A retrospective study on the characteristics of androgenetic alopecia among Asian races in the National Skin Centre, a tertiary dermatological referral centre in Singapore.

Objective: To study the characteristics and psychosocial impact of androgenetic alopecia among Asian races. Methodology: A retrospective telephone interview study of patients managed for androgenetic alopecia in 1997 in a tertiary dermatological referral centre in Singapore. Results: Two hundred and fifty-six patients (111 females and 145 males) were included in the study. Their mean age at presentation was 33.7 years. There were no significant statistical mean age differences among the different races (Chinese, Malay and Indian). The mean duration of disease before consultation was 31.2 months; 33.2 months for males and 28.9 months for females (ns). Almost all patients (96.4%) were socially embarrassed and "unhappy" about their androgenetic alopecia. Most (90.5%) sought treatment for "cosmetic" reason. Slightly more males sought treatment for cosmetic reason than female (P=0.01). 7.5% were worried about an underlying systemic disease as a cause of their alopecia. A positive family history of androgenetic alopecia was recorded in 58.9% (15½56). Male patients tend to have higher proportion of having a father or male sibling with similar problem, whereas female patients tend to have higher proportion of having a mother or females sibling with androgenetic alopecia. The predominant balding patterns for males were a combination of frontal, bi-temporal recession and vertex thinning (43%, 45% and 55%, respectively). Whereas in females, the predominant presentation was vertex thinning (60%) and, infrequently, frontal and bi-temporal thinning (19% and 15%, respectively). Diffuse pattern was also more predominant in females (28%) compared to males (10%). Conclusions: Most patients presented in their thirties with females presenting earlier than males and almost all patients presented for treatment for cosmetic reasons. Patients are generally unhappy about their appearance as a result oftheir alopecia. A strong positive family history appears to suggest that the disorder may be acquired through an autosomal dominant trait. Male patients tend to have a father or male sibling with similar condition and female patients tend to have a mother or female sibling with similar condition.