Almost half of the female population will experience some form of hair loss in their lives, with female pattern hair loss being one of the most prevalent causes.1 The effect of alopecia (hair loss) can often be more significant in women than in men because of adverse social consequences and the stigma surrounding women with the condition. As a result, their mental and emotional health is often compromised and their quality of life impacted.2
In men, pattern hair loss results in a receding hairline that starts above the temples and graduates to the top of the head. For women, however, hair loss begins with a gradually thinning parting and leads to an escalating diffuse hair loss which radiates from the top of the head. Female pattern hair loss less commonly leads to a receding hairline, unlike male pattern hair loss.3
While female pattern hair loss is common, there can be more severe causes for it, including certain medical conditions. Ovarian or adrenal tumours, PCOS (polycystic ovarian syndrome), and adrenal hyperplasia can all lead to alopecia in women. There is also evidence that hair loss is linked to hypertension in women older than 35 and coronary artery disease if you are above 50. When screening for metabolic cardiovascular risk factors, patterned hair loss is often used as an indicator.1
As such, unusual hair loss suggests a necessity to see a doctor or dermatologist to get a more thorough look into the cause and treatment.
Treatments
When treating female pattern hair loss, an early diagnosis is preferable. The treatments available today are much more effective at preventing the worsening of hair loss than inducing regrowth.2
Do note that while many treatments are available to manage the condition, restoring hair requires a substantial amount of time. It is vital that individuals have the support they need while waiting.2
An extensive review of the patient’s medical history should be done because FPHL can resemble other diagnoses and frequently coincides with them. Additional coexisting conditions should be looked into, and, if necessary, treated with the aid of other diagnostic techniques and tools.2
Medication (minoxidil)
Minoxidil is a medicine often used to treat female pattern baldness. When applied topically, it can stave off hair loss and stimulate some hair growth. It comes in the form of a solution or foam with a concentration of either 2% or 5% and is an established drug. Minoxidil is known to be very safe topically, but may lead to localised irritation and hypertrichosis around the temple in some people. If you are using this treatment, you must be committed to using it consistently in order to keep hairs in the growth cycle (anagen). Failure to be consistent will lead to suboptimal results.1
Melatonin
Melatonin possesses strong anti-oxidant properties and the capability to catch free radicals. It can regulate hair growth and other physiological processes in people. Studies have shown that a topical application of melatonin 0.1% solution greatly improves the growth of anagen hair.3
Spironolactone and anti-androgens
Spironolactone is a potassium-sparing diuretic medication that is administered orally. It is used to help prevent hair loss and has the greatest benefit when used for women who have documented hyperandrogenaemia and female pattern hair loss. Another option would be to utilise an oral contraceptive pill with an anti-androgen like cyproterone acetate.
Micro-needling
Micro-needling is a non-invasive dermatologic procedure where fine needles are used to create areas of controlled micro-trauma in the stratum corneum. Because of the physical trauma caused by the penetration of the needle, it creates a wound-healing cascade without any genuine harm caused to the skin, which can stimulate collagen formation – as well as neovascularisation and growth in the affected areas.2
This treatment also works well when performed concurrently with other hair growth therapies such as topical minoxidil and other medicines.2
Hair transplantation
Hair transplants are a crucial alternative for individuals with female pattern hair loss over 25 who have not found success with alternative forms of treatment. This procedure involves transferring hair from the occipital area to where the candidate is bald. The ideal candidates for hair restoration surgery with the most potential success are those women with thick hair over the occipital scalp and increased hair loss in the frontal area.3
Follicular unit hair transplantation occurs when hair follicular units are dissected and relocated to the bald area. The surgery is done while the patient is under local anaesthesia and is much less invasive than the previous versions of hair transplantation. The results are also highly seamless and reproducible.2
Conclusion
Female pattern hair loss can be observed in a significant percentage of women. Yet, the stigma attached to this condition, paired with the misconceptions surrounding it, has led to a dearth of knowledge in the general population.4
Fortunately, several treatments are available to slow down hair loss, if not stimulate hair growth in women, as detailed above. Still, it is essential to acknowledge the psychological and emotional pitfalls that come with hair loss in women – especially because the results of treatments show up slowly.
If you are experiencing symptoms of female pattern hair loss and are looking for treatment, find us at Angeline Yong Dermatology for a more personalised and focused visit to a dermatology clinic. Contact us today to learn more.
References
Chan, L., & Cook, D. K. (2018). Female pattern hair loss. Australian Journal of General Practice, 47(7), 459–464. https://doi.org/10.31128/ajgp-02-18-4498
Fabbrocini, G., Cantelli, M., Masarà, A., Annunziata, M. C., Marasca, C., & Cacciapuoti, S. (2018). Female pattern hair loss: A clinical, pathophysiologic, and therapeutic review. International journal of women’s dermatology, 4(4), 203–211. https://doi.org/10.1016/j.ijwd.2018.05.001
Bhat, Y. J., Saqib, N. U., Latif, I., & Hassan, I. (2020). Female Pattern Hair Loss-An Update. Indian dermatology online journal, 11(4), 493–501. https://doi.org/10.4103/idoj.IDOJ_334_19
Dinh, Q. Q., & Sinclair, R. (2007). Female pattern hair loss: current treatment concepts. Clinical interventions in aging, 2(2), 189–199.