Androgenic Alopecia and Seborrhea Relationship

Introduction to Androgenic Alopecia and Seborrhea

• Women with signs of androgen excess, such as hirsutism, severe acne, and androgenetic alopecia, warrant endocrinologic evaluation including free and total testosterone, DHEA-S, and androstenedione, as recommended by the American Academy of Dermatology 1
• Polycystic ovarian syndrome (PCOS) can manifest with both AGA and seborrhea due to hyperandrogenism, according to the American Academy of Dermatology 1

Clinical Presentation and Diagnosis

• AGA presents with patterned hair loss, affecting temples, vertex, and mid-frontal scalp in males, and central thinning with preserved frontal hairline in females, as described in Periodontology 2000 2
• The affected scalp in AGA may appear slightly reddened but is otherwise normal, without the inflammatory scaling characteristic of seborrheic dermatitis, as noted in the British Journal of Dermatology 3
• Clinical examination should include looking for miniaturized hairs and patterned distribution characteristic of AGA using dermoscopy, as suggested by the Praxis Medical Insights 4

Laboratory Testing and Treatment

• Endocrinologic testing is warranted only when clinical signs of androgen excess are present, including free and total testosterone, DHEA-S, luteinizing hormone, and follicle-stimulating hormone, as recommended by the American Academy of Dermatology 1
• Consider thyroid function (TSH, free T4) as thyroid disease associates with both conditions, and check serum ferritin, vitamin D, and zinc levels as nutritional deficiencies associate with hair loss, as suggested by the Praxis Medical Insights 4