Female Pattern Hair Loss
Causes, Signs & Treatments
Female pattern hair loss is a common and often distressing condition affecting millions of women worldwide. It is distinct from male pattern baldness, which typically involves a receding hairline and vertex balding. In fact female pattern hair loss usually appears as diffuse thinning over the crown and sides of the scalp. It is important to understand the causes of female pattern hair loss to stop progression and find the best treatment.
What is Female Pattern Hair Loss?
Female pattern hair loss is the form of androgenetic alopecia that occurs in women. It is a progressive thinning of hair that mainly affects the top and crown of the scalp. The most common signs are a widening parting and a reduction in hair volume. Complete or discrete patches of baldness are usually not common. This condition can begin anytime from puberty onwards but is more most common in postmenopausal women due to hormonal changes.
This type of hair loss occurs due to a complex interplay of genetic, hormonal and environmental factors. Together these result in the progressive miniaturisation of hair follicles. At the core of female hair loss is the androgenic effect on hair follicles. Androgens, particularly dihydrotestosterone (DHT), bind to androgen receptors in genetically predisposed hair follicles, leading to follicular miniaturisation. This process causes the hair growth cycle to shorten, with hair spending less time in the anagen (growth) phase and more time in the telogen (resting) phase. As a result, the hair follicles produce thinner and shorter hair shafts. Over time, affected hair follicles may become dormant and cease to produce hair altogether.
What Does it Look Like?
In women, the distribution of androgen receptors and 5-alpha reductase (the enzyme that converts testosterone to DHT) on the scalp differs from hair loss in men. This results in a distinct pattern of hair thinning. This pattern typically involves diffuse thinning over the crown and vertex. The frontal hairline is however not necessarily affected. The most common signs are:
- A widening part line
- Noticeable thinning on the crown
- Excessive shedding of hair
- Less hair density when styling
Causes & Who Gets it
There are multiple causes of female pattern hair loss and in general this is a multifactorial condition involving genetics, hormones and aging. Here are the key factors:
- Genetics: Women with a family history of hair loss, either from their mother or father’s side, are at a higher risk of developing female pattern hair loss. The inheritance of certain genes from parents can make hair follicles more susceptible to miniaturisation. It can also can also affect hair growth cycles, causing hair to spend less time in the growth phase and more time in the resting phase.
- Hormonal Changes: Conditions such as polycystic ovary syndrome (PCOS) and menopause can cause fluctuations in hormones especially androgens which play a significant role in female pattern hair loss. Androgens are male hormones present in both men and women, but women typically have lower levels. However, when these hormone levels increase or hair follicles become more sensitive to them, it can lead to hair thinning.
- Aging: Whilst androgenetic hair loss can begin as early as puberty, the incidence increases significantly with age. Studies suggest that about 40% of women experience noticeable hair thinning by age 50, and this number rises with increasing age. This is because as women age, it is natural for hair to thin due to the additive effects of aging and hormones on hair follicles. The hair growth cycle slows down and the follicles produce hair that is finer and less pigmented. Post-menopausal women often experience more pronounced hair loss due to a significant decrease in oestrogen levels, which normally help maintain hair density by prolonging the growth phase of hair. The reduction in oestrogen levels allows androgens to have a more pronounced effect on hair follicles, leading to increased hair thinning. Additionally, other age-related factors such as reduced blood circulation to the scalp, nutritional deficiencies and exposure to environmental toxins can also contribute to hair loss.
- Lifestyle: Although not a direct cause, factors such as stress, poor nutrition, certain conditions and medications can worsen female pattern hair loss.
Diagnosing Androgenetic Hair Loss in Women
Normally diagnosis of female pattern hair loss can be done with a detailed medical history and examination. Doctors may also use tools like a dermoscope or wood’s light to examine the scalp and hair follicles closely especially if a microbial infection or skin condition is suspected. Sometimes blood tests may be necessary to rule out other causes of hair loss such as thyroid problems or iron deficiency. This is especially likely in younger patients, if there are other symptoms and when the hair loss is sudden, severe or not responding to treatments. Further tests are always necessary in cases where the hair loss is atypical such as a female with male pattern hair loss. Factors contributing to this pattern include higher androgen levels and genetic predisposition.
If the diagnosis is female pattern hair loss then staging is typically done using the Ludwig Scale. This categorises the condition into three distinct stages based on the severity of hair thinning:
- Stage I is characterised by mild thinning, with a slight widening of the central part line and minimal hair loss that may not be immediately noticeable.
- Stage II involves moderate thinning, where the widening of the part becomes more pronounced. There is also a noticeable decrease in hair volume across the top of the scalp.
- Stage III represents severe thinning, with a significant widening of the part line and extensive thinning throughout the crown, often leading to a visible scalp.
Understanding these stages helps in diagnosing the extent of the female pattern hair loss and selecting the best treatment plan. It is also useful to objectively monitor progress.
Female Pattern Hair Loss Treatment Options
While it may not be entirely reversible, treatment can significantly slow down progression, stimulate regrowth and improve hair density. Here are the most common and effective hair loss treatments for women:
- Topical Minoxidil: This helps to stimulate hair growth and slow hair loss. Minoxidil is applied directly to the scalp and is available over-the-counter in strengths of up to 5% or by prescription for higher concentrations.
- Hormone Inhibitors: Finasteride and spironolactone can be effective in women, especially those with higher androgen levels. These prescription only medications are available either as tablets or in compounded topical solutions. They require careful monitoring due to risks and side effects especially in women of child bearing age.
- Hormone Therapy: For post-menopausal women, hormone replacement therapy (HRT) can sometimes help by restoring the balance between oestrogen and androgens.
- Platelet-Rich Plasma (PRP) Therapy: This involves injecting platelet-rich plasma from your own blood into the scalp to stimulate hair growth. PRP therapy is gaining popularity but more robust studies are needed to evaluate its effectiveness.
- Low-Level Laser Therapy (LLLT): These devices are used to stimulate hair follicles and promote hair growth. They are a non-invasive option that can be used at home often alongside other non invasive treatments.
- Hair Transplant Surgery: In severe cases, surgical options like hair transplants can move hair follicles from denser areas to thinning areas. This is quite an expensive procedure with variable results and potentially serious risks. As such its vital to choose a reputable medical provider to increase your chances and help you maintain your gains.
Living with Hair Loss
In addition to the above treatment options for female pattern hair loss, adopting a healthy lifestyle is also important to encourage regrowth:
- Balanced Diet: Ensure adequate intake of vitamins and minerals like biotin, iron and zinc.
- Gentle Hair Care: Avoid harsh treatments, excessive heat and tight hairstyles that can damage the hair or scalp.
- Stress Management: Chronic stress can make hair loss worse. Practices like yoga, meditation and regular exercise can help manage stress levels.
- Support: Dealing with female can also be emotionally challenging. It helps to seek support from friends, family and even professional counsellors. Joining support groups or forums where you can share experiences and coping strategies can also be of value.
Female pattern hair loss is a common but manageable condition with a number of treatment options. With the right approach, including medical treatments, lifestyle adjustments, and emotional support, women can achieve significant improvements in hair density and quality of life. If you notice significant thinning, shedding or changes in your hair pattern, it’s advisable to first see a health provider. They will provide a proper diagnosis, help you explore the best options for you and create a treatment plan that meets your needs.
SOURCES
https://cityskinclinic.com/hair-scalp-treatments/hair-loss-treatment-women
https://cityskinclinic.com/hair-loss-women-treatments
https://cityskinclinic.com/finasteride-hair-loss-regrowth
https://cityskinclinic.com/spironolactone-hair-loss-growth
https://cityskinclinic.com/minoxidil-hair-growth