Approach to the Adult Female Patient with Diffuse Nonscarring Alopecia

November 2002 in “ Journal of The American Academy of Dermatology ”

Molly Chartier, Diane M. Hoss, Jane M. Grant‐Kels

diffuse nonscarring alopecia female pattern hair loss androgenetic alopecia telogen effluvium diffuse alopecia areata loose anagen syndrome androgens follicular miniaturization thyroid function serum ferritin sex hormones anagen-to-telogen ratio female pattern baldness hair shedding hair thinning thyroid test iron levels hormone levels

TLDR The document concludes that careful evaluation is key to diagnose and treat women with hair loss, with tests for thyroid, iron, and hormones as needed.

The document from December 2002 reviews the evaluation and management of diffuse nonscarring alopecia in adult female patients, focusing on female pattern hair loss (androgenetic alopecia), acute and chronic telogen effluvium, diffuse alopecia areata, and loose anagen syndrome. It highlights the importance of patient history, physical examination, and diagnostic testing for a definitive diagnosis and treatment options. The pathophysiology of androgenetic alopecia is discussed, noting that while androgens are involved in follicular miniaturization, most women with the condition have normal androgen levels. The authors recommend tests for thyroid function, serum ferritin, and sex hormones/androgens when symptoms indicate. Histological findings in androgenetic alopecia include follicular miniaturization and a decreased anagen-to-telogen ratio. The document is a review and does not mention the number of people in a study.

View this study on jaad.org →

Discuss this study in the Community →

Research cited in this study

32 / 32 results

research Possible Mechanisms of Miniaturization During Androgenetic Alopecia or Pattern Hair Loss

116 citations, September 2001 in “Journal of The American Academy of Dermatology”

Hair loss occurs due to fewer papillary cells, smaller follicles, and shorter growth phases.

research Female Pattern Hair Loss

226 citations, September 2001 in “Journal of The American Academy of Dermatology”

Hair loss in women is genetic, diagnosed by examination and biopsy, and treated with minoxidil, finasteride, or transplantation.

research Lack of Efficacy of Finasteride in Postmenopausal Women with Androgenetic Alopecia

239 citations, November 2000 in “Journal of The American Academy of Dermatology”

Finasteride doesn't effectively treat hair loss in postmenopausal women.

research Androgenetic Alopecia and Microinflammation

131 citations, August 2000 in “International Journal of Dermatology”

Inflammation may be linked to hair loss, and targeting specific enzymes could help treat it.

research Female Androgenetic Alopecia: A Separate Entity

50 citations, July 2000 in “Dermatologic Surgery”

Female and male AGA are different diseases.

research Androgenetic Alopecia: In Vivo Models

27 citations, October 1999 in “Experimental and Molecular Pathology”

Stump-tailed macaque best for researching hair loss causes and treatments.

research Patient-Perceived Importance of Negative Effects of Androgenetic Alopecia in Women

32 citations, October 1999 in “Journal of women's health and gender-based medicine”

Hair loss greatly affects women's mental health and appearance satisfaction.

research The Psychosocial Consequences of Androgenetic Alopecia: A Review of the Research Literature

180 citations, September 1999 in “British Journal of Dermatology”

Hair loss affects self-esteem and quality of life; treatments can help.

research Update on Chronic Telogen Effluvium

2 citations, August 1999 in “PubMed”

Chronic telogen effluvium is a condition that causes ongoing hair shedding.

research Does Tissue Iron Status Have a Role in Female Alopecia?

34 citations, July 1999 in “Journal of The European Academy of Dermatology and Venereology”

Iron deficiency is not a significant cause of hair loss in women.

research Diffuse Hair Loss: Causes, Diagnosis, and Treatment

83 citations, May 1999 in “International Journal of Dermatology”

Hair loss that spreads out can often fix itself or be treated by finding and handling the cause.

research The Midline Part: An Important Physical Clue to the Clinical Diagnosis of Androgenetic Alopecia in Women

90 citations, January 1999 in “Journal of The American Academy of Dermatology”

"Christmas tree" pattern helps diagnose female hair loss.

Different Levels of 5α-Reductase Type I and II, Aromatase, and Androgen Receptor in Hair Follicles of Women and Men with Androgenetic Alopecia

research Different Levels of 5α-Reductase Type I and II, Aromatase, and Androgen Receptor in Hair Follicles of Women and Men with Androgenetic Alopecia

416 citations, September 1997 in “Journal of Investigative Dermatology”

People with hair loss have more androgen receptors and enzymes in certain follicles, with men and women showing different patterns.

research Loose Anagen Hair

24 citations, September 1997 in “PubMed”

Loose anagen hair can appear at any age and may improve over time.

research Chronic Telogen Effluvium: Increased Scalp Hair Shedding in Middle-Aged Women

234 citations, December 1996 in “Journal of The American Academy of Dermatology”

Middle-aged women with chronic telogen effluvium experience increased hair shedding but usually don't get significantly thinner hair.

research Androgen Metabolism as It Affects Hair Growth in Androgenetic Alopecia

143 citations, October 1996 in “Dermatologic Clinics”

Too much androgen can cause hair loss; finasteride may help.

research A Simplified Approach to the Diagnosis of Alopecia

12 citations, October 1996 in “Dermatologic Clinics”

A simplified method was introduced to diagnose most hair loss types by examining the patient's history and scalp, with some cases needing further tests.

research Androgenetic Alopecia: An Autosomal Dominant Disorder

80 citations, January 1995 in “The American Journal of Medicine”

Hair loss in androgenetic alopecia is caused by genetic factors and androgen excess, and can be treated with combined therapies.

research Disorders of Hair Growth: Diagnosis and Treatment

26 citations, January 1994 in “McGraw-Hill eBooks”

Many hair loss conditions can be treated.

research Diagnostic and Predictive Value of Horizontal Sections of Scalp Biopsy Specimens in Male Pattern Androgenetic Alopecia

309 citations, May 1993 in “Journal of The American Academy of Dermatology”

Horizontal scalp biopsy sections effectively diagnose and predict MPAA, with follicular density and inflammation impacting hair regrowth.

research Telogen Effluvium: A Comprehensive Review

214 citations, March 1993 in “Archives of Dermatology”

Telogen effluvium is a reversible hair loss condition that requires a detailed diagnosis and often resolves on its own.

research Loose Anagen Hair as a Cause of Hereditary Hair Loss in Children

55 citations, October 1992 in “Archives of Dermatology”

Loose Anagen Hair Syndrome is a hereditary condition causing hair loss in children due to abnormal hair follicles.

research Cultured Dermal Papilla Cells From Androgen-Dependent Human Hair Follicles Contain More Androgen Receptors Than Those From Non-Balding Areas Of Scalp

124 citations, April 1992 in “Journal of Endocrinology/Journal of endocrinology”

Beard hair follicles have more androgen receptors than non-balding scalp hair follicles.

research Biochemical and Trichological Characterization of Diffuse Alopecia in Women

124 citations, August 1990 in “British Journal of Dermatology”

Diffuse alopecia in women may be related to androgens and iron deficiency, and basic hormone and nutrient screening is useful.

research Loose Anagen Hair of Childhood: The Phenomenon of Easily Pluckable Hair

85 citations, February 1989 in “Journal of The American Academy of Dermatology”

Children with loose anagen hair have easily pluckable hair due to root sheath problems, and it might improve without treatment.

research Increased Androgen Binding Capacity in Sebaceous Glands in Scalp of Male-Pattern Baldness

51 citations, January 1989 in “Journal of Investigative Dermatology”

Men with male-pattern baldness have more androgen receptors in their scalp's oil glands, which may contribute to hair loss.

research Patterned Androgenic Alopecia in Women

130 citations, May 1988 in “Journal of The American Academy of Dermatology”

"Male-pattern" hair loss is common in women, especially after menopause, and doesn't always mean there's a problem with hormone balance.

research Postfebrile Telogen Effluvium in Critically Ill Patients

21 citations, January 1988 in “Critical Care Medicine”

Critically ill patients may experience temporary hair loss after a fever.

Plasma Testosterone Glucosiduronate: A Reliable Indicator of Female Hyperandrogenism (Idiopathic Hirsutism and Androgenic Alopecia)

research Plasma Testosterone Glucosiduronate: A Reliable Indicator of Female Hyperandrogenism (Idiopathic Hirsutism and Androgenic Alopecia)

6 citations, November 1980 in “Clinical Endocrinology”

Measuring plasma testosterone glucosiduronate is a reliable way to detect high male hormone levels in women.

research Classification of the Types of Androgenetic Alopecia (Common Baldness) Occurring in the Female Sex

666 citations, September 1977 in “British Journal of Dermatology”

Common baldness, also known as Androgenetic Alopecia, is caused by a combination of genetic factors and hormones called androgens.

research Androgenetic Alopecia

3 citations, January 1977 in “Archives of Dermatology”

Unable to summarize document.

research Pathologic Dynamics of Human Hair Loss

33 citations, September 1961 in “Archives of Dermatology”

Colchicine causes rapid hair loss by damaging hair follicles.

Related Research

7 / 7 results

research Time to Loss of Response for Dupilumab in Ophiasis-Pattern Alopecia Areata

2 citations, September 2021 in “JAAD case reports”

Dupilumab helped a woman with severe hair loss regrow her hair quickly and maintain it for six months after stopping treatment.

research Efficacy of Systemic Minoxidil and Tofacitinib Combination in Treatment-Resistant Alopecia Universalis

1 citations, October 2020 in “Journal of Cosmetic Dermatology”

Using minoxidil and tofacitinib together can effectively treat severe hair loss.

research Topical and Intralesional Therapies for Alopecia Areata

36 citations, May 2011 in “Dermatologic therapy”

No treatments fully cure or prevent alopecia areata; some help but have side effects or need more research.

research Alopecia Areata: Clinical Presentation, Diagnosis, and Unusual Cases

109 citations, May 2011 in “Dermatologic Therapy”

Alopecia areata is a type of hair loss that can lead to complete baldness, often associated with other autoimmune conditions, and half of the cases may see hair return within a year.

research Alopecia Areata: Evidence-Based Treatments

71 citations, March 2009 in “Seminars in cutaneous medicine and surgery”

Alopecia areata can cause unpredictable hair loss, and treatments like corticosteroids and minoxidil may help but have varying side effects.

research Diagnosis of Hair Loss: Clinical Features of Common Causes

1 citations, April 1992 in “PubMed”

The document describes the signs of different common types of hair loss.

research Diagnosis and Management of the Hair Loss Patient

7 citations, September 1987 in “PubMed”

Most hair loss cases are caused by four main conditions, and understanding them is key to treatment.