A Canadian Consensus on Androgenetic Alopecia: Approach and Management

Abstract

Androgenetic alopecia (AGA) is the most common hair loss condition affecting between 40% to 50% of Canadian men and women by 50 years of age. This nonscarring hereditary condition can significantly affect patients, impacting their overall well-being and quality of life. Despite the multitude of interventions and the willingness of people with AGA to try treatments, there are no clear Canadian guidelines on its management. An expert panel of 11 physicians developed Delphi-based consensus recommendations of interventions for the management of AGA in male and female adults. Forty-five interventions were reviewed. Seven interventions are recommended, including oral dutasteride; oral finasteride; topical finasteride; topical minoxidil; platelet-rich plasma; microneedling; and oral minoxidil. Five interventions are recommended with near consensus: intralesional dutasteride; ketoconazole shampoo; low level laser therapy; aminexil; as part of a regimen and 17 are not recommended (adenosine; cetirizine; carboxytherapy; amla syrup; microfilament thread; Nourkrin; injectable minoxidil; caffeine; ceramide; topical herbal formulations; piroctone olamine shampoo or leave-on; rosemary oil; shampoo and lotion hair care products containing fermented papaya, fermented mangosteen, and caffeine; basic Fibroblast Growth Factor (bFGF); flutamide).

Keywords: Canadian consensus; androgenetic alopecia; modified Delphi.