Challenges in Diagnosing Female Pattern Hair Loss

June 2012 in “ Journal of Cosmetic Dermatology ”

Kristen Richards, Rashid M. Rashid

female pattern hair loss FPHL androgens scarring alopecia inflammatory alopecia nonscarring hair loss testosterone dermoscopy histopathology alopecia female pattern baldness pattern baldness hair loss skin biopsy

TLDR Female pattern hair loss diagnosis is challenging and should use dermoscopy and histopathology instead of pattern recognition, as hormones may not always be the cause.

The document from 2012 discusses the challenges in diagnosing female pattern hair loss (FPHL), highlighting that it may not always be linked to androgens as previously thought. The authors point out that hair loss patterns alone are not reliable for diagnosis, as they can be similar to those seen in scarring and inflammatory alopecias. They describe three nonscarring hair loss patterns specific to women and note that many women with FPHL have normal testosterone levels. The paper suggests moving away from the term "pattern" in diagnosing alopecia and recommends using dermoscopy and histopathology for more accurate identification. The authors call for further research into the histopathologic causes of hair loss in women, proposing that a classification system based on histopathology could improve diagnosis and treatment.

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