Pattern Balding Hair Loss in Women
There are a lot of myths and mysteries around hair loss in women. Female pattern hair loss, also known as androgenic alopecia is a form of diffuse hair loss. It is very common. Around 40% of women show signs of thinning hair or hair loss by the age of 50. Less than 45% of women will reach the age of 80 with a full head of hair. Understanding what contributes to female pattern baldness, whether it can be prevented, and how it can be treated helps you make better-informed decisions for your hair health. In this article we will take an in-depth look at hair loss in women, and what to do about it.
Female pattern baldness is different than male pattern baldness. Male pattern baldness hair loss tends to present itself in a horseshoe pattern. A bald spot at the back of the crown of the head. However, female pattern baldness presents as a diffuse thinning of hair throughout the head. This can either be due to increased shedding, reduction in hair volume, or both.
There is a strong genetic component that contributes to female pattern baldness. This is a polygenic condition. This means that there could be many genes that contribute to female pattern hair loss. These genes are passed down from one or both parents. However, there is no reliable genetic testing to assess whether one is more genetically predisposed to female pattern baldness or not.
The Lifecycle of Your Hair
Everyone is born with a fixed number of hair follicles on their scalp. Hair naturally goes through a life cycle of growing resting and shedding. During the growth or anagen phase, the hair grows from the base of the follicle at a rate of about one centimeter per month, this phase lasts for about 3 years. From there hair enters the hair dies and enters its catagen phase. From there it enters its telogen phase and stops growing, it stays in this dormant resting stage for around three months.
After telogen, the hair follicle undergoes another anagen phase, producing new hair from the same follicle. As this new hair grows, the old hair falls out to make room for the new growth. It is normal to lose up to 50-100 hairs a day, when the hair cycle is in balance, there is new hair growth at the same rate that it is being shed. When female pattern baldness is occurring hair is being shed at a faster rate than it is regrowing which contributes to reduced density of the hair overall, the appearance of a wider part, or thinner hair around the forehead and temples. Keeping an eye on the amount of hair that is shed as you go about your day is a good indicator as to whether you are experiencing female pattern hair loss.
Follicular Shrinkage Causes Hair Loss in Women
One of the reasons why these changes occur in the hair is because the hair follicles shrink over time. This results in hair that is shorter, finer, and more prone to breakage. Eventually, the follicles stop growing new hair altogether. If the follicles remain alive, then it is still possible for them to grow new hair. However, if the follicles have died, no amount of topical treatments, medications, or laser therapies can revive them.
We are learning more and more about the causes of female pattern baldness. all the time. At this time, there are several contributing factors. These include aging, and to some degree, thinning hair and changes in the hair follicle are a natural part of the aging process. Changes in hormones can stimulate higher levels of male hormones like androgens. Family history of female pattern baldness, anemia, and certain medications such as estrogenic oral contraceptives can also be contributing factors. Nutritional deficiency, heavy metal toxicity, thyroid imbalance or increased stress levels can also be contributing factors to female hair loss. For women that are experiencing hair loss due to anemia or hormonal imbalance, this is sometimes accompanied by heavy blood loss during menstruation.
Hair Loss in Women During Puberty
Some women may experience pattern hair loss as early as during puberty. This is rare and can be accompanied by a hormonal imbalance that may also present as excess facial or body hair. In the event of these symptoms, perform a hormone evaluation to determine the root cause. Changes in hormones following pregnancy are another reason why women may experience increased hair loss. During pregnancy, the hair stops shedding and grows at a faster rate, and then about 3 months postpartum it is not uncommon for the hair to start shedding to make way for new growth at a higher volume than usual. This will normally balance out within a year, but maintaining balanced nutrition during this time, especially if you are breastfeeding is very important.
If you suspect you are experiencing female pattern baldness, talk to your doctor or dermatologist. Hair loss in women can happen for many different reasons. In other words, it’s important to rule out other causes of hair loss such as thyroid disease, thyroid deficiency, or heavy metal toxicity. Order a blood panel to find out more. Your doctor will also examine the severity of your hair loss, so documenting your appearance and any shedding with photos between appointments can be helpful. They will also consider your medical history when making their recommendations. Things that could indicate that your body is producing too many androgens include an abnormal amount of new hair growth on the face, or near the belly button, pubic area. Changes to the menstrual cycle, or new acne.
Skin Disorders Cause Hair Loss
Hair loss in women may sometimes be attributed to skin disorders or fungal infections of the scalp. A dermatologist may order a skin biopsy from the scalp to determine whether these can be the cause. There is more and more evidence emerging that harsh ingredients in over-the-counter shampoos and other hair products such as parabens, sulfates, and alcohols can cause the hair shaft to become excessively dry and more prone to damage.
Another condition that can cause hair loss in women, traction alopecia is related to styling choices. Traction alopecia is caused by excessive pulling or weight on the hair shaft, causing the hair to get pulled out at the root. OUCH! Heavy braids, weaves, or tight ponytails are all examples of hairstyles that can cause a lot of pulling and weight on the follicles. Using high-heat hairdryers and styling tools like curling irons or straightening irons can also cause damage to the hair. To avoid damage from traction alopecia you will need to change your styling practices. Natural styles, low heat tools, and gentle/protective styling practices can reduce hair loss from traction alopecia.
Hair loss in women is not simply a cosmetic concern, it can cause a significant amount of emotional and psychological distress as well. Society puts a lot of pressure on women to display a youthful appearance to be attractive and long hair has a lot of associations with traditional expectations of femininity. Hair loss in women can trigger feelings of low self-esteem, depression, introversion, and feelings of unattractiveness. This can interfere with a woman’s desire to be social or to feel confident in the workplace.
Drugs Used for Hair Loss in Women
Minoxidil
While there is no known cure for female pattern baldness, there are some treatments that have been shown to reduce its effects. There is only one medication that has been approved by the United States Food and Drug Administration (FDA) for the treatment of female pattern baldness, and that is minoxidil.
Minoxidil, also known as Rogaine, and can be purchased in either 2% or 5% solutions. It is applied directly to the scalp and has been shown to slow, or even stop the rate of hair loss. This medication must be used on an ongoing basis in order to prevent further hair loss. If you stop using minoxidil you will start to lose your hair again.
Finasteride
Finasteride or Propecia is another hair loss medication, but it hasn’t been shown to be effective for women at all. Spironolactone is another medication that some doctors have started prescribing to treat female pattern hair loss. Spironolactone is FDA-approved for the treatment of fluid retention caused by a variety of conditions. This includes diseases of the liver and kidneys. It can treat conditions such as high blood pressure, heart failure, and hyperaldosteronism.
Spironalactone
Spironolactone slows down the production of androgens, male sex hormones that include testosterone. These hormones contribute to the formation of DHT which is responsible for the shrinking of hair follicles and hair loss due to androgenic alopecia. By slowing down the production of these androgens, the progression of hair loss slows. Spironolactone may encourage new growth as well. Spironolactone and minoxidil have been shown to work successfully together to improve hair growth. Additionally, they can increase density and reduce the rate of shedding.
The main downside when it comes to Spironolactone is that it takes a little while before you will see results. So it’s important to remember to stay patient and not get discouraged if you don’t see results right away. Most people can expect to wait at least six months before they will start seeing results, while others may have to wait up to a year. Spironolactone has been shown to be especially helpful for women experiencing hair loss before the onset of menopause. Women in menopause may find some success combining spironolactone with hormone replacement pills such as Prempro.
Cimetidine
Other treatments that your doctor may recommend such as cimetidine, also known as Tagamet, which has been shown to block DHT. Birth control pills with a low androgen index can also be an effective hair loss treatment for pre-menopausal women. High androgen index birth control pills may contribute to hair loss and should be avoided. Birth control pills that have a low androgen index include the following: Desogen, Ortho-Cept, Ortho-Cyclen, Ortho Tri-Cyclen, and Micronor. Basically, anything that changes the chemistry of the body can cause hair thinning and hair loss.
Surgical Options for Hair Loss in Women
If you aren’t seeing the results you want from medication or you are concerned about undesirable side effects then you may want to consider a more permanent solution. Hair transplant surgery might be the answer. There are two primary methods for performing hair transplantation: Follicular Unit Transplantation (FUT) and Follicular Unit Extraction (FUE). With both of these procedures, grafts of the hair follicles are harvested from the back of the head. That’s because that is where the hair is typically thicker. Then, hair is transplanted into areas of the scalp where the patient is experiencing thinning or balding hair.
FUT is performed by removing a thin strip of the scalp in order to harvest the grafts before the excised area is sutured. On the other hand, FUE involves the use of a small punch tool to remove the follicular grafts. In either instance, the hairs are transplanted into the recipient area in the same manner. Both are outpatient procedures. FUT is more invasive but also less time-consuming. Shaving is not necessary for this procedure. Consequently, this is a great choice if you don’t want to lose any hair length while undergoing surgery.
FUE is more time-consuming, and typically more expensive. However, it is also less invasive and has a faster recovery time with less discomfort. The entire donor area where the follicular grafts are must be shaved for an FUE procedure. The follicular grafts are harvested in a dispersed pattern instead of in a straight line. It takes about 2 weeks to initially recover from surgery. It may be up to a year for the newly transplanted grafts to become well established. However, the results speak for themselves.
Other Options to Fight Your Hair Loss
If surgery feels too invasive you can also look for a change in hairstyle or a hairpiece or wig to hide your hair loss. Hair systems are a good temporary solution if you have an important event to attend or want to feel extra confident. However, some of the tapes and adhesives keeping them in place can be damaging to hair health and make hair loss worse. The expenses involved with regular cleaning and replacing elements of your hair system can also add up. If you are looking for a permanent solution, hair transplantation is your best option.
Additionally, you may look into LLLT lasercaps for your hair loss solution. LLLT devices like the Capillus RX 312 can help stop female hair loss and female pattern baldness. This FDA-cleared device is a prescription-grade laser cap that uses low-level laser therapy to stimulate blood flow to the scalp. It’s less costly than transplants, convenient, and helps stop and reverse female hair loss. If you’d like to order a Capillus Laser Cap, you can do so on this site. We recommend consultations first. However, they are not necessary for most users.
Contact your doctor if you have been experiencing continuous hair loss, shedding, or if your hair loss is accompanied by any itching, skin irritation, or if you’ve noticed any other changes or symptoms. Once you and your doctor have worked to determine the cause of your hair loss, then you can start to come up with a treatment plan that is most appropriate for you.
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References:
- https://www.mountsinai.org/health-library/diseases-conditions/female-pattern-baldness
- https://www.everydayhealth.com/hair-loss/oral-contraceptives-as-a-hair-loss-treatment.aspx
- https://www.aocd.org/page/FemalePatternHair
- https://www.healthline.com/health/spironolactone-for-hair-loss
- https://www.ruthieharper.com/best-female-hair-loss-treatment/