FPHL, also known as androgenetic alopecia, is a gradual thinning of hair on the scalp, following a specific pattern. It’s distinct from male pattern baldness, manifesting differently in women. Unlike the receding hairline seen in men, FPHL typically presents as:
Diffuse thinning: Overall hair loss across the scalp, particularly noticeable at the crown and parting.
Widening of the central part: The parting becomes wider, revealing more scalp.
Reduced hair density: Hair appears thinner and less voluminous.
Before diving into treatments, let’s explore the causes of FPHL:
Genetics: Like male pattern baldness, FPHL often has a genetic predisposition. If there’s a family history of baldness, you’re more likely to be affected.
Hormonal imbalances: Fluctuations in hormones like estrogen, androgen, and testosterone can trigger hair loss, particularly during pregnancy, menopause, or due to polycystic ovary syndrome (PCOS).
Medical conditions: Certain medical conditions like thyroid disorders, anemia, and autoimmune diseases, can lead to hair loss.
Lifestyle factors: Stress, nutritional deficiencies, and certain medications can contribute to hair thinning.
If you are experiencing hair loss, it is crucial to seek a professional diagnosis to determine the underlying cause and develop an appropriate treatment plan. At Care Well Medical Centre, our experienced dermatologists and hair restoration specialists offer comprehensive consultations that include:
At Care Well Medical Centre, we understand that no single treatment fits all. We offer a personalized approach, tailoring treatment plans to your individual needs and preferences. Our range of treatment options for FPHL includes:
Women’s hair and follicles appear to be specifically sensitive to suppressed medical conditions. Since intrinsic medical conditions commonly cause a diffuse type of hair loss pattern that can be confused with genetic balding, it is essentially required that women with undiagnosed alopecia be appropriately examined by a physician specializing in hair loss. Check here for the systemic medical conditions that cause a diffuse pattern of hair loss:
Among the many known causes of hair loss in women, drug-induced hair loss is one of the most disregarded causes. FPHL from drugs is a generally reversible diffuse non-scarring hair loss that happens within days to a month of beginning a new medication or changing the dose. It may be stressful for the patient and may also result in poor compliance with the treatment.
Anagen effluvium is most widely recognized after the intake of cytotoxic drugs. Drug-induced hair shedding is awful and severe and may contribute to the loss of large amounts of scalp hair, eyelashes, and eyebrows. Telogen effluvium is the commonest type of hair loss prompted by drugs and is presented with abnormal shedding of telogen hairs. Drugs are known to promote effluvium through 3 distinct mechanisms i.e.:
Telogen effluvium may also take place as a consequence of a severe drug eruption such as toxic epidermal necrolysis, drug hypersensitivity syndrome, Stevens-Johnson syndrome in which hair shed for a few weeks to months after serious sickness and gradually re-grows again.
Scores of dermatologic conditions contribute towards localized hair loss in women and the pattern that they form is generally pretty different from the diffuse pattern hair loss in women. Female genetic hair loss and localized hair loss are easily distinguished by a skilled dermatologist. However sometimes, the diagnosis of localized hair loss is difficult to make and tests, such as a scalp biopsy are demanded. LHL in women can be further sub-divided into non-scarring and scarring types.
Alopecia Areata is a genetically inherited, auto-immune hair disorder that exemplifies the non-scarring form. It presents with the unexpected onset of discrete, disc-shaped patches of hair loss linked with normal underlying skin. It is highly responsive to local injections of corticosteroids. Localized hair loss could also be a result of constant pulling of scalp hair, either through using hair pieces, braiding, tight clips, or tightly pulled back hairstyles. The medical term used for this condition is called Traction alopecia, which often leads to reversible thinning by simply keeping the hair loose but, if there is a continuous strain on the hair follicles for an extended time period, the hair loss can become permanent.
Scarring hair loss can be caused by hosts of dermatologic or medical conditions including local radiation therapy, Discoid Lupus, thermal burns, Lichen Planus, and infections. Facelift surgery can cause permanent localized hair loss that could be especially worrisome if it appears around the temples or at the frontal hairline. Luckily, localized hair loss from medical illness or any injuries is many times amenable to hair restoration.
Many of the stimulating elements that cause the rate of hair loss to accelerate or slowly decelerate are not known, but what is known is that with age, a person’s total hair density will reduce. This is called senile alopecia. Even when there is no predisposition to hereditary hair loss or balding, hair throughout the scalp will thin over time resulting in lower hair volume. The age at which these effects become obvious varies from one person to another and is mainly related to an individual’s genetic formation.
The hair loss conditions in women can also be further classified into scarring and non-scarring types. Since the non-scarring, diffuse female hair loss pattern is caused by genetic disposition and is so prevalent, it has its own unique classification that is based upon the rate of miniaturizing known as the “Ludwig classification”. It is essential for all women struggling with extreme hair loss that an appropriate diagnosis is done for them.
This is specifically needed when hair loss is diffuse, as undisclosed medical conditions may be a contributing factor. It is highly advised to refer to the diagnosis of hair loss in females to gain an in-depth valuable insight into different causes that may play a key role in female hair loss other than genetics.
The Ludwig Scale uses 3 distinct classifications (type), to identify the severity of female hair loss.
In this stage, hair loss is counted as minimal. Most females may have failed to notice that hair loss has taken place, as the hairline remains comparatively unaffected. Hair loss mostly occurs on the front and top of the scalp, and gradually increases while making more and more scalp visible over time.
In this stage, females may observe each of the following:
In this final and extensive classification of female hair loss, hair is so thin that it has complexity camouflaging the scalp, making it visible to the naked eye. In all the 3 Ludwig stages of hair loss in women, there is significant hair loss on the top of the scalp and in front with relative conservation of the frontal hairline. The sides and back may or may not be involved. Despite of the severity of hair loss, only females with stable hair on the sides and back of the head are good or say only candidates for female hair transplant surgery.
Hair can grow back from female-pattern baldness, but it typically requires treatment. The most common female pattern baldness treatment options include minoxidil (a topical medication) and finasteride (a pill taken orally). These medications can help to slow or stop hair loss and may even promote new hair growth.
A combination of genetics and hormones causes female-pattern baldness. Treatments for this condition include medications, hair transplants, and laser therapy. Additionally, lifestyle changes, such as eating a healthy diet and reducing stress, may also help slow or prevent further hair loss.
Multiple factors, including genetics, hormonal changes, and certain medical conditions, can cause female balding. The most common cause is androgenetic alopecia, a genetic condition that is triggered by the presence of androgens. Medical conditions such as thyroid disorders, autoimmune diseases, and iron deficiency can be other causes of female hair loss.
Female-pattern baldness can occur at any age, but it most commonly begins in women in their 40s or 50s. However, it can also occur in women in their 20s or 30s or earlier. If you have a family history of hair loss, you may be more likely to experience it at an earlier age.
Female balding can often be slowed down, but it may not be possible to stop it completely. The most influential female pattern hair loss treatment is minoxidil, a topical solution applied directly to the scalp. It is important to note that hair loss can be a gradual process, so it may take several months before you see any improvement in hair growth.
Estrogen stimulates hair growth, and estrogen levels can affect the growth cycle. Some studies suggest that estrogen therapy, either alone or in combination with other hormone therapies, may help treat hair loss caused by hormonal changes. Still, it is not a proven treatment for women’s hair loss.
Doctors can diagnose the cause of female hair loss and recommend treatment options. These may include medications such as minoxidil, which can help to stimulate hair growth, or oral contraceptives to regulate hormones. Sometimes, a hair transplant or other surgical procedure may be recommended.
Several female pattern baldness treatment options can help to regrow women’s hair. Some common treatments are minoxidil (Rogaine) to stimulate hair growth, oral contraceptives, or hormone replacement therapy to regulate hormones and prevent hair loss caused by hormonal imbalances. Also, iron supplements can help treat hair loss caused by iron-deficiency anemia.
Several blood tests can help diagnose the cause of female hair loss. You can do a blood count (CBC) test to measure the red & white blood cells and platelets in your blood. Iron test to measure the levels of iron in your blood. Thyroid function tests measure the levels of thyroid hormones in your blood, and hormone tests check your blood’s hormone level.
Dihydrotestosterone (DHT) is a hormone produced by the conversion of testosterone in the body. In females, high DHT levels can be caused by various factors, including Hormonal imbalances, Polycystic ovary syndrome (PCOS), Obesity, Hirsutism, and Certain medications.
Estrogen is a hormone that plays a crucial role in female hair growth. It helps to increase the hair growth phase, leading to thicker, longer hair. It also helps to decrease the hair resting phase, which decreases hair loss. Other hormones that play a role in hair growth in females are Thyroid hormones, Insulin-like growth factor 1 (IGF-1, Progesterone, and Androgens.
DHT blockers, such as finasteride and dutasteride, inhibit the activity of dihydrotestosterone (DHT), a common cause of female hair loss. Some studies have found that DHT blockers may effectively treat hair loss in women caused by high levels of androgens.
Note: DHT blockers can cause congenital disabilities if a woman is pregnant or trying to conceive.
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