Androgenetic Alopecia: Narrative Review of Current Therapies and Proposal of a Practical Algorithm for Pharmacological Treatment.

Androgenetic alopecia is highly prevalent, affecting 80% of White men and up to 40% of women by age 70 or older.

• By age 70 or older, 80% of White men show signs of AGA
• Up to 40% of women show signs of AGA by age 70 or older
• AGA is characterized by a progressive reduction in hair density following a defined pattern
• The condition has a substantial impact on mental health and quality of life, particularly among women

Current treatments approved by American and European regulatory agencies have demonstrated safety and efficacy in the management of AGA.

• Both American and European regulatory agencies have approved treatments for AGA
• Approved treatments have demonstrated safety and efficacy
• Several additional therapies have also shown effectiveness beyond approved treatments
• The absence of randomized clinical trials for additional therapies has limited their inclusion in the Summary of Product Characteristics (SmPC)

The authors propose a practical management algorithm for pharmacological treatment of AGA to guide clinician decision-making.

• The algorithm is intended to help clinicians select the most appropriate therapy for each patient
• Selection criteria are based on clinical experience and disease severity
• The review summarizes currently available treatments alongside the proposed algorithm
• The algorithm addresses both approved and non-approved therapies with demonstrated effectiveness

AGA has a substantial impact on mental health and quality of life, with women being particularly affected.

• Mental health impact is noted as a key concern associated with AGA
• Quality of life impairment is described as substantial
• Women are specifically identified as experiencing particularly significant quality of life impact
• This psychosocial burden is presented as a key rationale for optimizing treatment selection