Androgenetic alopecia (AGA), also known as androgenic or pattern alopecia, is a frequently reported disorder that affects both the sexes, with a higher incidence generally reported in men. AGA has immense psychological effects on the patient, irrespective of the age or stage of baldness. This consensus document has been developed taking into account the opinions of leading experts in the field of dermatology. The objective of this article is to provide the dermatologists with an evidence-based platform for choosing efficacious and safe therapy for patients with AGA. This review articulately summarizes the key opinions of the experts on all aspects of treatment for the effective management of AGA.

Male-pattern hair loss (MPHL, androgenetic alopecia) is a slowly progressive form of alopecia which begins after puberty. In 2010, we published the first Japanese edition of guidelines for the diagnosis and treatment of MPHL. It achieved the original goal of providing physicians and patients in Japan with evidence-based information for choosing efficacious and safe therapy for MPHL. Subsequently, new therapeutic drugs and treatment methods have been developed, and women\'s perception of MPHL has undergone change and the term \"female-pattern hair loss (FPHL)\" is becoming more common internationally. Thus, here we report a revised version of the 2010 guidelines aimed at both MPHL and FPHL. In these guidelines, finasteride 1 mg daily, dutasteride 0.5 mg daily and topical 5% minoxidil twice daily for MPHL, and topical 1% minoxidil twice daily for FPHL, are recommended as the first-line treatments. Self-hair transplantation, irradiation by light-emitting diodes and low-level lasers, and topical application of adenosine for MPHL are recommended, whereas prosthetic hair transplantation and oral administration of minoxidil should not be performed. Oral administration of finasteride or dutasteride are contraindicated for FPHL. In addition, we have evaluated the effectiveness of topical application of carpronium chloride, t-flavanone, cytopurine, pentadecane and ketoconazole, and wearing a wig. Unapproved topical application of bimatoprost and latanoprost, and emerging hair regeneration treatments have also been addressed. We believe that the revised guidelines will improve further the diagnostic and treatment standards for MPHL add FPHL in Japan.

OBJECTIVE: The purpose of this study is to systematically evaluate the quality of methodological guidelines for androgenetic alopecia (AGA) using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument by searching and analysing the available worldwide guidelines. This could provide a reference for selecting clinical guidelines and for developing new guidelines in the future.
METHODS: We searched PubMed and other electronic databases for any AGA guidelines published until 2014. The AGREE II instrument was used by two researchers to create a systematic appraisal in six domains to determine the guidelines fulfilling the inclusion and exclusion criteria.
RESULTS: Five guidelines associated with the therapy of AGA were identified. The mean scores for the six AGREE II domains were as follows: 89.45% for \'scope and purpose\', 53.88% for \'stakeholder involvement\', 53.96% for \'rigour of development\', 87.22% for \'clarity of presentation\', 42.92% for \'applicability\' and 59.16% for \'editorial independence\'. The European guideline ranked the highest, whereas the American guideline of 1996 ranked the lowest. The Asian, European and Japanese guidelines were strongly recommended, and the two from America were recommended with modifications.
CONCLUSIONS: Guidelines should provide accurate and evidence-based recommendations. The AGREE II instrument is a useful tool to improve the quality of guidelines, and high-quality guidelines for clinical practice can be provided by using it.