Each year, women spend countless hours and dollars on their hair.
It can play a major role in a woman's self-confidence and self-esteem,
making female pattern hair loss a potentially debilitating condition,
socially and emotionally. But it doesn't have to be.
Determining the cause of hair loss is the key to determining the best
treatment.
"A receding hairline or balding spot usually characterizes hair loss in men,
but female pattern hair loss rarely displays either of these symptoms,"
explained Dr. Callender. "Instead, women see an overall thinning of their hair."
They may notice their center part gradually getting wider, a decrease in ponytail
diameter or more hair than usual in the shower drain, on the pillow or in a hairbrush.
To diagnose hair loss, dermatologists will perform a thorough
history, physical exam, laboratory evaluation and in some cases, a scalp biopsy.
This relatively simple procedure usually takes place in the office under local
anesthesia and involves removing a small piece of scalp for microscopic examination,
which can be extremely helpful in diagnosing the type of hair loss.
Women also suffer from pattern hair loss, although not as prominently as men. The condition occurs in up to 25 percent of pre-menopausal women and in 38 percent of post-menopausal women. While pattern hair loss normally does not affect the frontal hairline in women as it does in men, thinning over the front and top of the scalp is typical and can be devastating to a woman's self-esteem.
"Women are especially embarrassed by even slight hair loss," commented Dr. Shapiro. "More than men, women will try to hide their hair loss. Oftentimes, they'll discuss their problem with a hair stylist and try to develop a hair style that disguises the problem."
As the growth phase shortens, the hair becomes thinner and shorter, to the point where there is no growth at all. Because hereditary hair loss is gradual, the sooner treatment is started, the better the chances of results.
"When someone confronts his or her hair loss and treats it early, treatment is more effective," said Dr.Shapiro. "It's important for patients to realize all there is to gain by addressing hair loss sooner rather than later."
Although there is no cure, there are several different treatment options for women suffering from pattern hair loss:
Treatment Options Recommended by AAD
-- Minoxidil topical solution
Works on hair follicles to reverse the shrinking process and stimulate new growth on the top of the scalp. It is sold over the counter in 2 percent and 5 percent solutions and is approved by the U.S. Food and Drug Administration for use by men and women. Minoxidil is the only hair regrowth ingredient approved by the FDA for use by women. It must be used indefinitely to continue its effectiveness.
The recent result has been proven to re-grow hair in 60 percent of women with female pattern hair loss.
-- Hair transplant
Another option is hair transplantation, a good choice for women experiencing minimal to moderate hair loss. Surgery involves removing healthy hair follicles from one area of the scalp and transplanting them to the bald areas. Newer techniques such as strip harvesting and follicular unit grafting have revolutionized the procedure to give very natural-looking results.
"These newer techniques make for the best possible cosmetic results," said Dr. Shapiro. " Patients can expect a totally natural-looking hair transplant because the grafts are taken from the patient's own scalp."
Not every one can benefit from hair transplant. Patients must at least has healthy hair in another location that can be transplanted.
While the replacement technique is the same for men and women, there are some additional challenges with women. Transplant locations are usually chosen based on the density and texture of the hair in various areas, which must be carefully considered, especially in women.
Here is a list of other hair disorders:
Alopecia Areata
The difference between pattern hair loss and alopecia areata is the difference between thinning hair and a complete absence of hair on parts of the body. Patients suffering from alopecia areata have lost entire patches of hair, and not necessarily just on the scalp. Other areas potentially affected are the eyebrows, eyelashes, beard, moustache, and pubic hair. This autoimmunecondition affects almost 2 percent of the U.S. population, or 4.5 million people. It occurs in men and women of all ages and races, although it typically begins before age 20 in 60 percent of all patients.
"Alopecia areata can be psychologically devastating," stated Dr. Shapiro. "The cause is unknown and there is no cure. Fortunately, some patients develop only a few bare patches that regrow hair within a year."
Alopecia areata occurs in two forms that behave quite differently: a mild patchy form where less than 50 percent of scalp hair is lost, and an extensive form where greater than 50 percent of scalp hair is lost. The good news is that all affected hair follicles remain alive and have the capacity to resume normal hair production, sometimes even without treatment. When treatment is required, there are several options, depending mainly on the patient's age and the extent of hair loss.
For the mild, patchy alopecia areata the most common treatment is a monthly cortisone injection into the patches of bare skin. Topical minoxidil may also regrow hair on the scalp, eyebrows, and beard when applied in the stronger, 5 percent solution.
In addition, anthralin cream or ointment, a synthetic, tar-like substance often used for psoriasis, can be applied once a day to bare patches of skin, with new hair growth possibly occurring in eight to 12 weeks.
For the extensive alopecia areata where greater than 50 percent of hair is lost, cortisone pills are sometimes given for extensive scalp hair loss. Cortisone taken internally is much stronger than local injections of the drug into the skin. Topical minoxidil is again effective, as is topical immunotherapy, which produces an allergic rash that induces hair regrowth.
Whether a person is experiencing pattern hair loss or alopecia areata, there are an increasing number of treatments available, commented Dr. Shapiro. That’s why it’s important to consult with a dermatologist who can get to the root of the problem and begin treatment early.