Psychological features of androgenetic alopecia

To evaluate the psychological features of subjects with male (MAGA) and female androgenetic alopecia (FAGA).

We performed a retrospective study of 100 patients with FAGA and the same number of patients with MAGA based on the features registered in the personal history of individuals who attended our Trichology Unit (Hospital Universitario Virgen Macarena, Sevilla, Spain) from January 1993 to January 1995.

Depression was more frequent in FAGA than in MAGA (55:3), but anxiety (78:41) and aggressiveness or hostility were more frequent in MAGA than in FAGA (22:3), and three men were considered anxious and depressive. Treatment resulted in improvement in 89% of FAGA and 76% of MAGA, and the subjects continued attending with periodic check-ups. There were requests for surgical treatment by 3% of FAGA and 12% of MAGA, and 6% of FAGA and 12% of MAGA did not return for follow-up consultation. All of the MAGA showed aggressiveness and lack of willingness to follow the correct treatment.

In general, AGA patients tend to have elusive personalities and, although the individuals may go to the trichology centre accompanied they preferred to present alone to the desk or at least to the trichological examination room, except for subjects with depression who would often not agree to the physician removing hairs for the trichogram. Most subjects accepted the prescribed medical or surgical treatment, but several phoned before the second treatment session because the results of the first session were not as good as they had expected. The drop-out rate was higher in men (1 in 2), who were probably subjects showing aggressiveness.