Female Genetic Hair Loss (Female Androgenetic Alopecia)

Women Can Lose Hair?

It seems incredible to most people that a woman might lose her hair.  After all – isn’t that something that only happens to men?  The truth is that many women suffer from hair loss and that Female Pattern Hair Loss (or FPHL for short) can be emotionally devastating in a culture where you can even tell which Disney Princess it is by the color of her hair.

Androgenetic alopecia in a woman (sometimes termed androgenic alopecia) is the diagnosis of Female Pattern Hair loss.  Most women associate this hair loss with post-menopausal changes, but it can happen at any time, even starting as early as a woman’s late teens and twenties.  It typically takes the form of decreased hair mass on the top of the head but sparing the frontal hairline. 

Femail Hair Loss

Female Hair Loss Classification Chart.

Several other patterns exist, though, including thin wispy hair at the temples, side loss, vertex thinning (i.e. where a man’s “bald spot” would be), and diffuse loss all over the scalp.  Any combination of these patterns is fair game too, with crown loss sometimes occurring along with diffuse loss for example.  However, all of these different patterns exist under the rubric of androgenetic alopecia – and it often surprises people to know that “male pattern” hair loss can happen in a woman, and vice versa.  Regardless of the “pattern” that manifests in an individual, it is ALL androgenetic alopecia, and it is ALL devastating to deal with.

Indentifying a Chameleon:

Since it comes in so many different “flavors” – androgenetic alopecia can be difficult to diagnose definitively.  A woman has a higher risk of FPHL if other women OR men in her family have pattern hair loss, too.  One of the first signs may also be shedding, but since shedding can also be completely benign, it helps to involve a doctor in the process and possibly do a “hair count” to check if the number of hairs being shed is within the normal range.  Lab tests can help to rule out other medical conditions that might cause hair loss (like thyroid changes, PCOS, and others…).  If no easy answer is found, a scalp biopsy can give a definitive diagnosis.

Why is getting a definitive diagnosis so important?  Different forms of hair loss respond best to different treatments, so getting the diagnosis right the first time makes a big difference in what you will be able to do about your hair loss and how successful those treatments will be.

Dealing with it…

Women are particularly good a hiding hair loss because, let’s face it – women have to be good at this!  Shaving one’s head is not an option unless you want to channel Britney Spears on one of her bad days…  Wigs, extensions, scarves, hair fibers powders, and scalp make-up, hats, hair color, perms, and different hairstyles and haircuts all play a role in camouflaging women’s hair loss.

Treatments do exist!

Since FPHL is a genetic problem, many in the hair world are waiting for the time when genetic therapies might provide the definitive cure.  Medical treatments have started to help, though.  Rogaine liquid or foam (or any product containing 5% minoxidil solution) is a mainstay of treatment for many women and it works quite well provided that you use it daily.  Contrary to many online myths, you do not lose more hair if you stop using it, but you will stop seeing the benefit of growing thicker hair!  Hair skin and nails vitamins are expensive and only really help if the woman has an underlying deficiency that is causing her hair loss (again – this is why getting a definitive diagnosis to start with is so important.)  Hair lasers show some promise, but are not a panacea and also require regular and ongoing use.  Finasteride (also known as Propecia) and Spironolactone (also known as Aldactone) might also end up being a reasonable off-label therapies for some women.

Hair restoration surgery is another good option and it is increasingly used in women for limited but solid improvement in their hair mass.  It works by relocating hair from the areas that have more, stronger hair genetically – like the back of the head – to areas that are thinned – like the top and hairline.  The procedure takes a full day and should be performed by a specialist in hair restoration surgery who has lots of experience with female pattern hair loss (good hair surgeons can be researched at ISHRS.org).  Recovery takes about 3-7 days in most patients.  Like any cosmetic surgery, the cost can be reasonable or expensive depending on how much needs to be done and how expert the surgeon is, but women should expect to pay between $5000 and $15,000 dollars for a good and lasting hair transplant.  Best of all, the results are completely natural, undetectable, and permanent.

No matter which treatment a woman uses, patience will be the name of the game.  Hair takes a long time to grow because it grows in several phases, so at least a year of any treatment is needed to see results.  This is good to know if an online hair therapy promises nearly instant results since it is impossible to “re-grow all your hair” in three weeks, or even three months!  It is possible to restore hair, though, so if you do end up being one of these affected women, remember that there is hope and start on some treatments right away.

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