Hair Loss, Women

  • Best Results6-12 months+
  • Treatment RecoveryNA
  • Procedure TimeNA
  • Skin SpecialistMedical dermatologist
  • Duration of ResultsLong -term
  • AnaestheticNA
  • Back to WorkNA
  • Cost$-$$

Hair Loss, Women

Hair loss in women is more complex than hair fall in men. Common conditions include androgenic alopecia or female pattern hair loss, however other conditions such as telogen effluvium, hormonal imbalances, iron deficiency & thyroid disorders should be considered. A medical dermatologist can diagnose & efficiently manage. As with most hair loss disorders, early management gives the best results.

FactsFacts on Treating Hair Loss in Women

  • Telogen effluvium & female pattern hair loss are the most common forms of hair loss in women
  • The former is self-limiting whilst the latter is progressive
  • The very first step is to obtain a firm diagnosis by a medical dermatologist
  • Effective treatments are available to slow down, & in many cases regrow hair
  • Minoxidil is an effective over the counter solution for most cases
  • Other treatments include PRP or platelet rich plasma
  • Less common causes include alopecia areata, frontal fibrosing alopecia, traction alopecia, trichotillomania, inflammatory & drug induced causes

What conditions What are the most common causes of hair loss in women? more common in Asian and ethnic skin?

The most common causes of hair loss include androgenetic alopecia (female pattern hair loss or baldness) & telogen effluvium (limited hair loss). It is not uncommon for both conditions to co-exist. 

Other causes of hair loss include alopecia areata, traction alopecia, drug induced hair loss (e.g. Accutane), iron & vitamin deficiencies, inflammatory conditions like lupus, lichen planopilaris, trichotillomania, & many others. The very first step in treating hair loss is to identify the cause. A medical dermatologist can investigate, diagnose, & treat.

Disclaimer: I am a procedural dermatologist, namely my work in the context of hair loss disorders is FUE for complex cases. For medical management, please see my colleagues at Clinic Cutis.

What is a sensible hair loss treatment routine for women?

The treatment outlined below refers to cases of androgenic alopecia, or female pattern hair loss/baldness.

AM: Minoxidil 5% 1 ml.

PM: Minoxidil 5% 1ml

PRP 3 sessions monthly, followed by maintenance 3-6 months.

Option for minoxidil tablets 1mg daily, option for cyproterone acetate pulsed monthly, option for OTC vitamins including saw palmetto, option for Low Level Laser Therapy (home use). The above applies to cases of androgenic alopecia, also known as female pattern hair loss.

What is minoxidil & why is this the first step in treating female pattern hair loss?

Minoxidil is a very old (but very effective) drug used for the management of male & female pattern hair loss. It can be purchased from most pharmacies & cost approximately 60 to 80 cents per day.

Twice daily use of topical minoxidil has shown to improve hair counts by week 24. As with male pattern hair loss, minoxidil should be initiated early in the course of treatment. Currently there are 3 forms of delivery-

  1. Minoxidil lotion (with propylene glycol)
  2. Minoxidil foam (without propylene glycol)
  3. Minoxidil tablets

What percentage of minoxidil is best for female pattern hair loss?

The stronger 5% topical formulation is most widely recommended by dermatologists. FDA approval for females is 2%, however research has shown that 5% works better. There is scientific evidence that twice a day application works better than once a day.

Some dermatologists prefer to compound a compounded formulation with finasteride 0.1 to 0.25%. Addition of finasteride is off-label & classed as category X. Contraception measures will be discussed by your treating dermatologist.

*For patients with super sensitive skin or documented allergies to propylene glycol, the foam solution of minoxidil is advisable.

Davin’s Viewpoint on Hair Loss in Women

Hair fall is something that most women will experience. The majority of cases are self limiting, namely telogen effluvium (delayed hair loss)  postpartum (after childbirth).  This is due to the fact that the hair cycle is partially disrupted, & shedding of dormant follicles occur after the telogen or sleeping phase. This usually occurs at 3-6 months after a traumatic event (pregnancy, surgery, emotional stress, trauma, physical stress, crazy diets).

Where it gets challenging is if one has two synchronous hair loss conditions, the most common being telogen effluvium & female pattern hair loss. Both can give telogen hair, however the latter is more insidious & associated with follicular miniaturization. A medical dermatologist can investigate & manage accordingly. Hair loss is a very complex field of dermatology as there are many other hair fall conditions ranging from inflammatory dermatoses such as frontal fibrosing alopecia, lupus, drug induced causes,  through to alopecia areata, chronic telogen effluvium & over 100 more conditions. A firm diagnosis is the very first step.  

Surgical options for women, unlike male pattern hair loss, are limited due to lack of donor dominance in females. The diffuse pattern of female hair loss negates the use of follicles in posterior or occipital regions of the scalp. In this context the most frequent application of FUE hair transplantation is treatment of lichen planopilaris, namely FFA patterns involving the eyebrows & frontal/temporal scalp. FFA should be in remission for at least two years before attempts at FUE hair transplantation. Recurrence rates should be discussed prior to hair transplantation.

Disclaimer: I am a procedural dermatologist. I do not provide medical management for hair loss conditions. Please see my colleagues at Cutis Medical for hair loss disorders.

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