Hair Loss (Androgenetic Alopecia)

Androgenetic alopecia is the medical name for male and female pattern hair loss. Genetically sensitive follicles shrink under the influence of dihydrotestosterone (DHT), producing finer, shorter hairs with each cycle until some stop producing visible hair.

It is progressive and lifelong, but slow. Medicines can hold the line and thicken what remains; they work far better at keeping hair than at bringing it back. A transplant redistributes hair and does not stop the underlying process.

Symptoms

• Men: recession at the temples forming an M shape
• Men: thinning at the crown that may join the frontal loss
• Women: widening of the central parting with the frontal hairline preserved
• Hairs that become finer, shorter and lighter before disappearing
• More scalp visible in bright light or when hair is wet
• No itching, pain or scarring of the scalp

Causes and risk factors

The cause is inherited, from either side of the family, and involves many genes, the androgen receptor gene among them. The enzyme 5-alpha reductase converts testosterone to DHT, which shortens the growth phase in susceptible follicles on the top of the scalp. Follicles at the back and sides are resistant, which is why transplanted hair survives. In women, onset often follows menopause; early or severe loss with irregular periods or acne should prompt a check for polycystic ovary syndrome. Hormone levels are normal in most affected people.

How it is diagnosed

• Clinical pattern: Diagnosis is usually made on appearance. Severity is graded with the Norwood scale in men and the Ludwig or Sinclair scale in women.
• Trichoscopy: Variation in hair shaft diameter of more than 20 percent in the affected zone confirms miniaturisation.
• Blood tests: Ferritin and thyroid function to exclude contributors; androgen profile in women with signs of hormone excess.
• Donor area assessment: Density and hair calibre at the back of the scalp determine whether, and how much, transplantation is possible.

Treatment options

• Minoxidil: Topical solution or foam, or low dose tablets prescribed off label. Expect a temporary shed in the first weeks and judge the result at 6 to 12 months.
• Finasteride: A daily tablet for men that lowers scalp DHT. It halts progression in most users and gives visible regrowth in roughly two thirds. Not for women who could become pregnant.
• Dutasteride: A stronger DHT blocker used off label when finasteride is not enough.
• Anti-androgens for women: Spironolactone or certain contraceptive pills, with reliable contraception, under medical supervision.
• FUE or DHI hair transplant: Individual follicular units are moved to the hairline and crown. Usually one long day under local anaesthetic; growth shows from month 4 and matures at 12 to 18 months.
• Adjuncts: PRP, microneedling and low level laser have limited evidence and variable results.
• Cosmetic options: Fibres, scalp micropigmentation and hair systems are legitimate choices for those who prefer no medicine or surgery.

When it is urgent

Pattern hair loss never needs emergency care. If you take finasteride and notice persistent low mood, or minoxidil tablets and develop chest pain, a racing pulse or ankle swelling, stop the medicine and see a doctor locally.

Travelling to Türkiye for treatment

This is the condition most hair transplant travellers have. A typical visit is 3 to 4 days: consultation and blood tests, the procedure, and a first wash the next day. Be realistic about graft numbers, because the donor supply is finite and loss continues elsewhere. Plan to continue medical treatment at home to protect your native hair, or the transplanted area may eventually stand alone.

Send your reports, scans and a short history and a Clinic-Y coordinator replies within 24 hours with suitable teams and written, all-inclusive proposals side by side. Reviewing your case is free.

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