Hair Loss on the Sides and Back of the Scalp

We frequently see women who have hair loss in our practice. Typically the cause is genetic, but unlike male pattern hair loss, female hair loss can present itself either as diffuse hair loss on the top, receded like male pattern hair loss or in some cases on the side of the scalp. It is not uncommon for us to see very fairly diffuse thinning above the ears as a presentation of female pattern hair loss. In this case a 53-year-old female came to see us for hair loss and thinning around the sides and back of her scalp and she naturally was very distressed.

She had previously tried topical minoxidil but developed a contact allergy to it, she had also tried oral Spironolactone. In women, the use of spironolactone can help block androgen receptors at the level of the hair follicle. It can help reduce unwanted facial hair and also help regrow thinning hair on the scalp. Unfortunately this patient did not favorably to spironolactone.

After further consultation with Dr. Rogers she began hair loss therapy with oral Finasteride 5mg daily. Finasteride is FDA-approved for hair loss in men under the trade name Propecia but Dr. Rogers will often prescribe it for post-menopausal females in higher doses. We also started her on oral minoxidil 125mg daily.

After six months she had remarkable improvement. Sometimes going the systemic root is a really helpful. This treatment protocol is not for everyone, but in her situation, she did very well.