Androgenic alopecia, commonly known as male pattern baldness, is the most prevalent form of hair loss among men. This hereditary condition affects a large proportion of the male population, but the onset and progression can vary significantly from one individual to another.

Early Onset of Androgenic Alopecia

Interestingly, androgenic alopecia can begin at an early age for some men. Approximately 5% of the male population experiences the onset of this condition before the age of 20. The initial signs typically appear at the temples (bitemporal recession) and later progress to the crown (vertex).

Typical Hair Parameters

The hair characteristics of men with androgenic alopecia differ noticeably from those with normal hair. Below are some typical hair parameters based on various studies:

Hair Length and Diameter

• Normal Hair:
• Average diameter: 77 micrometers
• Hair length: Longer than 40 mm in the majority of cases
• Androgenic Alopecia Hair:
• Average diameter: 60 micrometers (thinner hairs)
• Nearly 48.5% of meaningful hairs are 40 mm or shorter in length

Hair Loss Rates

• Normal Individuals:
• Average hair loss during washing: 28 hairs per wash
• Androgenic Alopecia:
• Average hair loss during washing: 52 hairs per wash

Detecting the Onset of Androgenic Alopecia

Early detection of androgenic alopecia is crucial for effective management. Here are some indicators that can help diagnose the condition:

1. Increased Hair Shedding: A noticeable increase in hair shedding during washing or brushing/ combing.
2. Thinner Hair Strands: The average diameter of hair strands becomes thinner compared to normal hair.
3. Presence of Vellus Hairs: An increase in the percentage of vellus hairs (short, fine, less pigmented hairs). For instance, individuals with androgenic alopecia have around 8.3% vellus hairs compared to 1% in normal individuals.

Progression and Balding Estimates

The progression of androgenic alopecia varies among individuals, but studies provide some insights into the average rates of hair loss and balding:

• Natural Progression: Men with androgenic alopecia experience a gradual reduction in hair density and meaningful hair length over time. According to a study, hair density decreased by 6.5% after 12 months and by 11.9% after 24 months. Similarly, meaningful hair density (non-vellus hairs/cm²) decreased by 10.8% after 12 months and by 22.7% after 24 months.
• Balding Estimates: Based on the average hair loss rates, it is estimated that without treatment, male pattern baldness can significantly worsen within a few years. Encouragingly, treatments that maintain existing hair and promote the growth of shorter hairs can improve the appearance and manage the condition effectively.

Understanding the early signs and progression of androgenic alopecia is essential for managing and treating this common condition. By staying informed and seeking appropriate treatments, individuals can maintain healthier and fuller hair for longer periods.

Sources:

https://pubmed.ncbi.nlm.nih.gov/1934570/

https://pubmed.ncbi.nlm.nih.gov/35115799/