Lifestyle Risk Factors in Male Androgenetic Alopecia: A Cross-sectional Study

Introduction: Male Androgenetic Alopecia (AGA) is a prevalent form of hair loss affecting a significant portion of the population worldwide. While genetic predisposition is a primary factor, lifestyle factors such as smoking, alcohol consumption, obesity and psychological stress have been increasingly recognised as potential contributors to the progression and severity of male AGA. This study was conducted to identify these risk factors in male AGA utilising various tools like the Depression, Anxiety and Stress Scale (DASS) 21 scale, Body Mass Index (BMI), smoking index and Alcohol Use Disorders Identification Test (AUDIT) scale. Aim: To identify lifestyle-related risk factors such as smoking, alcohol consumption, obesity and psychological stress in male AGA. Materials and Methods: A hospital-based observational crosssectional study was conducted in the dermatology department of a tertiary care facility, involving 100 male patients with AGA aged 18 to 55 years. The study utilised consecutive sampling methods for the enrollment of participants. Each patient underwent a thorough clinical evaluation and the severity of alopecia was determined using the Hamilton-Norwood classification. Detailed questionnaires assessed risk factors including smoking history (using the smoking index), alcohol consumption (using the AUDIT scale), psychological stress levels (using the DASS-21 scale) and obesity was assessed by measuring BMI. Data were analysed using statistical software Statistical Package for the Social Sciences (SPSS) version 26.0 (SPSS Inc., Chicago, IL, USA). Results: Among the study population, the mean age was 28.78 +/- 5.91 years. Family histories included 12 with maternal AGA, 56 with paternal AGA and 32 with no family history. Significant associations were found between AGA severity and several factors, including higher alcohol screening scores (4.71 +/- 5.30) (p-value=0.0006) and a greater smoking index (17.31 +/- 15.10) (p-value=0.016). The results for BMI (22.33 +/- 3.91) (p-value=0.056) and DASS-21 stress score (14.96 +/- 5.9677) (p-value=0.351) were not found to be significant with the severity of AGA. Overall, the findings underscore the multifactorial nature of AGA, influenced by lifestyle, genetic predisposition and anthropometric measures, with implications for clinical management and future research. Conclusion: The study highlights the multifaceted nature of AGA, influenced by lifestyle habits and factors. The findings suggest a strong association between higher alcohol and smoking indices and the severity of AGA. These insights could inform prevention strategies and targeted interventions for individuals affected by AGA.