Androgenetic alopecia in men
Introduction
Introduction to male androgenetic alopecia Male androgenetic alopecia, male pattern alopecia, is an androgen-dependent hereditary hair loss that is autosomal dominant with variable penetrance, the most common form of baldness. Most of the men are around 20 to 30 years old. The hair loss is mainly at the top of the head. It starts from the hair on both sides of the forehead, and also starts from the top. The hair loss area gradually expands upwards, and the hair is gradually thinner and thinner. The top of the hair is mostly or completely detached, but the hair behind the pillow and the sides of the squat are in a horseshoe-like appearance. basic knowledge The proportion of illness: 0.0005% Susceptible people: mostly men aged 20 to 30 Mode of infection: non-infectious Complications: congenital cataract glaucoma retinoblastoma multi-fingery polycystic kidney allergic rhinitis multiple pregnancy diabetes insipidus
Cause
The cause of androgenetic alopecia in men
Genetic inheritance (40%):
High incidence, Caucasian distribution curve in the population, the more the number of patients in the relatives of the patient, the higher the risk of the disease; the risk of the incidence of serious female patients is higher than that of the milder, and the female patient is more susceptible than the male patient. Offspring, it has also been suggested that early onset (before 30 years old) and late onset (after 50 years of age) may be inherited by different single genes.
Androgen (20%):
Male hair loss can also be determined by adequate androgen stimulation at a specific age. If the eunuch is in adolescence or before it is castrated, no alopecia occurs. If androgen is given, it can cause alopecia. 5-testosterone reductase is The expression in the scalp of alopecia patients is elevated, resulting in elevated levels of dihydrotestosterone. The genes encoding type I and II 5a-reductase are located on chromosomes 5 and 2, respectively. Type I enzymes are mainly found in the skin and sebaceous glands. Type II enzyme expression and genitourinary tissue, patients with congenital 5-reductase deficiency do not develop alopecia due to the lack of type II isoenzyme.
Prevention
Male androgenetic alopecia prevention
Men androgenetic alopecia prevent the focus of our current prevention and treatment efforts. We should first focus on and improve those factors that are closely related to our lives, such as smoking cessation, proper diet, regular exercise and weight loss. Appropriate exercise, enhance physical fitness and improve your disease resistance. Anyone who follows these simple and reasonable lifestyles can reduce their chances of getting sick.
Complication
Male androgenetic alopecia complications Complications congenital cataract glaucoma retinoblastoma multi-fingery polycystic kidney allergic rhinitis multiple pregnancy diabetes insipidus
The disease is a genetic disease, so the diseases involved include the following aspects:
There are many types of autosomal dominant diseases, such as achondroplasia, short-finger malformation, renal diabetes, congenital cataract, night blindness, glaucoma, retinoblastoma, congenital drooping, and polymorphism. , polycystic kidney disease, hereditary neurological deafness, allergic rhinitis, tooth hypertrophy, multiple pregnancy and diabetes insipidus.
Symptom
Men with androgen-derived alopecia symptoms common symptoms alopecia all bald itching
Most of the men are around 20 to 30 years old. The hair loss is mainly at the top of the head. It starts from the hair on both sides of the forehead, and also starts from the top. The hair loss area gradually expands upwards, and the hair is gradually thinner and thinner. The top of the hair is mostly or completely detached, but the hair behind the pillow and the two sides of the ridge are in a horseshoe-like appearance. The hair in the belt is normal, the skin at the hair loss is bright, the pores are reduced or a little soft bristles remain, and the rate of hair loss is The extent and severity are affected by heredity and individuality. Generally, it is the fastest growing in about 30 years old. It is rare in all cases of severe baldness. Most women are diffuse hair loss that occurs on the top of the head. The hair on the head is sparse, and the symptoms are absent. If accompanied by sebum. Overflow or seborrheic dermatitis, mild itching, Hamilton according to the severity of baldness, male baldness is divided into VIII grade, Ludwig also divided women's diffuse alopecia into grade III, hair loss classification is good for evaluating hair loss Severity and observation of treatment effect, grade I is normal hair coverage, hair loss at the apex of both sides, seen in pre-pubertal men and women.
In addition to the alopecia loss in the second stage, bald spots can also appear behind the head.
At the top of the class III, the hair is thin, and the bald area is fused into a piece.
The level IV only horseshoe-shaped scalp has a hair on the edge of the scalp called the Hippocrates bald (calvities hippocratica).
There is no atrophy in the hair loss area, but it looks thin due to the lack of hair bulbs. The hair follicles are visible and contain short, slender bristles. The hair loss at the hair loss can no longer moisturize the hair and remain on the scalp, so the scalp is particularly oily.
Examine
Examination of male androgenetic alopecia
Histopathology: The earliest detectable change was the shortening of hair follicle growth in the bald area, and the percentage of hair follicles in the rest period increased. These hairs were loose and easy to fall. After several consecutive cycles, the hair follicles became smaller and the terminal hair was replaced by bristles. In the end, many of the hair follicles disappeared. The earliest histological changes were degeneration of the lower part of the hair follicle connective tissue root sheath, accompanied by changes in vascular basophilicity. The hair follicle gradually atrophied leaving a bundle of hardened glassy connective tissue with a thin epidermis. The epidermal mutation was flat, the subepidermal capillary plexus almost disappeared, the sulphur-containing mucopolysaccharide deposition in the dermis increased, and the enzymatic activity of the hair follicle was generally normal.
Diagnosis
Diagnosis and diagnosis of androgenetic alopecia in men
diagnosis
According to family history and typical clinical manifestations, the diagnosis of this disease is not difficult.
Differential diagnosis
However, female male baldness needs to be differentiated from diffuse hair loss caused by other causes, such as postpartum, anemia, endocrine changes or other systemic diseases.
Diffuse alopecia, also known as sparse alopecia, means that the amount of hair loss increases significantly in a short period of time, making the hair sparse, leaving it to cause the hair follicle to shrink or even die, the hair can no longer grow, causing baldness. Because most patients with diffuse alopecia are caused by nutritional imbalance, severe diffuse hair loss is also a healthy warning. Unbalanced nutrition can affect the immune system, and there are opportunities to cause serious diseases. Hair loss is no longer It only involves the appearance of appearance, but it can reflect the health of the body, so we must not take it lightly.
