Androgenetic Alopecia: Narrative Review of Current Therapies and Proposal of a Practical Algorithm for Pharmacological Treatment

Androgenetic alopecia (AGA) is characterized by a progressive reduction in hair density, typically following a defined pattern. By the age of 70 years or older, 80% of White men and up to 40% of women show signs of AGA, with a substantial impact on mental health and quality of life, particularly among women. Currently, treatments approved by American and European regulatory agencies have demonstrated safety and efficacy in the management of this condition. However, several additional therapies have also shown effectiveness, although the absence of randomized clinical trials has limited their inclusion in the Summary of Product Characteristics (SmPC). Therefore, this review aims to summarize currently available treatments and propose a practical management algorithm to help clinicians select the most appropriate therapy for each patient according to clinical experience and disease severity.