Dermatologist Dr Martin Wade explains what is Female Pattern Hair loss, what causes Female Pattern Hair loss, what are the signs and symptoms of Female Pattern Hair loss and how a Dermatologist treats Female Pattern Hair loss.
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Female pattern hair loss is the most common form of hair loss in women and presents as diffuse thinning or hair loss from the vertex of the scalp.
The term female pattern hair loss is sometimes used interchangeably with androgenetic alopecia where it’s also sometimes used as more of an umbrella term to encompass both androgenetic alopecia but other forms of hair loss which may cause diffuse thinning on the vertex of the scalp which may have an underlying cause such as polycystic ovary syndrome.
The underlying pathophysiology of Female pattern hair loss is miniaturisation of the hair follicles on the vertex of the scalp. Each time the hair goes through the hair cycle the hair shaft and follicle becomes smaller and smaller until some of the follicles are so small that they don’t protrude from the scalp surface, therefore these hairs don’t contribute to the general volume of the hair, Women with Female pattern hair loss present with diffuse thinning from the vertex of the scalp. This may be a slow process an usually occurs in years rather than months but can occur at different rates in different people.
Women will also notice an increase in hair shedding and may find when washing their hair or brushing their hair that they see more hair being shed than what they feel is normal or what they’ve been used to in the past. Women rarely tend to go completely bald but just become slowly diffusely thin on the vertex of the scalp.
The first consideration in treating women with female pattern hair loss is to ensure that we have the correct diagnosis. This may mean we sometimes need to perform blood tests looking at underlying causes and occasionally a scalp biopsy is also required to prove that the process of miniaturization is occurring underneath the skin and to rule out any other inflammatory causes of hair loss which can sometimes present in this manner.
There are two main types of treatment for female pattern hair loss. The first is topical treatment in the form of minoxidil which is clinically proven to stimulate hair growth. When used consistently hair grows thicker and faster and a good cosmetic result can be obtained with topical minoxidil. The other form of treatment is oral treatment and involves use of anti androgen medication. this could include spironolactone, some types of the oral contraceptive pill such as Dianette or Yasmin and occasionally Finasteride. Oral minoxidil is now also being used in some cases for Female pattern hair loss to stimulate hair growth.
Better responses to treatment for Female pattern hair loss are seen when treatment is started early. Female pattern hair loss is generally more difficult to treat than androgenetic alopecia in men. This is why clinical photography to allow objective assessment is very important in determining response to treatment.
This video on how a Dermatologist treats Female Pattern Hair loss is part of the series of Dermatology video’s on dermatology conditions, produced to help patients and their families, general practitioners and other specialists, and for those who are interested in Dermatology. You can watch all the videos on The London Skin and Hair Clinic YouTube channel.
Looking for further information? You can find out more about Female Pattern Hair Loss here.