Female Pattern Baldness


Female pattern baldness involves a typical pattern of loss of hair in women, caused by hormones, aging, and genes. The Ludwig Scale can be used to categorize typical hair loss patterns in women.

Causes
Baldness occurs when hair falls out but new hair does not grow in its place. The cause of the failure to grow new hair in female pattern baldness is not well understood, but it is associated with genetic predisposition, aging, and levels of endocrine hormones (particularly androgens, the male sex hormones).

Changes in the levels of androgens can affect hair production. For example, after the hormonal changes of menopause, many women find that the hair on the head is thinned, while facial hair is coarser. Although new hair is not produced, follicles remain alive, suggesting the possibility of new hair growth.

Female pattern baldness is usually different from that of male pattern baldness. The hair thins all over the head, but the frontal hairline is maintained. There may be a moderate loss of hair on the crown, but this rarely progresses to total or near baldness as it may in men.

Hair loss can occur in women for reasons other than female pattern baldness, including the following:

  • Medications
  • Certain skin diseases
  • Hormonal abnormalities
  • Iron deficiency
  • Underactive thyroid
  • Vitamin deficiency
  • Temporary shedding of hair (telogen effluvium)
  • Breaking of hair (from such things as styling treatments and twisting or pulling of hair)
  • Patchy areas of total hair loss (alopecia areata -- an immune disorder causing temporary hair loss)

Treatment
The hair loss of female pattern baldness is permanent. In most cases, it is mild to moderate. No treatment is required if the person is comfortable with her appearance. The only drug or medication approved by the United States Food and Drug Administration (FDA) to treat female pattern baldness is minoxidil, used on the scalp. For women, the 2% concentration is recommended. Minoxidil may help hair to grow in 20% to 25% of the female population, and in the majority it may slow or stop the loss of hair. Treatment is expensive, however, and hair loss starts again when minoxidil use is stopped.

Hair transplants consist of removal of tiny plugs of hair from areas where the hair is continuing to grow and placing them in areas that are balding. This can cause minor scarring in the donor areas and carries a modest risk for skin infection. The procedure usually requires multiple transplantation sessions and may be expensive. Results, however, are often excellent and permanent.