Androgenetic alopecia: evaluation of hormonal profile and its systemic implications


  • Prateek Pathak Department of Dermatology, F. H. Medical College and Hospital, Agra, Uttar Pradesh, India
  • Mohammad Adil Department of Dermatology, Jawaharlal Nehru Medical College, Aligarh, Uttar Pradesh, India
  • Fariz Sarshar Department of Dermatology, ESIC Medical College, Patna, Bihar, India
  • Jyoti Singh Department of Dermatology, AIIMS, Bhopal, Madhya Pradesh, India



Androgenetic alopecia, Hormonal profile, PCOD


Background: Androgenetic Alopecia is a hereditary androgen-dependent disorder characterized by a gradual conversion of terminal hair into miniaturized hair with typical bitemporal recession and balding vertex and is considered the most common type of baldness characterized by progressive hair loss. This study evaluated the hormonal profile in males with androgenetic alopecia. This study evaluated the hormonal profile of early androgenetic alopecia in males.

Methods: This prospective study included 84 patients attending the outpatient Department of Dermatology. Forty-four cases and 40 controls were included in the study. The study had 44 male patients presenting with complaints of grade ≥ 3 androgenetic alopecia in the age group 19-35 years, whereas 40 age and sex-matched patients attending Dermatology OPD for unrelated complaints with no history of hair loss or clinical examination suggestive of androgenetic alopecia were included in the control group. After a detailed history, and examination, testosterone, LH, FSH, Prolactin, and SHBG were estimated.

Results: The mean age of onset was found to be 24.29±3.28 years. Positive family history was seen in 65.90% of patients. The mean testosterone, LH, FSH, prolactin, SHBG and free androgen index in cases versus controls was 6.44±2.58 versus 3.32±1.53 ng/ml, 8.01±2.64 IU/l versus 3.01±1.16 IU/l, 3.82±1.33 IU/l versus 5.07±1.27 IU/l, 15.50±5.11 ng/ml versus 9.84±3.91 ng/ml, 12.72±2.63 nmol/l versus 29.18±4.90 nmol/l and 51.03±21.78 versus 11.40±4.66 respectively. LH/FSH ratio was 2.17±0.54 versus 0.63±0.27. These parameters had p values <0.05 and were statistically significant.

Conclusions: Our study concluded that serum testosterone, prolactin, LH, LH/FSH, and FAI are increased whereas serum FSH and SHBG are decreased in cases of androgenetic alopecia compared to controls.


Orentreich N. Pathogenesis of alopecia. J Soc Cosmet Chem. 1960;11:479-99.

Yi SM, Son SW, Lee KG. Gender-specific association of androgenetic alopecia with metabolic syndrome in a middle-aged Korean population. Br J Dermatol. 2012;167:306-13.

Trueb RM. Molecular mechanisms of androgenetic alopecia. Exp Gerontol. 2002;37:981-90.

Richards JB, Yuan X, Geller F, Waterworth D, Bataille V, Glass D, et al. Male-pattern baldness susceptibility locus at 20p11. Nat Genet. 2008;40(11):1282-4.

Richards JB, Yuan X, Geller F, Waterworth D, Bataille V, Glass D, et al. Male-pattern baldness susceptibility locus at 20p11. Nat Genet. 2008;40(11):1282-4.

Guarrera M, Cardo P, Arrigo P, Rebora A. Reliability of Hamilton-Norwood classification. Int J Trichol. 2009;1:120-2.

Khumalo NP, Gumedze F. The adapted classification of male pattern hair loss improves reliability. Dermatology. 2012;225:110-4.

Lee WS, Ro BI, Hong SP, Bak H, Sim WY, Kim DW, et al. A new classification of pattern hair loss that is universal for men and women: basic and specific (BASP) classification. J Am Acad Dermatol. 2007;57(1):37-46.

Reynolds EL. The appearance of adult patterns of body hair in man. Ann N Y Acad Sci. 1951;53:576-84.

Marshall WA, Tanner JM. Variations in pattern of pubertal change in girls. Arch Dis Child. 1969;44:291-03.

Marshall WA, Tanner JM. Variations in the pattern of pubertal changes in boys. Arch Dis Child. 1970;45:13-23.

Hamilton JB. Age, sex and genetic factors in the regulation of hair growth in man. A comparison of Caucasian and Japanese populations. In: Montagna W, Ellis RA editors. The biology of hair growth. New York: Academic Press. 1958;399-433.

Hamilton JB. Patterned loss of hair in man; types and incidence. Ann NY Acad Sci. 1951;53:708-28.

Schweikert HU, Milerich L, Wilson JD. Aromatization of androstendione by isolated human hairs. J Clin Endocrinol Metab. 1975;40:413-7.

Moura HH, Costa DL, Bagatin E, Sodre CT, Manela-Azulay M. Polycystic ovary syndrome. A dermatologic approach. An Bras Dermatol. 2011;86:111-9.

Starka L, Hill M, Polacek V. Hormonal profile in men with premature androgenic alopecia. Sb Lek. 2000;101:17-22.

Duskova M, Hill M, Starka L. The polycystic ovary syndrome and its male equivalent. Cas Lek Cesk. 2007;146:251-5.

Matilainen VA, Makinen PK, Keinanen KS. Early Androgenetic Alopecia as a marker for insulin resistance. Lancet. 2000;356:1165-6.

Sanke S, Chander R, Jain A, Garg T, Yadav P. A comparison of the hormonal profile of Early Androgenetic Alopecia in Men With the Phenotypic Equivalent of Polycystic Ovarian Syndrome in Women. JAMA Dermatol. 2016;152:986-91.

Schimdt JB, Lindmaier A, Spona J. Hormonal parameters in androgenetic hair loss in the male. Dermatologica. 1991;182:214-7.

Tahir K, Aman S, Naddem M, Kazmi AH. Quality of life in patients with androgenetic alopecia. Ann King Edward Med Univ. 2013;19:150-4.

Salman KE, Altunay IK, Kucukunal NA, Cerman AA. Frequency, severity and related factors of androgenetic alopecia in dermatology outpatient clinic. Hospital-based cross-sectional study in Turkey. An Bras Dermatol. 2017;92:35-40.

Gupta S, Gupta I, Mahendra A. Quality of life assessment in patients with androgenetic alopecia. Int J Trichol. 2019;11:147-52.

Hamilton JB. The role of testicular secretion as indicated by the effects of castration in man and by studies of pathological conditions and the short life span associated with maleness. Recent Prog Horm Res. 1948;3:257-322.

Schmidt JB. Hormonal basis of male and female androgenic alopecia: clinical relevance. Skin Pharmacol. 1994;7:61-6.

Narad S, Pande S, Gupta M, Chari S. Hormonal profile in Indian men with premature and genetic alopecia. Int J Trichol. 2013;5:69-72.

Yildiz BO, Yarali H, Oguz H, Bayraktar M. Glucose intolerance, insulin resistance, and hyperandrogenemia in first degree relatives of women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2003;88:2031-6.

Starka L, Cermakova I, Duskova M, Hill M, Dolezal M, Polacek V. Hormonal profile of men with premature Balding. Exp Clin Endocrinol Diabetes. 2004;112:24-8.

Cohen PN, Givens JR, Wiser WL. Polycystic ovarian disease, maturation arrest of spermiogenesis and Klinefelter’s syndrome in siblings of a family with familial hirsutism. Fertil Steril. 1975;26:1228-38.

Duskova M, Cermakova I, Hill M, Vankova M, Samalíkova P, Starka L. What may be the markers of the male equivalent of polycystic ovary syndrome? Physiol Res. 2004;53:287-95.






Original Research Articles