Alopecia androgenetica (hormonal hair loss)

What Is Alopecia Androgenetica?

Alopecia iAndrogenetica s the most common form of progressive hair loss in both men and women. It is driven by hormonal sensitivity at the hair follicle level and develops gradually over time.

Importantly, it is not caused by poor hair care, shampoo use, stress alone, or nutritional deficiency.

The condition is rooted in how specific hair follicles respond to normal levels of androgens, particularly dihydrotestosterone (DHT).

What Alopecia Androgenetica is - and is NOT

Alopecia Androgeneticais the most common form of progressive hair loss in both men and women. It develops gradually and is driven by hormonal sensitivity at the hair follicle level.

Importantly, it is not caused by poor hair care, shampoo use, stress alone, or nutritional deficiency. The condition reflects how specific hair follicles respond to normal levels of androgens, particularly dihydrotestosterone (DHT).

Alopecia Androgenetica is:

A biologically driven condition
Progressive if left unaddressed
Pattern-based rather than random

Alopecia Androgenetica is NOT:

A sudden shedding disorder
Caused by stress alone
A sign of poor health

This distinction is essential, as alopecia androgenetica is frequently confused with temporary or reactive forms of hair loss.

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Androgenetic alopecia develops as a result of a combination of genetic predisposition and increased sensitivity of certain hair follicles to hormonal signals. This does not involve a hormonal disorder or abnormal hormone levels, but rather an inherited response of specific hair follicles.

This sensitivity varies between individuals and between different areas of the scalp, which explains why androgenetic alopecia develops according to recognisable patterns.

The role of dihydrotestosterone (DHT)

An important factor in androgenetic alopecia is dihydrotestosterone (DHT), a biologically active derivative of the hormone testosterone. DHT plays a role in normal physiological processes, but in individuals with a predisposition to androgenetic alopecia, certain hair follicles respond more strongly to its presence.

As a result of this increased sensitivity, the hair growth cycle of the affected follicles changes. The growth phase of the hair becomes shorter, meaning the hair has less time to grow before it sheds.

Miniaturisation of hair follicles

As a consequence of these changes in the hair growth cycle, sensitive hair follicles undergo a process known as miniaturisation. During successive growth cycles, these follicles produce:

thinner hair
shorter hair
hair with a reduced lifespan

Over time, the follicle may shrink to such an extent that little to no visible hair is produced. This process occurs gradually and explains why androgenetic alopecia typically becomes clearly noticeable only after several years.

Genetic sensitivity determines the pattern

Not all hair follicles respond to DHT in the same way. Genetic sensitivity varies across different regions of the scalp, which explains why androgenetic alopecia follows characteristic patterns.

In men, this most commonly affects the temples and the crown, whereas in women it usually presents as diffuse thinning around the central parting.

Why hormone levels are usually normal

It is important to emphasise that androgenetic alopecia is, in most cases, not caused by elevated hormone levels. Testosterone and DHT levels are generally within the normal range.

The difference lies in how the hair follicle responds to these hormones, not in the overall amount of hormone present in the body.

Why the process is not reversible, but may be influenced

Because follicular miniaturisation is a structural process, complete recovery of hair follicle activity that has already been lost is usually not possible. However, in some cases, the progression of androgenetic alopecia may be slowed or stabilised when the process is recognised at an early stage.

For this reason, understanding the type of hair loss involved and identifying when the process is active are of key importance.

How Alopecia Androgenetica develops over time

Alopecia Androgenetica develops gradually over many years. The changes occur at the level of individual hair follicles and often become noticeable only after a significant reduction in hair density has already taken place. To understand this process, it is important to first understand the normal hair growth cycle.

The normal hair growth cycle

Each hair follicle repeatedly goes through a cycle consisting of three phases:

Anagen (growth phase)
The hair grows actively. In healthy hair follicles, this phase can last several years.
Catagen (transition phase)
Hair growth slows and the follicle prepares for a resting period.
Telogen (resting and shedding phase)
The hair is eventually shed and replaced by a new growing hair.

Under normal conditions, hair follicles cycle independently of one another, which helps maintain overall hair density.

What changes in Alopecia Androgenetica

In androgenetic alopecia, certain hair follicles respond differently to hormonal signals. As a result, the hair growth cycle gradually changes:

the growth phase becomes progressively shorter
the hair grows thinner and for a shorter length of time
each successive growth cycle produces a weaker hair than the previous one

This process is known as follicular miniaturisation and does not occur suddenly, but accumulates over multiple hair growth cycles.

Why progression is slow but cumulative

Because the changes per hair growth cycle are relatively small, alopecia androgenetica progresses slowly. However, each cycle contributes to further weakening of the hair follicle. Over months and years, this cumulative effect leads to visibly thinner hair and reduced hair density.

Why early stages are often missed

In the early stages, hair is often still present, but its quality changes subtly. As a result, androgenetic alopecia is frequently not recognised immediately. At this stage:

hair distribution may still appear acceptable
hair becomes more difficult to style
density gradually decreases rather than disappearing suddenly

Only when follicular miniaturisation has progressed further does hair loss become clearly noticeable for most people.

Alopecia Androgenetica in men and women

Although Alopecia Androgenetica is driven by similar biological mechanisms in both sexes, its clinical presentation differs between men and women. These differences are primarily related to genetic sensitivity patterns of hair follicles across different areas of the scalp.

Understanding these distinctions helps explain why hair loss can look very different from one person to another, even when the underlying condition is the same.

Alopecia Androgenetica in men

In men, androgenetic alopecia typically follows well-defined and recognisable patterns. Hair follicles in specific areas of the scalp are more sensitive to hormonal signals, leading to progressive thinning over time.

Common characteristics include:

recession at the temples
thinning at the crown (vertex)
gradual enlargement of affected areas

These changes often begin in early adulthood and may progress steadily over many years. The pattern of hair loss is usually symmetrical and follows predictable stages.

Receding hairline at the temples
Thinning at the crown (vertex)
The affected areas gradually expand and may connect over time

Alopecia Androgenetica in women

In women, Alopecia Androgenetica generally presents differently. Rather than clear recession or bald areas, hair loss is more often diffuse and less sharply defined.

Typical features include:

gradual thinning across the top of the scalp
widening of the central parting
preservation of the frontal hairline in most cases

Because the hair loss is spread more evenly, early stages may be less noticeable and are often mistaken for general hair thinning or age-related changes.

Progressive widening of the central part line
Reduced hair density around the crown and mid-scalp
Preservation of the frontal hairline in most cases

Why patterns differ between men and women

The differences in presentation are not caused by different hormone levels, but by variations in genetic sensitivity of hair follicles across the scalp. These sensitivity patterns are influenced by hereditary factors and differ between men and women.

As a result, the same underlying process can lead to clearly visible baldness in men, while producing diffuse thinning in women.

Age and progression

The onset and rate of progression of Alopecia Androgenetica vary widely. In both men and women, the condition may begin at different ages and progress at different speeds. While some individuals notice changes early in adulthood, others may experience very gradual progression over decades.

Age influences how noticeable the condition becomes, but it does not determine whether Alopecia Androgenetica will occur.

Why recognition can be more difficult in women

Because hair loss in women is often diffuse and develops gradually, Alopecia Androgenetica may remain unrecognised for a long time. Hair density can decrease significantly before visible changes become obvious, especially when styling compensates for early thinning.

For this reason, understanding sex-specific patterns is essential when assessing hair loss.

Distinguishing Alopecia Androgenetica from other forms of hair loss

Not all hair loss is caused by Alopecia Androgenetica alopecia. Several other conditions can lead to hair shedding or thinning, sometimes with overlapping symptoms. Correctly distinguishing between these forms is essential, as the underlying mechanisms and expected course differ significantly.

The most common conditions that may be confused with Alopecia Androgenetica are telogen effluvium and alopecia areata.

Alopecia Androgenetica

Androgenetic alopecia is a chronic, progressive form of hair loss driven by genetic sensitivity of hair follicles to hormonal signals. It typically follows recognisable patterns and develops gradually over time.

Key characteristics include:

gradual onset and progression
pattern-based thinning rather than random loss
long-term changes in hair density and quality

Without intervention, the process usually continues over many years.

Telogen effluvium

Telogen effluvium is a form of diffuse hair shedding that occurs when a large number of hair follicles prematurely enter the resting (telogen) phase of the hair growth cycle. This condition is usually triggered by a temporary stressor.

Common triggers include:

physical or emotional stress
illness or surgery
hormonal changes
nutritional deficiencies

Hair loss in telogen effluvium is typically sudden and widespread, but in many cases it is temporary, with regrowth occurring once the underlying trigger resolves.

Alopecia areata

Alopecia areata is an autoimmune condition in which the immune system mistakenly targets hair follicles. This leads to sudden, well-defined patches of hair loss.

Typical features include:

round or oval bald patches
sudden onset
possible involvement of eyebrows or body hair

The course of alopecia areata is unpredictable and differs fundamentally from Alopecia Androgenetica.

Why correct differentiation matters

Although these conditions can all result in hair loss, their causes, progression, and long-term outlook differ substantially. Alopecia Androgenetica is usually chronic and progressive, while telogen effluvium is often temporary, and alopecia areata follows an autoimmune course.

Because symptoms may overlap, especially in early stages, misinterpretation is common. A structured assessment is often needed to clarify which form of hair loss is most likely.

Gaining insight into your type of hair loss

Understanding whether hair loss is pattern-based, diffuse, or patch-like is an important first step in determining the underlying cause. This distinction helps guide realistic expectations and appropriate next steps.

How Alopecia Androgenetica Is identified in practice

Alopecia androgenetica is not identified based on a single symptom or observation.

In clinical practice, assessment is based on a combination of pattern, timing, and follicular behavior, evaluated together rather than in isolation.

This structured approach helps distinguish androgenetic alopecia from temporary or reactive forms of hair loss and reduces the risk of misclassification.

No single sign is decisive

Hair loss can present in many ways, and similar symptoms may have different underlying causes.

For this reason, clinicians do not rely on shedding alone, visible thinning alone, or family history alone to identify androgenetic alopecia.

Instead, diagnosis emerges from the overall pattern and progression over time.

Key elements clinicians consider

When assessing for alopecia androgenetica, clinicians typically evaluate the following. No single factor is sufficient on its own. Assessment is cumulative, integrating multiple observations.

Pattern and distribution
Whether thinning follows characteristic androgen-sensitive areas rather than occurring randomly across the scalp.
Onset and progression
Gradual change over months or years, rather than sudden or episodic hair loss.
Hair shaft variability
The presence of thick, terminal hairs alongside thinner, weaker hairs in the same area, a sign of progressive follicular miniaturization.
Stability of the frontal hairline
Particularly relevant in women, where preservation of the frontal hairline supports androgenetic rather than scarring or autoimmune causes.
Scalp condition
Absence of scarring, inflammation or sharply defined patches.
Contextual factors
Age, hormonal status and other background factors that influence likelihood and presentation.

If you are unsure how these clinical criteria apply to your situation, the next step is structured assessment based on pattern, timing, and risk factors rather than guesswork.

The role of long-term support and the TRIX Hair Check

Alopecia Androgenetica is a chronic condition that develops over time. Because the underlying genetic sensitivity of hair follicles cannot be altered, the focus is not on curing the condition, but on understanding its progression and supporting hair follicle function over the long term.

Gaining clarity about the type of hair loss involved is an essential first step. Without understanding whether hair loss is pattern-based, diffuse, or patch-like, it is difficult to determine which next steps are appropriate.

Why early insight matters

In the early stages of Alopecia Androgenetica, many hair follicles are often still active, even though subtle changes in hair quality and density may already be occurring. As the condition progresses, follicular activity can decline further.

Recognising Alopecia Androgenetica at an early stage helps establish realistic expectations and supports informed decision-making around long-term support.

The value of a structured assessment

Because different forms of hair loss can present with overlapping features, a structured assessment is often necessary. Such an evaluation considers factors including hair loss pattern, onset, progression over time, and individual characteristics.

The TRIX Hair Check is designed to guide users through a short, structured assessment to help identify which type of hair loss is most likely and which form of support may be relevant.

Long-term support in Alopecia Androgenetica

Support strategies for Alopecia Androgenetica typically focus on maintaining hair follicle function and scalp condition over time. These approaches are not intended to reverse the condition, but to align with its long-term and progressive nature.

TRIX Basic Alpha is formulated as daily nutritional support for individuals with Alopecia Androgenetica and is intended to be used as part of a broader, long-term approach.

Gaining clarity about your situation

Understanding the type and pattern of hair loss involved can provide clarity and direction. A structured assessment can help distinguish androgenetic alopecia from other forms of hair loss and support informed next steps.

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Based on 20+ years of dermatological expertise

Frequently asked questions about Alopecia Androgenetica

What is Alopecia Androgenetica?

Alopecia Androgenetica is a chronic, genetically determined form of hair loss in which certain hair follicles are sensitive to hormonal signals. This sensitivity leads to gradual hair thinning in recognisable patterns in both men and women.

Is Alopecia Androgenetica permanent?

Alopecia Androgenetica is generally a long-term condition. The underlying genetic sensitivity of hair follicles cannot be changed. Progression varies between individuals, and early recognition helps set realistic expectations and next steps.

Does Alopecia Androgenetica also occur in women?

Yes. Alopecia Androgenetica affects both men and women. In women, it typically presents as diffuse thinning—often around the central parting—while the frontal hairline is usually preserved.

Is Alopecia Androgenetica caused by stress?

No. Alopecia Androgenetica is not caused by stress. Stress can trigger other forms of hair loss, such as telogen effluvium, which are sometimes confused with Alopecia Androgenetica. Distinguishing between these conditions is important.

Are hormone levels abnormal in Alopecia Androgenetica?

In most cases, hormone levels are normal. Testosterone and DHT levels are typically within the normal range. The difference lies in how genetically sensitive hair follicles respond to these hormones.

How is Alopecia Androgenetica different from telogen effluvium?

Alopecia Androgenetica develops gradually and follows characteristic patterns. Telogen effluvium usually causes sudden, diffuse shedding and is often temporary. The causes and expected course of these conditions differ significantly.

How can I determine which type of hair loss I have?

Because different forms of hair loss can share similar features, a structured assessment is often helpful. This considers pattern, onset, progression, and individual characteristics. The TRIX Hair Check is designed to provide insight in a structured way.

Can Alopecia Androgenetica be influenced?

Alopecia Androgenetica cannot be cured. However, understanding the type of hair loss and when the process is active can support informed decisions about long-term support.

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