Androgenetic Alopecia in Women: A Narrative Review of Pathophysiology, Clinical Evaluation, and Treatments.

American journal of clinical dermatology 2026 Vol.27(2) p. 363-389

Kearney CA, Brinks AL, Lawrence CN, Maas DE, Spindler AJ, Coric C, Gener-Pangilinan LA, Lasheras-Pérez MA, Shapiro J, Lo Sicco KI

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Abstract

Androgenetic alopecia (AGA) affects nearly 50% of women during their lifetime, representing the most prevalent form of chronic hair loss in this population. Despite its high incidence, AGA in women remains underdiagnosed and undertreated, with significant psychosocial consequences including diminished self-esteem, impaired social functioning, and reduced quality of life that often exceed impacts observed in men. AGA pathophysiology involves complex interactions between hormonal, genetic, and environmental factors. Androgens promote follicular miniaturization through progressive shortening of the anagen phase, while estrogens may provide protective effects. Genetic studies reveal sex-specific differences in disease mechanisms, and environmental factors like oxidative stress and pollution may contribute to disease progression. Clinical evaluation requires careful consideration of differential diagnoses including chronic telogen effluvium, diffuse alopecia areata, and scarring alopecias. Diagnostic tools include trichoscopy, pull testing, and trichometric measurements to assess hair density and miniaturization patterns. Currently, topical minoxidil is the only FDA-approved treatment for female AGA, also referred to as female pattern hair loss (FPHL). Off-label therapies include low-dose oral minoxidil, anti-androgens such as spironolactone and 5-alpha reductase inhibitors (finasteride and dutasteride), and hair transplantation. Adjunctive treatments like low-level light therapy and platelet-rich plasma may further augment improvement and are often best used in conjunction with medical therapies. Critical research gaps persist, including the paucity of randomized controlled trials for AGA that include female patients. There is an urgent need for additional FDA-approved therapies for AGA in women to increase treatment access and reduce its psychosocial burden.

추출된 의학 개체 (NER)

유형영어 표현한국어 / 풀이UMLS CUI출처등장
시술 hair transplantation 모발이식 dict 1
해부 hair scispacy 1
해부 oral scispacy 1
해부 platelet-rich plasma scispacy 1
합병증 trichoscopy scispacy 1
약물 estrogens C0014939
estrogens
scispacy 1
약물 effluvium C0263519
Anagen effluvium
scispacy 1
약물 minoxidil C0026196
minoxidil
scispacy 1
약물 low-dose C1708745
Low-Dose Treatment
scispacy 1
약물 anti-androgens C0002842
Androgen Antagonists
scispacy 1
약물 spironolactone C0037982
spironolactone
scispacy 1
약물 5-alpha scispacy 1
약물 finasteride C0060389
finasteride
scispacy 1
약물 dutasteride C0754659
dutasteride
scispacy 1
약물 platelet-rich C0370220
Platelet rich plasma
scispacy 1
질환 Androgenetic Alopecia C0162311
Androgenetic Alopecia
scispacy 1
질환 chronic hair loss scispacy 1
질환 impaired social functioning C0679477
impaired social functioning
scispacy 1
질환 alopecia areata C0002170
Alopecia
scispacy 1
질환 alopecias C0002170
Alopecia
scispacy 1
질환 trichoscopy scispacy 1
질환 hair loss C0002170
Alopecia
scispacy 1
질환 FPHL → female pattern hair loss scispacy 1
질환 AGA → Androgenetic alopecia scispacy 1
질환 disease scispacy 1
기타 Women scispacy 1
기타 AGA → Androgenetic alopecia scispacy 1
기타 men scispacy 1
기타 follicular scispacy 1
기타 female scispacy 1
기타 5-alpha reductase scispacy 1
기타 patients scispacy 1

MeSH Terms

Humans; Alopecia; Female; Minoxidil; Quality of Life; Androgen Antagonists; Hair; 5-alpha Reductase Inhibitors; Diagnosis, Differential

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