Medical content reviewed by Dr. Enrico Giorgio Morales Tedone Dermatologist · Medical registration no. 461205707 · Last reviewed 8 August 2026
Androgenetic alopecia, or common pattern baldness, is the most frequent cause of hair loss. It has a genetic and hormonal basis, progresses slowly and, with correct diagnosis, can be slowed. Some patients improve with medication through follicular regeneration. At the trichology unit of dermaMER Instituto Médico Dermatológico, in Valencia, we use medicines with the strongest evidence and are honest about an important point: it can be controlled but not cured, and benefits last while treatment continues. We select the most appropriate individual regimen for long-term use, aiming for some improvement and disease control while minimising side effects.
Why it develops
In genetically predisposed follicles, androgens — specifically dihydrotestosterone, DHT — shorten the hair growth phase and cause miniaturisation (thinning): each cycle produces finer, shorter hair until it resembles vellus hair.
It is a non-scarringalopecia: the follicle is not destroyed and retains thickening potential in early or moderate stages, declining after years of miniaturisation.
One myth needs clarifying: baldness does not mean high testosterone. Most men with androgenetic alopecia have normal hormone levels; local genetic follicular sensitivity, inherited from both sides of the family, is decisive.
Healthy follicle
Produces thick, strong hair (terminal hair).
DHT action
The hormone DHT acts on genetically sensitive follicles.
Miniaturisation
The follicle shrinks and hair becomes progressively finer and shorter.
Inactive follicle
Hair thins and the area loses density.
Pattern and diagnosis
In men, the typical pattern affects the temples, frontal region and crown, with better preservation of the sides and back.
Diagnosis is mainly clinical, supported by digital trichoscopy, showing varied hair thickness with preserved follicular openings. Blood tests are not usually needed with a classic, gradually progressive pattern. Diffuse, patchy or unpatterned loss requires exclusion of other causes, such as telogen effluvium or alopecia areata.
Treatment: options and limitations
Selection depends on severity, age, progression speed and preferences. Your dermatologist chooses the most appropriate regimen for your case, including topical and oral medicines, scalp mesotherapy and scalp PRP, always with scientifically supported active ingredients. With early diagnosis, the aim is to avoid needing a hair transplant; in selected advanced cases, this may be considered after 6-12 months of medical treatment. We do not perform hair transplants at dermaMER; if indicated, we will advise you and refer you to a specialist.
Both scalp mesotherapy and scalp PRP are supportive procedures: they complement prescribed medication to seek the best results. Mesotherapy with active ingredients supported by stronger evidence is preferred for this alopecia; for patients declining oral and topical treatment, it may be considered alone with its limitations explained.
Transplantation redistributes resistant follicles from the donor area but does not stop native-hair miniaturisation: ongoing medical treatment remains necessary.
Combining measures, starting early and continuing usually works best. In early alopecia, the realistic aim is preservation and thickening; in advanced baldness, smooth areas respond poorly because follicles are no longer viable, while areas retaining miniaturised follicles may improve.
What treatment cannot do
Androgenetic alopecia has no cure. Treatments slow progression, maintain density and partly thicken hair: realistic results are stabilisation and variable improvement, rather than teenage density.
Results are not immediate: first changes appear around the fourth month. Preventing expected loss is already a good result, though difficult to perceive without comparable photographs. Benefits are lost within a few months of stopping.
Adverse effects and precautions
Topical treatment may cause mild, reversible side effects.
Oral medication is associated with uncommon side effects in a minority of patients. Your dermatologist explains these according to your age, history and medication.
These treatments are therefore always recommended and monitored with dermatological assessment.
When to seek advice and your first consultation at dermaMER
Seek advice for progressive loss before marked thinning: treatments act on still-viable follicles. It is not an emergency, but early assessment matters with rapid progression, family history of early baldness, planned oral medication or uncertain diagnosis.
At the first visit, we assess onset age, progression speed and previous treatments, reviewing relevant history before oral medication. We examine the scalp, classify the pattern and suggest digital trichoscopy: image comparison is the most reliable way to measure response, detect activity and adjust medicine doses. We also define a realistic goal and explain on-label and off-label use.
It is part of our hair medicine service in Valencia, available in Spanish, English and Italian, and you can meet the medical team before your visit.
Frequently asked questions about androgenetic alopecia
Can lost hair be restored?
Shedding can be slowed and miniaturised hair thickened, so improvement is common, but inactive follicles are harder to recover. This is why early treatment matters.
Are treatments lifelong?
This is a chronic genetic condition, so effects last while treatment continues: after stopping, the process tends to resume.
Do helmets, caps or frequent washing affect it?
No. It depends on genetic predisposition and hormonal effects on follicles: caps, helmets and frequent washing neither cause nor slow it.
Do mesotherapy or PRP help?
They are supportive procedures within a broader regimen. Of the two, mesotherapy with better-supported active ingredients is preferred for this alopecia. PRP may also be suggested for particular cases; your dermatologist will advise.
At what age should I seek advice about hair loss?
As soon as it is persistent or density decreases: earlier action preserves more follicles.
Does androgenetic alopecia also affect women?
Yes, with a different pattern: loss is usually diffuse across the top, preserving the front hairline. See its dedicated page on female hair loss.
Does health insurance cover alopecia assessment?
The dermatology consultation is usually covered, depending on insurer and policy type. Digital trichoscopy and supportive procedures are usually excluded and paid for separately. Check our partner insurers.
Trichology consultation for androgenetic alopecia in Valencia
dermaMER Instituto Médico Dermatológico
Calle Timoneda 4, Bajo, 46008 Valencia
Mon–Wed 9:00–14:00 and 15:00–19:00 · Thu 10:00–14:00 and 15:00–19:00 · Fri 9:00–14:00
☏ +34 960 20 71 71
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