Female androgenetic alopecia (FAGA) is one of the most prevalent causes of non-scarring alopecia in women. The onset can occur at any age after puberty, and the frequency rises with age. Clinically, it is characterised by widespread hair loss throughout the middle scalp, with the frontal hairline generally remaining intact. FAGA has the potential to have a major psychological impact, resulting in anxiety and despair. As a result, early detection is critical for halting disease development. The major pathogenetic mechanism investigated in FAGA is the sex hormonal milieu. The function of androgens is unclear, and only one-third of women with FAGA had elevated androgen levels. Endocrinological disorders linked with hyperandrogenism in FAGA include polycystic ovarian syndrome (PCOS), hyperprolactinemia, adrenal hyperplasia, and, in rare cases, ovarian and adrenal tumours. Typically, FAGA is diagnosed clinically. Other symptoms of hyperandrogenism might be revealed by a thorough clinical examination as well as a blood test. Trichoscopy reveals the usual hair shrinkage. When a clinical examination fails to offer a firm diagnosis or when cicatricial alopecias with hair loss in the distribution of FAGA or alopecia areata are suspected, a scalp biopsy may be performed. FAGA is a disease that progresses slowly.
The objective of treatment is to halt the course of hair loss and promote aesthetically acceptable hair regrowth. Topical minoxidil and oral anti-androgens are the most significant medications. The goal of this study is to offer an update on FAGA and to provide a guideline for the diagnosis and therapy of this common hair condition, which is not always distinguishable from cicatricial alopecias with comparable distribution.
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