Consensus Recommendations for the Management of Androgenetic Alopecia in Egypt: A Modified Delphi Study

Abstract

Background: Androgenetic alopecia (AGA) is a common dermatologic condition with significant psychological and social impact. Treatment remains challenging due to heterogeneity in patient response and limited long-term efficacy data. Objective: To develop expert consensus guidelines for the diagnosis and management of AGA tailored to the Egyptian population, considering region-specific clinical and systemic factors. Methods: A modified Delphi process was conducted in two rounds. Initially, a structured, evidence-informed questionnaire was distributed to 1,000 practicing dermatologists across Egypt; 723 completed the survey. Responses were analyzed and refined into consensus statements, which were subsequently evaluated by a panel of 20 senior dermatology professors. Statements achieving ≥75% agreement were considered consensus. Results: Twenty-seven consensus statements were established and categorized into seven key areas: diagnosis, minoxidil, antiandrogens, low-level laser therapy, adjuvant treatments, hair transplantation, and counseling/hair aids. These recommendations reflect a synthesis of current evidence and national clinical experience. Conclusion: This consensus provides a regionally relevant, evidence-based framework for AGA management in Egypt. It emphasizes individualized care, multidisciplinary strategies, and the integration of emerging therapies, and may serve as a model for practice in similar healthcare settings.