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
Fatores de risco
- family history of baldness
- advancing age
- polycystic ovary syndrome in women
- white ethnicity
- insulin resistance
- prostate cancer
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- hair-pull test
- thyroid function test
- serum ferritin
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
Algoritmo de tratamento
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
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.

Diagnósticos diferenciais
- Diffuse alopecia areata
- Acute telogen effluvium
- Chronic telogen effluvium
Mais Diagnósticos diferenciaisGuidelines
- 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 GuidelinesLog in or subscribe to access all of BMJ Best Practice
Use of this content is subject to our disclaimer