Adult women often experience female pattern hair loss. It shows up as a diffuse and gradual loss of hair density, especially in the frontal and mid-portions of the scalp. The prognosis for this condition is constant hair loss and extensive thinning if it is not treated. This condition can have a huge impact on a woman's self-esteem.

According to a Brazilian study, the fear of losing all of a woman's scalp hair is similar to the fear of developing a myocardial infarction. This highlights how critical it is for women to have access to a variety of treatment options in order to combat this issue. Despite the high prevalence of female pattern baldness, the adequate management of the problem is still faces several impediments in dermatologic practice. The principal aim of therapy is to increase the hair coverage of the scalp, and also to slow down the progression of hair thinning.

Pharmacological methods

The antibiotic minoxidil, applied topically, is the first-line treatment. This treatment has the highest level of evidence for reversing female pattern hair loss. Minoxidil is a drug that acts as a vasodilator and opens potassium channels. In cultured dermal papilla cells, it has been shown to increase the production of vascular endothelial growth factors. Minoxidil facilitates hair growth in the clinical setting by lengthening the anagen phase, or active hair growth phase.      

Only the affected areas of the scalp are treated with a 1 mL twice-daily minoxidil solution for a minimum of twelve months. This time frame may be required before any signs of efficacy can be seen. The most common side effects are contact dermatitis and other forms of contact dermatitis. The propylene glycol used as a solution car is commonly linked to these.

Oral synthetic anti-androgen drugs are used to prevent the binding of androgen receptors. Spironolactone, flutamide, and cyproterone acetate are among them. Although there is plenty of anecdotal evidence of effectiveness, especially when biochemical hyperandrogenism is the root cause of hair loss, there isn't enough credible evidence to support their routine use.

Finasteride inhibits type 2 5-reductase, the isotype of the enzyme most commonly found in hair follicles, by acting as a competitive inhibitor. This drug inhibits the intracellular conversion of testosterone to dihydrotestosterone, which appears to be a key step in the hair miniaturisation process.

Despite the lack of large-scale research on its efficacy, smaller case series have shown efficacy in both premenopausal and postmenopausal women with hyperandrogenism.

Nutritional supplementation and counseling

Women with female pattern hair loss have long been known to suffer from low self-esteem, which leads to a lower quality of life. As a result, it's critical to provide adequate counselling about treatment options so that expectations are reasonable. Psychotherapy and the use of anxiolytics may be considered in severe cases of anxiety. This is particularly true in depressed patients, who often misinterpret even normal hair shedding as a serious and excessive hair loss disorder.

It's debatable if dietary supplementation with biotin, zinc, amino acids, and other micronutrients can help women with female pattern baldness.

A 6-month supplementation with B-complex vitamins, L-cystine, and medicinal yeast resulted in a normalisation of hair growth rate, as measured by in vivo hair growth measurement, according to one study.

Surgical procedures and other treatment options

Hair transplantation is an excellent choice for women who have a limited amount of hair loss in the frontal scalp and a high hair density in the donor area (over the occipital scalp). To prevent further hair loss, it is best used in conjunction with pharmacological treatments. Again, it's critical that patients have reasonable expectations of what they can expect from surgery before they have it. Low-level laser therapy has gained significant media attention and marketing budgets in recent years as a novel treatment. Despite the lack of independent, peer-reviewed research studies demonstrating its effectiveness in female pattern hair loss, this is the case.

Camouflaging products are effective at concealing visible hair loss and covering exposed areas on the scalp. They may also add volume by providing lift at the base of the hair shaft. These products are recommended for women who have mild to moderate hair loss and, more importantly, are compatible with the use of minoxidil as a topical treatment.

Finally, ongoing gene discovery efforts show a lot of promise as they try to identify a number of novel genes involved in hair growth and hormone-induced hair changes. As a result, in the not-too-distant future, a wide range of topically delivered treatment options that can target vital pathways and stimulate hair growth may become available

Editorial Team,
Dermatology Research and Skin Care
Ph No: 828 214-3944
London, United Kingdom