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Androgenetic alopecia

Última revisão: 28 Nov 2025
Última atualização: 19 May 2023

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • family history of baldness
  • gradual receding of frontal hairline, central, and crown (vertex)
  • diffuse thinning of the central scalp with preservation of frontotemporal hairline
Detalhes completos

Fatores de risco

  • family history of baldness
  • advancing age
  • polycystic ovary syndrome in women
  • white ethnicity
  • insulin resistance
  • prostate cancer
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • hair-pull test
  • thyroid function test
  • serum ferritin
Detalhes completos

Investigações a serem consideradas

  • CBC with differential
  • comprehensive metabolic panel
  • antinuclear antibodies
  • rapid plasma reagin
  • free testosterone
  • serum dehydroepiandrosterone (DHEA)-sulfate
  • sex hormone-binding globulin
  • dermatoscopy/trichoscopy
  • scalp biopsy
Detalhes completos

Algoritmo de tratamento

CONTÍNUA

men who opt for conservative management

men who opt for medical management

women who opt for conservative management

women who opt for medical management

failed medical treatment

Colaboradores

Autores

Carolyn Goh, MD

Associate Clinical Professor

Department of Medicine

Division of Dermatology

UCLA Medical Center

Los Angeles

CA

Declarações

CG has spoken for the International Society of Hair Restoration Surgeons, the American Academy of Dermatology, the Pacific Dermatologic Association, the California Society of Dermatology and Dermatologic Surgery, and has had manuscripts published in a variety of journals. CG has also participated in advisory boards for Pelage Pharmaceuticals and Pfizer, Inc.

Agradecimentos

Dr Carolyn Goh would like to gratefully acknowledge Dr Robert Haber, Dr Christiane Querfeld, and Dr Christopher R. Shea, previous contributors to this topic. RH has an ownership interest in a company that manufactures light-based hair growth devices and receives royalties for the sales of a surgical device used in hair restoration surgery. CQ and CRS declare that they have no competing interests.

Revisores

Marcelo G. Horenstein, MD

Director of Dermatopathology

The Dermatology Group

Verona

NJ

Declarações

MGH declares that he has no competing interests.

Alvin R. Solomon, MD

Professor of Dermatology

Emory University School of Medicine

Atlanta

GA

Declarações

ARS declares that he has no competing interests.

David Whiting, MD, FACP

Medical Director

The Baylor Hair and Skin Research and Treatment Center

Dallas

TX

Declarações

DW is an author of a number of references cited in this topic. We have since been made aware that Dr David Whiting is deceased.

Créditos aos pareceristas

Os tópicos do BMJ Best Practice são constantemente atualizados, seguindo os desenvolvimentos das evidências e das diretrizes. Os pareceristas aqui listados revisaram o conteúdo pelo menos uma vez durante a história do tópico.

Declarações

As afiliações e declarações dos pareceristas referem--se ao momento da revisão.

Referências

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Principais artigos

Starace M, Orlando G, Alessandrini A, et al. Female androgenetic alopecia: an update on diagnosis and management. Am J Clin Dermatol. 2020 Feb;21(1):69-84. Resumo

European Dermatology Forum. S3 - European Dermatology Forum guideline for the treatment of androgenetic alopecia in women and in men. 2017 [internet publication].Texto completo

Olsen EA, Messenger AG, Shapiro J, et al. Evaluation and treatment of male and female pattern hair loss. J Am Acad Dermatol. 2005 Feb;52(2):301-11. Resumo

Olsen EA, Whiting D, Bergfeld W, et al. A multicenter, randomized, placebo-controlled, double-blind clinical trial of a novel formulation of 5% minoxidil topical foam versus placebo in the treatment of androgenetic alopecia in men. J Am Acad Dermatol. 2007 Nov;57(5):767-74. Resumo

Kaufman KD, Olsen EA, Whiting D, et al. Finasteride in the treatment of men with androgenetic alopecia. Finasteride Male Pattern Hair Loss Study Group. J Am Acad Dermatol. 1998 Oct;39(4 Pt 1):578-89. Resumo

Lucky AW, Piacquadio DJ, Ditre CM, et al. A randomized, placebo-controlled trial of 5% and 2% topical minoxidil solutions in the treatment of female pattern hair loss. J Am Acad Dermatol. 2004 Apr;50(4):541-53. Resumo

Olsen EA, Hordinsky MK, Price VH, et al. Alopecia areata investigational assessment guidelines: part II. National Alopecia Areata Foundation. J Am Acad Dermatol. 2004;51:440-7. Resumo

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
  • Androgenetic alopecia images
  • Diagnósticos diferenciais

    • Diffuse alopecia areata
    • Acute telogen effluvium
    • Chronic telogen effluvium
    Mais Diagnósticos diferenciais
  • Guidelines

    • S3 - European dermatology forum guideline for the treatment of androgenetic alopecia in women and in men
    • Medical guidelines for clinical practice for diagnosis and treatment of hyperandrogenic disorders
    Mais Guidelines
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