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Alopécia androgenética

Última revisão: 12 Aug 2025
Última atualização: 19 May 2023

Resumo

Definition

History and exam

Key diagnostic factors

  • presença de fatores de risco
  • história familiar de alopécia
  • regressão gradual da linha capilar frontal, central e da coroa (vértice)
  • afinamento difuso da parte central do couro cabeludo com preservação da linha capilar frontotemporal
Full details

Risk factors

  • história familiar de alopécia
  • idade avançada
  • síndrome do ovário policístico nas mulheres
  • etnia branca
  • resistência insulínica
  • câncer de próstata
Full details

Diagnostic investigations

1st investigations to order

  • teste de tração do cabelo
  • teste da função tireoidiana
  • ferritina sérica
Full details

Investigations to consider

  • Hemograma completo com diferencial
  • perfil metabólico completo
  • fator antinuclear
  • reagina plasmática rápida
  • testosterona livre
  • sulfato de prasterona (DHEA) sérico
  • globulina ligadora de hormônios sexuais
  • dermatoscopia/tricoscopia
  • biópsia do couro cabeludo
Full details

Treatment algorithm

ONGOING

homens que optam pelo tratamento conservador

homens que optam pelo tratamento clínico

mulheres que optam pelo tratamento conservador

mulheres que optam pelo tratamento clínico

tratamento clínico malsucedido

Contributors

Authors

Carolyn Goh, MD

Associate Clinical Professor

Department of Medicine

Division of Dermatology

UCLA Medical Center

Los Angeles

CA

Disclosures

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.

Acknowledgements

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.

Peer reviewers

Marcelo G. Horenstein, MD

Director of Dermatopathology

The Dermatology Group

Verona

NJ

Disclosures

MGH declares that he has no competing interests.

Alvin R. Solomon, MD

Professor of Dermatology

Emory University School of Medicine

Atlanta

GA

Disclosures

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

Disclosures

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.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

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. Abstract

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

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. Abstract

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. Abstract

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. Abstract

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. Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Alopécia androgenética images
  • Differentials

    • Alopécia areata difusa
    • Eflúvio telógeno agudo
    • Eflúvio telógeno crônico
    More Differentials
  • Guidelines

    • S3 - European dermatology forum guideline for the treatment of androgenetic alopecia in women and in men
    • Guidelines for the diagnosis and treatment of male-pattern and female-pattern hair loss
    More Guidelines
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