Summary
Definición
Anamnesis y examen
Principales factores de diagnóstico
- 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
Factores de riesgo
- história familiar de alopécia
- idade avançada
- síndrome do ovário policístico nas mulheres
- etnia branca
- resistência insulínica
- câncer de próstata
Pruebas diagnósticas
Primeras pruebas diagnósticas para solicitar
- teste de tração do cabelo
- teste da função tireoidiana
- ferritina sérica
Pruebas diagnósticas que deben considerarse
- 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
Algoritmo de tratamiento
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
Colaboradores
Autores
Carolyn Goh, MD
Associate Clinical Professor
Department of Medicine
Division of Dermatology
UCLA Medical Center
Los Angeles
CA
Divulgaciones
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.
Agradecimientos
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 por pares
Marcelo G. Horenstein, MD
Director of Dermatopathology
The Dermatology Group
Verona
NJ
Divulgaciones
MGH declares that he has no competing interests.
Alvin R. Solomon, MD
Professor of Dermatology
Emory University School of Medicine
Atlanta
GA
Divulgaciones
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
Divulgaciones
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.
Agradecimiento de los revisores por pares
Los temas de BMJ Best Practice se actualizan de forma continua de acuerdo con los desarrollos en la evidencia y en las guías. Los revisores por pares listados aquí han revisado el contenido al menos una vez durante la historia del tema.
Divulgaciones
Las afiliaciones y divulgaciones de los revisores por pares se refieren al momento de la revisión.
Referencias
Artículos principales
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. Resumen
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. Resumen
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. Resumen
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. Resumen
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. Resumen
Artículos de referencia
Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.

Diferenciales
- Alopécia areata difusa
- Eflúvio telógeno agudo
- Eflúvio telógeno crônico
Más DiferencialesGuías de práctica clínica
- 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
Más Guías de práctica clínicaInicie sesión o suscríbase para acceder a todo el BMJ Best Practice
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