Sonographic comparison of subcutaneous fat layer thickness in the scalp area in patients with androgenetic alopecia compared to healthy individuals: Cross-sectional.

INTRODUCTION: Androgenetic alopecia (AGA) is one of the most common alopecia among men and women worldwide. It is a nonscarring alopecia that has a characterized pattern. In female pattern AGA, the hairline is stable but general thinning occurs most notably in the frontal region. In male-pattern AGA, the hairline is receding and the thinning is most notable in the frontotemporal region. AGA has a complex pathogenesis and relation of subcutaneous fat in the scalp region and the miniaturization of terminal hair follicles is vague. In this study, subcutaneous fat in the frontal scalp an important region for AGA is compared to the occipital scalp that is spared in AGA. METHOD: Our study is a cross-sectional study that has four groups. Male patient, female patient, male control, female control. Every group has 15 individuals. All of the people in the study are those referred to Rasoul Akram's dermatology clinic. The severity of alopecia is classified by Norwood scaling for male pattern AGA and Ludwig scaling for female pattern AGA. Subcutaneous tissue in the frontal and occipital regions is measured by ultrasonography. For evaluating the effect of aging on subcutaneous fat thickness, we subdivided any group into more than 40 years old and between 20 and 40 years old and compared these two subgroups. RESULTS: The mean age of the three groups of male patient, female patient, and female control is 40 y/o and the mean age of male control is 41 y/o. The mean subcutaneous fat layer thickness in frontal region in male patients group is 6.0 mm (more than 40 y/o = 6.6 mm, between 20 and 40 y/o = 5.5 mm), in female patients group 5.1 mm (more than 40 y/o = 5.7 mm, between 20 and 40 y/o = 4.6 mm), in the male control group is 4.4 mm (more than 40 y/o = 4.7 mm, between 20 and 40 y/o = 4 mm) and in the female control group is 4.1 mm (more than 40 y/o = 4.5 mm, between 20 and 40 y/o = 3.6 mm). The mean subcutaneous fat layer thickness in the occipital region in the male patient's group is 6.4 mm (more than 40 y/o = 6.7 mm, between 20 and 40 y/o = 6 mm), in the female patient's group 6.1 mm (more than 40 y/o = 6.5 mm, between 20 and 40 y/o = 5.7 mm), in the male control group is 6.3 mm (more than 40 y/o = 6.8 mm, between 20 and 40 y/o = 5.7 mm) and in the female control group is 6.2 mm (more than 40 y/o = 6.6 mm, between 20 and 40 y/o = 5.8 mm). CONCLUSION: This study demonstrates that the subcutaneous fat layer in the frontal region in both males and females is thicker in AGA patients than healthy group and the more severe the AGA, the thicker is subcutaneous layer in the frontal region. In the male patients group, the subcutaneous fat layer in the frontal region is thicker than in the female patients group but in the male and female control groups is not so different. The subcutaneous fat layer in the occipital region is thicker in older individuals in both patients and control groups but is not different when compared to AGA patients and control individuals.

Asymmetry of the Receding Hairline in Men With Early Androgenetic Alopecia.

BACKGROUND: The Norwood classification system is commonly used to ascertain the progress of androgenetic alopecia (AGA) with a robust and quick assessment, but it lacks precision in the frontal region, notably during the onset of male pattern hair loss. OBJECTIVE: Due to the ongoing technical improvement in restorative hair transplantation practices, we aim to develop simple quantitative methods for measuring the progression of AGA. METHODS: Here, we used a quantitative system to evaluate the progress of AGA of the frontal receding hairline in a case study with 41 patients. RESULTS: We found subtle differences in the extent of frontotemporal regressions that were not captured by the Norwood classification system. The majority of patients exhibited significantly larger right-sided frontotemporal regressions. CONCLUSION: These results indicate that the quantification system used is a valuable tool in complementing the Norwood classification system to more precisely determine the recessing hairline characteristics in early stages of hair loss. Our findings also suggest that hairline regression in AGA-affected patients is asymmetrical, a hitherto unnoticed disorder-associated phenomenon with unknown biological causality.

Male androgenetic alopecia: population-based study in 1,005 subjects.

CONTEXT: Male androgenetic alopecia (AGA) is a common condition. There is limited information on its prevalence and patterns. AIMS: (1). To find the prevalence and most common pattern (2). To correlate the age and pattern of alopecia. SETTINGS AND DESIGN: Population-based study. MATERIALS AND METHODS: This is a population-based study from the public. The selection was random. The method involved was asking the age and, if found to between 30 and 50 years, the scalp was examined for alopecia and the pattern was determined using the Hamilton Norwood classification. RESULTS: Of 1,005 subjects, the youngest was 30 years old and the oldest 49 years old, with a mean age of 37.05 ± standard deviation 4.79. 39.2% of the subjects were in the age group of 30-35, 34.4% in the 36-40 year age group, 26.0% in the 41-45 years age group and 0.4% in the 46-50 years age group. Five hundred and eighty-three subjects (58%) had AGA, the most common type being grade II (27.27%) followed by grade I (22.12%) and grade III (21.78%). 47.5% (P = 0.003) had pattern alopecia in the 30-35 years age group, 58.7% in the 36-40 years age group (P = 0.8) and 73.2% in the 41-45 years age group (P ≤ 0.001). In the 30-35 years age group, grade I was 51.18%, grade II was 42.77% and grade VI was 18.52%. In the 41-45 years age group, grade I was 13.38%, grade III was 33.85% and grade VI was 66.67%. CONCLUSIONS: Fifty-eight percent of the male population aged 30-50 years had AGA. Its grade increased with increase in age. 12.9% of the male population had grades IV to VI, and would benefit from hair transplantation while 44.1% had grades I to III and are potential candidates for medical treatment.