*Content reviewed by HotPause Health Medical Advisor & Board-Certified Dermatologist Dr. Marisa Chapman

What is Female Pattern Hair Loss (FPHL)

Female Pattern Hair Loss (FPHL), also known as androgenetic alopecia, is the most common type of hair loss affecting women. It involves a typical pattern of hair thinning, which usually becomes more noticeable after menopause, although it can begin as early as puberty. Unlike men, women with FPHL rarely go completely bald, but significant hair thinning can occur, which can be distressing. Dermatology expert, Dr. Maris Chapman address why understanding FPHL is essential for managing expectations and exploring treatment options effectively.

The Causes of Female Pattern Hair Loss

• Hormonal Influence: The primary cause of FPHL is related to hormonal changes in the body. It involves a genetic sensitivity of hair follicles to dihydrotestosterone (DHT), a breakdown product of the male hormone testosterone, which women also produce. DHT can cause the hair follicles to shrink, resulting in thinner and shorter hair strands.
• Genetic Predisposition: FPHL is often hereditary, meaning it can run in families. If your family members have experienced hair thinning or baldness, you are at a higher risk of developing FPHL.

Symptoms of Female Pattern Hair Loss

• Increased Hair Shedding: A noticeable increase in hairs found in your brush or shower drain may be an early sign of FPHL.
• Gradual Thinning on Top of the Head: The most noticeable symptom of FPHL is a gradual thinning of hair on the top of the head or the crown area. This thinning might widen the part in a woman’s hair, and rarely progresses to complete baldness.
• Hairline Remains Intact: Unlike male pattern baldness, the hairline usually doesn’t recede in women with FPHL.

Diagnosis of Female Pattern Hair Loss

A diagnosis of FPHL typically involves:

• Medical History: Discussing your health history and family history of hair loss.
• Physical Exam: A thorough examination of the scalp to look at the pattern and extent of hair loss.
• Scalp Biopsy: Taking a small sample of the scalp to examine under a microscope if the diagnosis is uncertain.
• Blood Tests: Checking for underlying conditions like thyroid disease, anemia, and low vitamin D, which can also contribute to hair loss.

Treatment and Management of Female Pattern Hair Loss

Managing hair loss can be very challenging, and often requires a combination of treatments to optimize results. There are also many gimmicks and products on the market, and it is important to be aware of false medical claims. Below are evidence-based options to consider and discuss with your dermatologist or healthcare provider.

• Minoxidil : Topical minoxidil, commonly Rogaine, is the only topical medication approved by the FDA for female pattern hair loss. Oral minoxidil is used as an off-label medication, and is available by prescription. Minoxidil can help slow down or stabilize hair thinning, and possibly regrow some hair. It’s most effective when started at the first signs of hair thinning.
• Hormone Replacement Therapy: For some women, particularly those who are postmenopausal, hormone replacement therapy (HRT) may help improve hair health and density by replenishing estrogen levels.
• Hair Transplant Surgery: In more severe cases, hair transplant surgery can be considered. This involves transplanting hair follicles from denser areas of the scalp to the thinning areas.
• Laser Treatment: Low-Light Laser Therapy (LLLT) has been FDA-approved for hair loss, in the form of laser caps or combs. The light energy is thought to stimulate cell growth within the hair follicles, as well as increase blood flow in the scalp. It only works on active follicles, thus making it important to start this type of treatment in the early phase of hair loss to maximize the potential benefit.
• Platelet Rich Plasma (PRP) Injections: PRP involves utilizing a person’s own blood, and concentrating the platelet cells in the plasma using a machine called a centrifuge. Platelets contain growth factors that may help stimulate hair follicles. The plasma is injected at multiple sites within the scalp, typically requiring a series of treatments over the course of several months. PRP may help protect hair follicles from prematurely shedding, and may stimulate new hair growth. Results are variable and the procedure can be expensive. It is best to discuss this option with your healthcare provider to determine if this is a good option for you.
• Lifestyle Modifications: A nutritious diet rich in vitamins and minerals can support hair health. Regular exercise and stress reduction techniques can also help manage this condition. Nutritional supplements can also be helpful to promote overall health and support hair growth.

Conclusion

Female Pattern Hair Loss is a significant concern for many women, affecting their self-esteem and quality of life. Understanding its causes, recognizing the symptoms, and seeking early treatment can greatly help manage this condition effectively. It’s important to consult with a healthcare provider or a dermatologist specializing in hair loss to explore the most suitable treatment options based on the individual’s condition and health profile.