Androgenic alopecia
ICD-10 L64 · ICD-11 ED70.0

Androgenetic Alopecia in Women with Hyperandrogenism: When Topical Minoxidil Has Not Stopped Hair Loss

Clinical Scenario

This protocol addresses female patients with androgenetic alopecia and clinical or biochemical evidence of hyperandrogenism, in whom a prior course of topical minoxidil did not achieve the required treatment goals.

Previous Treatment — Insufficient Response

First-line therapy with topical minoxidil was assessed at 6 months. The required goals — stopping hair loss and inducing hair regrowth (increased hair count) — were not achieved. This inadequate response triggers escalation to the current protocol.

Next-Line Approach (Overview Only)

The next step involves an oral anti-androgen agent, prescribed within a structured hormonal regimen. The specific agent, formulation, combination, and detailed schedule are set out in the full protocol.

Treatment Goal

Prevention of further progression of androgenetic alopecia — specifically, halting ongoing hair loss.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1111/jdv.14624

Oral CPA can be considered to prevent progression of AGA in women with clinical or biochemical evidence of hyperandrogenism.

Cyproterone acetate is generally prescribed in combination with an oestrogen as an oral contraceptive in oral contraceptive pills (2 mg over 21 days or added to an oral contraceptive on days 1–10 at 5–50 mg per day for enhanced anti-androgen activity).

As AGA is a naturally progressive disease, therapy can have two required outcomes, namely stop of hair loss and induction of hair regrowth.

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