Female Pattern Thinning
What is the difference between female and male pattern hair loss? The common thread is that both are inherited. While men get receding hairlines and thinning on the crown of the head, female hair loss looks totally different. In female pattern hair loss the frontal hairline almost always remains intact. Woman tend to lose hair more diffusely particularly over the frontal 1/3 – 2/3 of the scalp, classified according to the Ludwig distribution.
As thick terminal hairs are gradually replaced by fine thin hairs, the overall appearance becomes more and more see-through. Under magnification, there is greater variation in the thickness of the hairs and more hairs become single-hair follicles (rather than occurring in groupings of 2-4 hairs).
Women can notice hair thinning in their teens, twenties, or even in the thirties. The diagnosis of female pattern hair loss can be tricky because women often suffer with hair loss from other causes. Pregnancy, hormonal problems and diet related shedding just to name a few. The key is to make the diagnosis as soon as possible so they can get started on treatment that will help preserve and enhance the hair they have.
It is not uncommon for women to develop age-related thinning as they approach their 60’s and 70’s. Hormone levels are usually normal. A combination of medical therapy (Rogaine, finasteride, spironolactone) as well as hair transplantation can be used to address this condition. Nearly everyone can benefit from one form of treatment or the other.
It is important to mention that for some women, hair loss may be a symptom of more serious hormonal problems. These women should undergo blood testing as part of their work up for hair loss.
Women with thinning hair should take comfort in consulting with their dermatologist and understand that they are not alone. Dermatologists are trained to work up, diagnose and treat hair loss in women and the sooner you seek treatment the better your results will be. Women often think they must deal with the condition on their own. It can be difficult to find validation from family members or providers who dismiss their concerns. They may feel too self-conscious to even bring up the matter with their doctors. When they do bring up the matter with their doctor, they may undergo extensive blood testing with normal results, only to lose precious months or years as their hair continues to thin.
It is important to mention that for some women, hair loss may be a symptom of more serious hormonal problems. Polycystic ovarian syndrome (PCOS) affects 15% of all females in their childbearing years and causes female pattern hair loss, irregular menses, acne, infertility, or unwanted body or facial hair. These women should undergo blood testing as part of their work up for hair loss. PCOS is more often diagnosed by obstetricians using ultrasound of the ovaries, but does not always fulfill the traditional criteria.