

The evolution of baldness progresses from thinning in the temporal areas producing a reshaping of the anterior part of the hairline (temporal recession) then on to the loss of hair from the vertex region. [2] The grade of male AGA can be assessed using Hamilton [6] and Norwood's [7] classification.

In our study, we conclude that the prevalence of AGA in the male population between the ages of 30 and 50 years is 58%. A similar result has been quoted by Ellis et al., [4] Thomas, [2] Bader et al. [8] and Otberg et al., [9] who concluded that prevalence of AGA is approximately 50% in the population.

The prevalence increases with increase in age. The grade of alopecia gradually increases from the earlier grades (I and II) to the more severe type as the age increases.

Grade II is the most common type of AGA, accounting to 27.27%.

Minoxidil and fenasteride are known to be effective medical treatments in AGA, especially during the initial grades. [9] Hair transplantation is useful in the moderate to severe grade of AGA. 12.9% of the male population has grade IV to VI, and would benefit from hair transplantation, while 44.1% had grades I to III and are potential candidates for medical treatment.

 
   References Top

1.Springer K, Brown M, Stulberg DL. Common hair loss disorders. Am Fam Physician 2003;68:93-102.  Back to cited text no. 1  [PUBMED]  [FULLTEXT]  
2.Thomas J. Androgenetic alopecia: Current status. Indian J Dermatol 2005;50:179-90.  Back to cited text no. 2      
3.Hanneken S, Ritzmann S, Nφthen MM, Kruse R. Androgenetic alopecia: Current aspects of a common phenotype. Hautarzt. 2003;54:703-12.  Back to cited text no. 3      
4.Ellis JA, Sinclair R, Harrap SB. Androgenetic alopecia: Pathogenesis and potential for therapy. Expert Rev Mol Med 2002;4:1-11.  Back to cited text no. 4      
5.Prodi DA, Pirastu N, Maninchedda G, Sassu A, Picciau A, Palmas MA, et al. EDA2R is associated with androgenetic alopecia. J Invest Dermatol 2008;128:2268-70.  Back to cited text no. 5      
6.Hamilton JB. Patterned long hair in man; types and incidence. Ann NY Acad Sci 1951;53:708-14.  Back to cited text no. 6  [PUBMED]  [FULLTEXT]  
7.Norwood OT. Male pattern baldness: Classification and incidence. South Med J 1975;68:1359-70.  Back to cited text no. 7  [PUBMED]  [FULLTEXT]  
8.Bader U, Trόeb RM. Androgenetic alopecia in the man. Ther Umsch 2002;59:211-6.  Back to cited text no. 8      
9.Otberg N, Finner AM, Shapiro J. Androgenetic alopecia. Endocrinol Metab Clin North Am 2007;36:379-98.  Back to cited text no. 9  [PUBMED]  [FULLTEXT]  


    Figures

  [Figure 1], [Figure 2], [Figure 3]
 
 
    Tables

  [Table 1], [Table 2]


This article has been cited by
1 Association of androgenetic alopecia with a more severe form of COVID-19 infection
Dunja Veskovic, Tatjana Ros, Tijana Icin, Kristina Stepanovic, Nebojsa Janjic, Dusan Kuljancic, Sonja Sedlarevic, Dmitar Vlahovic
Irish Journal of Medical Science (1971 -). 2022;
[Pubmed] | [DOI]
2 No increased risk of alopecia in ankylosing spondylitis patients: A population-based cohort study in Taiwan
Jason Peijer Hsieh, Yung-Heng Lee, Bo-Jyun Wun, Yu-Hsun Wang, Hsi-Kai Tsou, James Cheng-Chung Wei
International Journal of Rheumatic Diseases. 2022;
[Pubmed] | [DOI]
3 Transcriptome analysis to identify the downstream genes of androgen receptor in dermal papilla cells
Kai Furuya, So Fujibayashi, Tao Wu, Kouhei Takahashi, Shin Takase, Ai Orimoto, Eriko Sugano, Hiroshi Tomita, Sayo Kashiwagi, Tohru Kiyono, Tsuyoshi Ishii, Tomokazu Fukuda
BMC Genomic Data. 2022; 23(1)
[Pubmed] | [DOI]
4 Induction of hair growth in hair follicle cells and organ cultures upon treatment with 30 kHz frequency inaudible sound via cell proliferation and antiapoptotic effects
Hyangtae Choi, Yonghee Lee, Seung Shin, Jin Nam, Won-Seok Park, Byung Park, Beom Kim
Biomedical Reports. 2022; 16(3)
[Pubmed] | [DOI]
5 Case Study of Hair Regrowth with Topical Cannabidiol (CBD)
Gregory L. Smith, John Satino
International Society of Hair Restoration Surgery. 2021; 31(4): 140
[Pubmed] | [DOI]
6 Innovative method of alopecia treatment by autologous adipose-derived SVF
Sun Jong Kim, Myung Jin Kim, Young Jun Lee, Joo Chan Lee, Ji Hyang Kim, Do Ha Kim, Young Hoo Do, Jun Woo Choi, Sung Ill Chung, Byung-Rok Do
Stem Cell Research & Therapy. 2021; 12(1)
[Pubmed] | [DOI]
7 Physcion, a novel inhibitor of 5a-reductase that promotes hair growth in vitro and in vivo
Zizhao Lao, Yaohua Fan, Yuhang Huo, Feng Liao, Rongwen Zhang, Bei Zhang, Ziyun Kong, Haishan Long, Jieliang Xie, Chuanlan Sang, Ludi Fu, Ji Lin, Yina Wu, Liangwen Yu, Geng Li
Archives of Dermatological Research. 2021;
[Pubmed] | [DOI]
8 Comparison of 5% minoxidil lotion monotherapy versus its combination with autologous platelet rich plasma in androgenetic alopecia in hundred males
Rahul Ray, Aseem Sharma
Medical Journal Armed Forces India. 2021; 77(3): 355
[Pubmed] | [DOI]
9 Randomized control trial to study the efficacy and safety of platelet-rich plasma as intraoperative holding solution in hair restoration surgery: A pilot study
Vikas Pathania, Aradhana Sood, Nagendra Beniwal, Sukriti Baveja, Prerna Shankar, Seema Patrikar
Medical Journal Armed Forces India. 2021;
[Pubmed] | [DOI]
10 Pharmacological Management of Pattern Hair Loss
Sandeep Suresh Sattur, Indu Sandeep Sattur
Indian Journal of Plastic Surgery. 2021;
[Pubmed] | [DOI]
11 A Multimodal Hair-Loss Treatment Strategy Using a New Topical Phytoactive Formulation: A Report of Five Cases
Sanusi Umar, Marissa J. Carter, Jacek Cezary Szepietowski
Case Reports in Dermatological Medicine. 2021; 2021: 1
[Pubmed] | [DOI]
12 Types and Treatment of Hair Loss in Men and Women
Emma Coleman
Plastic Surgical Nursing. 2020; 40(1): 6
[Pubmed] | [DOI]
13 Types and Treatment of Hair Loss in Men and Women
Emma Coleman
Plastic Surgical Nursing. 2020; 40(4): 222
[Pubmed] | [DOI]
14 Comparative Study to Evaluate Tolerability of Topical 5% Minoxidil Novel Formulation and Alcohol-Based Conventional Solutions in Treatment of Androgenetic Alopecia in Indian Men: Randomized Double-Blind Study
Rashmi Sarkar, Suneel Vartak, Shivani Acharya, Nikhil Kumar Kursam, Amey Mane, Suyog Mehta, Sujeet Narayan Charugulla
Dermatology and Therapy. 2020; 10(3): 469
[Pubmed] | [DOI]
15 Platelet-Rich Plasma for Hair Restoration
Natalie Justicz, Adeeb Derakhshan, Jenny X. Chen, Linda N. Lee
Facial Plastic Surgery Clinics of North America. 2020; 28(2): 181
[Pubmed] | [DOI]
16 The effectiveness of combination therapies for androgenetic alopecia: A systematic review and meta-analysis
Yi Zhou, Chenglong Chen, Qian Qu, Chunhua Zhang, Jin Wang, Zhexiang Fan, Yong Miao, Zhiqi Hu
Dermatologic Therapy. 2020; 33(4)
[Pubmed] | [DOI]
17 Human Derived Immortalized Dermal Papilla Cells With a Constant Expression of Testosterone Receptor
Tomokazu Fukuda, Kouhei Takahashi, Shin Takase, Ai Orimoto, Takahiro Eitsuka, Kiyotaka Nakagawa, Tohru Kiyono
Frontiers in Cell and Developmental Biology. 2020; 8
[Pubmed] | [DOI]
18 Regenerative medicine and hair loss: how hair follicle culture has advanced our understanding of treatment options for androgenetic alopecia
Claire A Higgins,Angela M Christiano
Regenerative Medicine. 2014; 9(1): 101
[Pubmed] | [DOI]
19 Guidelines for management of androgenetic alopecia based on BASP classification-the Asian consensus committee guideline
W.S. Lee,H.J. Lee,G.S. Choi,W.K. Cheong,S.K. Chow,M.T. Gabriel,K.L. Hau,H. Kang,M.R. Mallari,R.Y. Tsai,J. Zhang,M. Zheng
Journal of the European Academy of Dermatology and Venereology. 2013; 27(8): 1026
[Pubmed] | [DOI]
20 Characteristics of Androgenetic Alopecia in Asian
Won-Soo Lee,Hae-Jin Lee
Annals of Dermatology. 2012; 24(3): 243
[Pubmed] | [DOI]
21 Characteristics of androgenetic alopecia in asian
Lee, W.-S. and Lee, H.-J.
Annals of Dermatology. 2012; 24(3): 243-252
[Pubmed]



 

Top
 
  Search
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this article
    Abstract
    Introduction
    Materials and Me...
    Results
    Discussion
    References
    Article Figures
    Article Tables

 Article Access Statistics
    Viewed6271    
    Printed374    
    Emailed3    
    PDF Downloaded303    
    Comments [Add]    
    Cited by others 21    

Recommend this journal