Although not as prevalent as male-pattern hair loss, female-pattern hair loss will affect a large portion of women as they get older, causing hair to thin. The good news is that treatments are available. Dr Aleksandar Godic, a leading dermatologist at the London Dermatology Centre, offers a guide to hair loss in women.
What causes female-pattern hair loss?
Female pattern hair loss (FPHL) also called androgenic alopecia is a common condition among women in Britain. It is caused by a by-product of testosterone called dihydrotestosterone (DHT) and another hormone called dehydroepiandrosterone (DHEA), which is produced in the adrenal gland. Both DHT and DHEA bind to genetically-susceptible hair follicles, causing them to shrink and consequently produce thinner and shorter hair until hair thinning becomes apparent.
Female-pattern hair loss usually begins at around the age of 30 (sometimes as early as in the 20s or earlier) and becomes noticeable around the age of 40. After the menopause, it may become more pronounced due to a decrease in progesterone, which helps to protect the hair.
What are the signs of female-pattern hair loss?
By the age of 50, 50% of women will experience some degree of thinning - women may typically notice their parting becoming wider or their ponytail becoming less dense. Although women sometimes notice a receding hairline too, they will generally experience thinning at the top of the head or crown. Certain factors can cause generalised hair thinning all over the scalp, such as pregnancy, which resolves spontaneously within six months. If it does not change after six months, a woman may be experiencing female-pattern hair loss which was masked by childbirth.
Can female-pattern hair loss be treated?
Treatment options available for FPHL include clinically proven medications, off-label medications and hair restoration surgery. The aim of treatment is to slow the rate of progression of hair loss, rather than promote hair regrowth, which can, none-the-less, still be achieved in the early stages of hair loss.
Treatments available include;
- Spironolactone tablets
- Latanoprost solution - an off-label but efficient option
- Platelet-rich plasma (PRP)
Other treatments, such as Flutamide and cyproterone acetate (alone or with ethinylestradiol), are not frequently used in the UK as there isn’t much data available and the dosing regimens are not standardised. Finasteride, a popular treatment in men, is not recommended for women as there is currently little evidence to support its effectiveness.
Among the latest promising treatment options is platelet-rich plasma (PRP), which is approved by the US Food and Drug Administration. Platelets can be obtained from a patient’s blood sample and subsequently injected into the scalp, where they release growth factors, which are anti-inflammatory, prolong the anagen phase of the hair cycle, and promote the survival of hair follicles, which in turn leads to increased hair density, diameter, and quality. It has been established that PRP is superior to minoxidil. It is safe (there is no rejection reaction), efficient and cost-effective.