What is hair loss in women?
Hair loss, also known as androgenetic alopecia is a condition that affects both men and women. Though, it is commonly characterised as a disorder that occurs primarily in men, the truth is that it occurs in both, and differs only in the pattern of hair loss. Hair loss in men loss begins above the temples, with the hairline receding with time to form a ‘M’ shape. Hair thins at the crown and might progress to partial or complete baldness.
In women, androgenic alopecia does not usually affect the frontal hairline and complete baldness is rarely experienced. Instead, hair thinning all over the head is observed, most typically along the parting line and crown region.
What are the causes of the disorder?
Thinning of hair and hair loss are normal processes that accompany ageing. However, the pattern of hair loss, its onset and how soon it progresses can be determined by factors like your genes, hormones, medical ailments or certain medications that you might be taking.
Hormonal/genetic factors – This is the most common factor that may cause female-pattern hair loss.
If you inherit a set of genes that makes you susceptible to hair loss, certain sex hormones may trigger the disorder. Also, hormonal imbalances may occur during certain life stages that are not genetically triggered. These include pregnancy, childbirth, onset of menopause and discontinuation of birth control pills.
Medical factors – Certain medical conditions may trigger hair loss in women:
- Thyroid disorder – Improper functioning of the thyroid gland can cause hormone imbalances and lead to hair loss.
- Scalp infection – Certain infections, such as those caused by ringworm, result in hair loss by invading the hair and skin of your scalp. However, this condition is reversible, and hair can grow back with treatment.
- Alopecia areata – Smooth, round patches of hair loss develop when the body’s immune system attacks hair follicles.
- Skin disorders – Certain diseases like lupus and lichen planus can result in permanent hair loss at regions where scars develop (scarring is a characteristic of these diseases).
- Medication – Drugs used for treating arthritis, heart problems, depression, high blood pressure and cancer can cause hair loss as a side effect.
Further, deficiency of vitamin B or other vitamin deficiencies may also lead to hair loss.
What you need to know about symptoms or signs?
It is important to note that female pattern baldness is markedly different from the baldness and hair loss that occurs in men. Following signs signify hair loss in women:
- Hair loss begins by thinning of hair on the top of the head and crown of the scalp. The central hair parting starts to widen.
- Unlike male-pattern hair loss that begins at the front, the frontal hairline remains intact in women.
- Your hair loss will not lead to complete baldness.
- Itching in the scalp and skin sores are generally not seen.
Which specialist should you consult if you have any of the signs and symptoms?
Your general practitioner will refer you to a dermatologist who specialises in treating skin-related problems.
What are the screening tests and investigations done to confirm or rule out the disorder?
Your doctor’s diagnosis of hair loss will depend on the following factors:
- Ruling out other disorders that may be causing hair loss
- The appearance and pattern of your hair loss
- Your medical and family history towards hair loss
- Any signs of excess male hormones in your body like abnormal growth of hair on face, pubic area or between belly button, changes in menstrual cycle or enlargement of clitoris, or development of acne.
Blood tests will be used to determine medical conditions like diabetes, lupus or thyroid disorder. Skin biopsies will also help to determine the skin disorders causing hair loss. Samples are scraped out from the skin and few hairs are plucked from the scalp to determine the infection. Tugging and pulling of hair to see how many fall out helps the doctor to establish the stage of the shedding process.
What treatment modalities are available for management of the disorder?
Hair loss in women is treated in the following ways:
- Topical medication – The only approved medicine to treat androgenetic alopecia in women is minoxidil, which is rubbed into a dry scalp to slow down hair loss and encourage regrowth. However, it takes time (at least six months) to see results and you must continue usage to maintain the positive effects.
- Hair transplant – This procedure involves transferring skin micrografts containing hair follicles from one region of the scalp to another. Performed by a dermatologic surgeon, the procedure is safe. Multiple sessions may be required to negate the effects of hair loss that is taking place due to genetic factors.
- Scalp reduction and flap surgery – Generally performed only on men, these procedures can help women in certain circumstances. The scalp skin without hair is removed surgically (scalp reduction) and the scalp with hair is moved to an adjacent area that lacks hair (flap surgery).
What are the known complications in management of the disorder?
Given the social importance to hair, adjusting to hair loss can be difficult as a woman. In extreme situations, hair loss may interfere with your social life or job, or make you reluctant to leave the house.
What are the dietary and physical activity requirements during the course of the treatment?
A good diet is important in maintain healthy hair. Practise good hair care to minimise damage to hair and reduce hair breakage. Wear a cap while swimming and rinse hair immediately after. Avoid using styling products and brushing your hair when wet.
How can you prevent the disorder from happening or recurring?
There is no known method to prevent female pattern hair loss.