Androgenetic alopecia
By The Treatment Registry editors
Hereditary pattern hair loss in men and women, driven by androgen sensitivity in genetically predisposed follicles. Treatment combines medical therapy to slow progression with surgical hair restoration to redistribute donor follicles. Surgical results are best in patients with stabilised pattern loss and adequate donor density; the underlying genetic process continues so combined medical-surgical management is often appropriate.
Treatment ladder
Conservative options are first-line where appropriate; surgical options are typically reserved for cases where lower-tier options are unsuitable or have failed. Decisions are individual and depend on clinical assessment.
Conservative
- Topical minoxidil
Over-the-counter 2% or 5% solution/foam applied twice daily. Slows progression and may produce modest regrowth in early-stage disease; effect lost on stopping. First-line in both men and women.
- Oral finasteride (men)
5-alpha reductase inhibitor 1mg daily. Effective in male pattern loss; sexual side effects in a small proportion. Requires prescription and ongoing use.
- Low-level laser therapy
FDA-cleared device-based therapy with modest evidence; an adjunct rather than a primary therapy.
Procedural
- Hair transplant — FUE · View procedure page
Follicular Unit Extraction: individual follicular units harvested from a donor area (usually occipital scalp) using small punches and implanted into thinning recipient sites. Leaves no linear scar; longer extraction time than FUT.
- Hair transplant — DHI
Direct Hair Implantation: an FUE variant using a Choi pen-like implanter; allows precise angle and depth control without prior site-making. Often marketed as a distinct technique.
- Hair transplant — FUT
Follicular Unit Transplantation: a linear strip of donor scalp is excised and dissected into follicular units. Leaves a linear donor-area scar but allows higher graft yields per session.
Surgical
- Scalp reduction (historic, rarely performed)
Surgical excision of bald scalp with advancement of hair-bearing scalp. Largely superseded by modern transplantation techniques and rarely performed today.