Female Pattern Hair Loss

September 2001 in “ Journal of The American Academy of Dermatology ”

Elise A. Olsen

female pattern hair loss androgen-dependent hair diameter anagen topical minoxidil systemic antiandrogens finasteride scalp biopsy hair transplantation Rogaine Propecia

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

Female pattern hair loss is a genetic and androgen-dependent condition that affects women similarly to male pattern baldness. Diagnosis can be difficult due to less recognizable patterns. The condition causes a decrease in hair diameter and percentage of hairs in anagen in affected areas. Topical minoxidil is effective but has risks, while systemic antiandrogens have shown improvement in small trials but require more research. The effectiveness of finasteride for treating female pattern hair loss is uncertain and more research is needed. Diagnosis is made through physical examination and scalp biopsy, and treatment options include topical minoxidil, oral finasteride, and hair transplantation.

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Research cited in this study

26 / 26 results

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234 citations, February 2001 in “British Journal of Dermatology”

FPHL affects hair density and diameter, causing visible hair loss in older women.

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

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Some people with pattern hair loss may also have scalp inflammation and scarring similar to lichen planopilaris.

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research Measuring Reversal of Hair Miniaturization in Androgenetic Alopecia by Follicular Counts in Horizontal Sections of Serial Scalp Biopsies: Results of Finasteride 1mg Treatment of Men and Postmenopausal Women

145 citations, December 1999 in “Journal of Investigative Dermatology Symposium Proceedings”

Finasteride 1mg helps reverse hair miniaturization in men and postmenopausal women.

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

"Christmas tree" pattern helps diagnose female hair loss.

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CTE can distort results in hair growth trials, so exclude it carefully.

research Comparison of Finasteride Versus Spironolactone in the Treatment of Idiopathic Hirsutism

76 citations, December 1997 in “Fertility and Sterility”

Finasteride reduces hair growth better, but spironolactone has more side effects.

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.

Outcome of Long-Term Treatment with the 5α-Reductase Inhibitor Finasteride in Idiopathic Hirsutism: Clinical and Hormonal Effects During a 1-Year Course of Therapy and 1-Year Follow-Up

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75 citations, November 1996 in “Fertility and Sterility”

Finasteride effectively reduces hair growth in women with idiopathic hirsutism, but requires careful contraception during treatment.

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75 citations, October 1996 in “Dermatologic Clinics”

Chronic Telogen Effluvium is a hair loss condition in middle-aged women that usually doesn't lead to complete baldness.

research Alterations in Androgen Conjugate Levels in Women and Men with Alopecia

24 citations, October 1994 in “Fertility and Sterility”

People with hair loss may have different levels of certain hormones due to changes in hormone processing.

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82 citations, March 1994 in “Archives of Dermatology”

2% topical minoxidil effectively treats female hair loss with minimal side effects.

research Comparison of Flutamide and Spironolactone in the Treatment of Hirsutism: A Randomized Controlled Trial

165 citations, February 1994 in “Fertility and Sterility”

Flutamide is more effective and has fewer side effects than spironolactone for treating hirsutism.

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.

The Importance of Adequate Serum Ferritin Levels During Oral Cyproterone Acetate and Ethinyl Estradiol Treatment of Diffuse Androgen-Dependent Alopecia in Women

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83 citations, April 1992 in “Clinical Endocrinology”

Having enough iron improves the effectiveness of a specific hair loss treatment in women.

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32 citations, January 1990 in “Clinical Endocrinology”

Women with female pattern hair loss have higher levels of certain androgens, suggesting increased androgen exposure to hair follicles.

research Minoxidil Stimulates Mouse Vibrissae Follicles in Organ Culture

121 citations, March 1989 in “Journal of Investigative Dermatology”

Minoxidil can help grow hair in mice by making cells grow and improving hair quality. More research needed.

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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 Female Androgenic Alopecia

14 citations, September 1986 in “Archives of Dermatology”

Women with low SHBG levels and a high 3a-diol G to SHBG ratio are likely to experience female pattern baldness, possibly due to a slight excess of androgens affecting sensitive hair bulbs.

research Topical Minoxidil in Early Male Pattern Baldness

138 citations, August 1985 in “Journal of The American Academy of Dermatology”

Minoxidil promotes hair growth in male pattern baldness.

research Oral Spironolactone Therapy for Female Patients with Acne, Hirsutism, or Androgenic Alopecia

101 citations, January 1985 in “British Journal of Dermatology”

Spironolactone is effective for treating acne, hirsutism, and androgenic alopecia in women with few side effects.

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24 citations, May 1982 in “Biochemical Pharmacology”

These drugs cause hair growth without affecting testosterone or adrenal hormones.

research Low Sex-Hormone Binding Globulin Levels in Young Women with Diffuse Hair Loss

40 citations, March 1982 in “British Journal of Dermatology”

Young women with diffuse hair loss may have low SHBG levels, which could lead to more active testosterone and contribute to their hair loss.

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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 Hair Diameter in Female Baldness

63 citations, October 1972 in “British Journal of Dermatology”

Women with thinning hair have thinner hair strands than women without hair loss.

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