An Insight To Female Pattern Hair Loss & Treatment Options

Hair loss in women is normal, especially during ageing, and about two-thirds of women will suffer from increased hair fall in their lifetime. Only less than 45% of women manage to go through life with a full head of hair.¹

Female hair loss often causes great psychological distress and impaired social functioning because it’s less socially acceptable compared to men.

The most common cause of hair loss in women is Female Pattern Hair Loss. However, the sooner you get treated, the faster you’ll be able to stop the loss — and possibly even regrow hair.

Let us delve deeper into Female Pattern Hair Loss and what happens when this condition surfaces.

What is Female Pattern Hair Loss?

Also known as androgenetic alopecia, Female Pattern Hair Loss is a non-scarring, gradual reduction in hair density that affects the majority of areas around the head; resulting in diffuse hair loss throughout the scalp. Most of the time, the loss of hairs is usually incomplete and the frontal hairline will usually be spared.^{1 2}

It is usually caused by a gradual decrease in the ratio of thick to thin hair (known as miniaturisation), where the hairs produced by the affected follicles slowly become smaller in terms of diameter and became shorter and lighter until the follicles completely shrink. This stops the production of hair.⁵

Also known as hair thinning, the term Female Pattern hair Loss is used because it affects the scalp in a general distribution, as opposed to bald patches. The Ludwig Scale is used to describe the distinct differences of Female Pattern Hair Loss in 1977⁴ and has classified it into three grades of severity:⁶

Grade I: The balding process in the female usually starts with a reduction of the hair on the crown. In this stage, hair loss is considered mild. In fact, most women may not even notice that they are suffering from hair loss, since the frontal hairline is unaffected.

However, hair loss will still occur at the top and front of the scalp and may be noticeable when the hair is parted down the centre.³

Grade II: This stage is considered moderate. During this point, women may notice the following: A decrease in volume of hair, thinning, shedding, and a wider centre part.³

Grade III: When hair loss progresses to this stage, it usually means that all the hair at the crown may be lost. This is the final and the most extreme stage of female hair loss. At this point, hair is too thin to camouflage the scalp and causes it to be highly visible.³

Causes of Female Pattern Hair Loss

Female Pattern Hair Loss is usually caused by a combination of genetic and hormonal factors. It can be associated with conditions in which a group of hormones (androgens) are heightened, such as polycystic ovarian syndrome (PCOS).

The thing is, FPHL may begin when you start puberty. It has been widely acclaimed that the prevalence of FPHL increases after menopause due to the possible hormonal influence. FPHL can also be hereditary, although it is unclear as to exactly how genetic plays a role since the causative genes are not identified.

If you suspect that you are suffering from FPHL, please see a dermatologist. They will be able to confirm if you have Female Pattern Hair Loss and determine the root cause of hair fall.

Treating Female Pattern Hair Loss

The plethora of treatment options could affect FPHL in two ways. They either reverse or stabilise the hair follicle miniaturization. It’s preferable to have an early diagnosis and initiation of treatment as the majority of oral and topical medications aim to reduce the progression, rather than stimulating the regrowth of hair.³

Minoxidil

The only drug that is approved by the FDA to treat female pattern hair loss, it is available usually in 2% or 5% formulas. You are supposed to apply the affected areas of the scalp once to twice per day and continue to use the solution to maintain the effect. Otherwise, it may stop working and your progress will reverse.

Although it may not fully restore all the lost hair, minoxidil can help restore a reasonable amount of hair to give your hair an overall fuller appearance. Results may not show until six or 12 months later.

However, starting many over-the-counter formulations may cause side effects such as dizziness and light-headedness, as well as skin irritation due to the high alcohol content. Since it is harmful to an unborn child, pregnant women should not use this.

To alleviate some of the side effects, Dr Angeline has formulated our own minoxidil solutions and foams which has lower alcohol content. Unlike over-the-counter variants, our formula also comes with less propylene glycol to lessen scalp irritation and improve the user’s tolerance to the solution.

In addition, oral minoxidil is sometimes used if topical minoxidil does not work as well or there is issues with compliance and user-tolerability with topical formulations. There is however increased potential side effects such as increased facial hair growth when using oral forms of minoxidil.

Laser Therapy

Studies have revealed that low-level laser treatments work on Female Pattern Hair loss. This will be good for those who do not want to risk taking medication for fear of the side effects or getting more invasive solutions such as hair transplant surgery.

It works by allowing weak cells to absorb photons into scalp tissues. By doing so, it helps to move the follicles into a growing phase. This helps to restore hair follicles to coax the hair into re-growing.⁷

To achieve better results, Dr Angeline can combine laser therapy with micro-needling scalp treatment to stimulate hair growth. Studies have shown that combination treatment can boost hair growth faster, as opposed to just using a single treatment⁸.

Hair Transplant Surgery

Hair transplant surgery work by removing the hair follicles from a denser area of hair that is not affected by Female Pattern Hair Loss and implanting the hair into the affected areas of the scalp. Because the hair the area was taken from is not affected by miniaturisation, the transplanted hairs would usually grow as normal.

There are two main types of hair transplants performed in Singapore:

Follicular unit transplantation (FUT): The surgeon would remove one piece of skin from the denser hair area and stitch the incision up. A microscope will then be used to separate that piece of skin into small sections that contain several hair follicles and insert these sections into the intended area.

Follicular unit extraction (FUE). Using a tiny punch tool, the surgeon will remove follicles from the denser hair area. This procedure, while noted to leave some scarring, it is less noticeable and the patient usually does not require stitches.

Both techniques are effective but can achieve different results for some people. Another thing to note is that since it is a surgical procedure, there are bound to be some side effects. Some of the side effects such as pain and swelling, infection or bleeding and scarring (in the case of the FUE method, it may also leave miniature, non-visible scars at the section where the surgeon used the punch tool to removes the follicles.

Resolve hair loss and regain your confidence today

Ultimately, the best way to optimise the treatment option ideal for you is to consult a dermatologist because an early diagnosis will ensure a better chance of holding on to the remaining hair follicles. Early treatment may also help achieve better results.

Possessing years of experience managing various types of hair loss such as Female Pattern Hair Loss, Dr Angeline Yong is a dermatologist in Singapore that has extensive expertise in hair disorders, be it for medical or surgical management.

Previously the founding consultant and lead of the hair transplant service in the National Skin Centre, Dr Angeline possesses in-depth knowledge and expertise from medications to laser therapy and hair transplants. Her clinic offers a variety of hair loss treatments that will ensure you can cope with any hair loss condition. Contact us for details regarding our hair transplant cost or book a consultation today.

References

Dinh, Q. Q., & Sinclair, R. (2007, June). Female pattern hair loss: Current treatment concepts. NCBI. Retrieved September 22, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2684510/.

Bhat, Y. J., Saqib, N.-U.-, Latif, I., & Hassan, I. (2020, July 13). Female pattern hair loss-an update. NCBI. Retrieved September 22, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7413422/.

Fabbrocini, G., Cantelli, M., Masarà, A., Annunziata, M. C., Marasca, C., & Cacciapuoti, S. (2018, June 19). Female pattern hair loss: A clinical, pathophysiologic, and Therapeutic Review. International journal of women’s dermatology. Retrieved September 22, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6322157/.

Ludwig, E. (1977). Classification of the types of androgenetic alopecia (common baldness) occurring in the female sex. British Journal of Dermatology, 97(3), 247–254. https://doi.org/10.1111/j.1365-2133.1977.tb15179.x

British Association of Dermatology. Female Pattern Hair Loss (Androgenetic Alopecia). Bad.org. (2012, June). Retrieved September 22, 2021, from https://www.bad.org.uk/shared/get-file.ashx?id=3830&itemtype=document.

Singal, A., Sonthalia, S., & Verma, P. (2013). Female pattern hair loss. Indian Journal of Dermatology, Venereology, and Leprology, 79(5), 626–640. https://doi.org/10.4103/0378-6323.116732

Avci, P., Gupta, G. K., Clark, J., Wikonkal, N., & Hamblin, M. R. (2014, February). Low-level laser (light) therapy (LLLT) for treatment of hair loss. Lasers in surgery and medicine. Retrieved September 22, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3944668/.

Dhurat, R., Sukesh, M. S., Avhad, G., Dandale, A., Pal, A., & Pund, P. (2013). A randomized evaluator blinded study of effect of microneedling in androgenetic alopecia: A pilot study. International Journal of Trichology, 5(1), 6. https://doi.org/10.4103/0974-7753.114700

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An Insight To Female Pattern Hair Loss & Treatment Options