This protocol addresses androgenetic alopecia (AGA) in female patients aged 18 years or older who present without clinical or biochemical hyperandrogenism — a normoandrogenic pattern of female hair loss.
Female patient, aged 18 years or older, with confirmed androgenetic alopecia and no evidence of clinical or biochemical hyperandrogenism. This normoandrogenic status is a key factor that distinguishes and shapes the recommended management approach for this population.
The first-line approach for normoandrogenic female patients with AGA involves a topical scalp therapy directed at halting progression and stimulating regrowth.
The primary objectives are to stop hair loss progression and induce hair regrowth, measured by increased hair count. Treatment response is formally assessed at 6 months.
DOI: 10.1111/jdv.14624
Topical Minoxidil 2% solution 1 mL twice daily or half a cap of 5% minoxidil topical foam once daily is recommended to improve or to prevent progression of AGA in female patients above 18 years with AGA.
We cannot make a recommendation for the use of oral anti-androgens (chlormadinone acetate, cyproterone acetate (CPA), drospirenone, spironolactone, flutamide) to improve or prevent progression of AGA in normoandrogenic female patients at the present time.
As AGA is a naturally progressive disease, therapy can have two required outcomes, namely stop of hair loss and induction of hair regrowth.
The response to treatment should be assessed at 6 months.
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