Alopecia: complete guide to causes, types and the effect of genetics

The alopecia is one of the most common concerns in today's population, affecting approximately 40% of people over 35 years of age only in Spain. This condition, which manifests itself as hair loss or partial hair loss, can have a significant impact on both men and women.

The baldness is not just an aesthetic issue; it has profound psychological and social implications. Fortunately, advances in science now allow us to predict and treat alopecia more effectively than ever before.

What is alopecia?

The alopecia is the medical term to describe abnormal hair loss. While it is normal to lose between 50-100 hairs daily, alopecia involves an abnormal hair loss. hair loss The excessive deficit is not compensated for by new growth.

The baldness can manifest itself in multiple forms: from small circular bald patches to complete hair loss. Understanding the different types is critical to choosing the right treatment.

Types of Alopecia

Androgenic alopecia or common baldness

The androgenic alopecia is the most frequent type of capillary loss, accounting for 95% of the cases of baldness. Also known as androgenetic baldnessaffects both men and women, although with different patterns.

Androgenic alopecia in men

The alopecia in men follows a characteristic pattern:

• Pattern 1No visible capillary loss
• Pattern 2Front recession forming an "M".
• Pattern 3Thinning at the crown ("corona")
• Pattern 4Union of the affected areas, forming an "island of hair".

The androgenetic alopecia male is strongly influenced by:

• Genetics80% heritability
• HormonesEspecially dihydrotestosterone (DHT).
• Age:Gradual progression over the years

Androgenic alopecia in women

The female androgenic alopecia has different characteristics:

• Grade ISlight thinning in the upper part of the body
• Grade IIMore evident loss but without complete baldness.
• Grade IIISevere thinning with visible scalp

The hair loss in women typically related to androgenic alopecia:

• Preserves the front hairline
• Concentrated in the upper part of the scalp
• Intensifies after menopause due to hormonal changes

Key genes in androgenic alopecia

The androgenic alopecia has a complex genetic basis. The most important genes include:

Wnt Signaling Pathway:

• WNT10AFormation of hair follicles
• RSPO2Capillary density
• LGR4Follicular development
• TWIST1Hair growth regulation

Androgen Receptor:

• Gen AREncodes the androgen receptor.
• Variations increase receptor activity
• Increased sensitivity to DHT

Genetic test to know your predisposition to alopecia

What is a genetic test for alopecia?

An alopecia test genetic analysis analyzes specific variants in your DNA to determine your predisposition to developing different types of baldness. At ADNTRO we use validated algorithms with real patients to calculate your polygenic risk.

Benefits of genetic testing for alopecia:

1. Early predictionKnow your risk before symptoms appear
2. Personalized treatment: Selection of therapies based on your genetics
3. Preventive planningImplementing measures before hair loss
4. Nutritional optimization: Specific supplementation according to your genes

Alopecia areata

The alopecia areata is an autoimmune disorder where the immune system attacks the hair follicles. Unlike androgenic alopecia, of alopecia areata may appear suddenly.

Types of Alopecia Areata:

• Alopecia areata in patchesCircular or oval localized loss
• Alopecia areata totalComplete loss of scalp
• Universal alopecia areataLoss of all body hair
• Diffuse alopecia areataGeneralized thinning
• Ophiasic alopecia areataBand-shaped loss
• Alopecia areata barbaeSpecific bald patches in the beard

Genetics of alopecia areata

The alopecia areata involves genes of the immune system:

• IL GenesImmune regulatory interleukins
• HLA-DQImmune response
• BCL2L11Pro-apoptotic factor

Differences between Alopecia Areata and Androgenic Alopecia

Feature	Alopecia Areata	Androgenic Alopecia
Cause	Autoimmune	Hormonal-genetics
Pattern	Circular patches	Progressive recession
Reversibility	Potentially reversible	Progressive
Age of onset	Any age	Typically adults

Other Types of Alopecia

• Cicatricial Alopecia: permanent destruction of follicles by inflammation or scarring.
• Telogen Effluvium: temporary loss after stressful events, surgery or illness.
• Secondary Alopecia: caused by medical treatments such as chemotherapy.

Treatments pharmacological drugs for alopecia

Minoxidil

• MechanismVasodilator that improves circulation
• EffectivenessEspecially under 40 years of age
• Genetics: The gene PTGES2 determines the response

Finasteride

• Mechanism: Inhibits 5-alpha-reductase type 2
• IndicationMale androgenic alopecia: Male androgenic alopecia
• Genetics: Gene-related effectiveness SRD5A2

Dutasteride

• MechanismInhibits both types of 5-alpha-reductase.
• AdvantageBroader spectrum of action than finasteride
• GeneticsUseful with variants in SRD5A1 and SRD5A2

With ADNTRO's genetic test, you can also find out which of these drugs may be more effective for you according to your genetics.

Alopecia in women: special considerations

Causes of female hair loss

The female hair loss may be due to:

1. Female androgenic alopeciaFemale pattern baldness
2. Hormonal changesPregnancy, menopause, PCOS
3. Alopecia areataMore frequent in young women
4. Nutritional factorsDeficiencies of iron, vitamins
5. StressTelogen effluvium

Specific genes in female alopecia

ESR2 (Estrogen Receptor 2)

• Alteration in estrogenic signaling
• Impact on the hair cycle

CYP19A1 (Aromatase)

• Conversion of androgens to estrogens
• Hormonal imbalance

However, given the lack of scientific evidence of genetic variants associated with female baldness, at ADNTRO we have decided to evaluate only the predisposition to suffer male baldness, for which there is consolidated scientific support.

Prevention of alopecia

Protective lifestyle habits

✅ Positive Recommendations:

• Balanced dietRich in protein and micronutrients
• Regular exerciseImproves circulation
• Stress managementRelaxation techniques
• Adequate sleep: 7-9 hours per day
• Gentle hair careAvoiding trauma

❌ Harmful Habits:

• SmokingActivates immune cells (risk of alopecia areata).
• Obesity: Increased risk 15%
• Restrictive dietsNutritional deficits
• Braided hairstylesTraction alopecia

Alopecia and quality of life: psychological impact

Emotional Consequences

The baldness can generate:

• Low self-esteem
• Social anxiety: Avoidance of public situations
• Depression
• Couple problemsImpact on privacy

Coping strategies

1. Psychological supportSpecialized therapy
2. Support groups: Sharing experiences
3. Camouflage techniques: Micropigmentation, wigs
4. Comprehensive approachMedical treatment + emotional support

Remember that genetics loads the gun, but the environment pulls the triggerYour genetic predisposition determines the risk, but environmental factors modulate its expression. Early detection is essentialand a alopecia test can identify risks before symptoms appear.