Androgenetic alopecia (AGA), also referred to as male pattern baldness, is the most common cause of hair loss in both sexes in adulthood. An option for topical treatment that selectively tar− gets the metabolic pathways involved in the balding process is alfatradiol, an estrasterid without hormonal activity. In a drug monitoring study, efficacy and safety of alfatradiol (0.025 %) was assessed in 233 patients with AGA (192 women, aged 14 ± 76 years, and 41 men, aged 17 ± 56 years). After 7.5 months of treat− ment, trichograms of 112 patients (92 women, 20 men) were evaluated. Under treatment with alfatradiol the proportion of frontal anagen hair increased statistically significantly, in wom− en from 69 % to 77 % (means) and in men from 56 % to 65 %. The proportion of telogen hair decreased accordingly. In 12 % of wom− en and 21 % of men a further decline in the number of anagen hair was observed. Merely three patients (1,3 %) reported mild local adverse reactions. In conclusion, Alfatradiol appears to be ef− fective and safe in the topical treatment of AGA in both men and women.