Female Pattern Hair Loss

    July 2018 in “ AJGP
    Linda S. Chan, David Cook
    From the encyclopedia
    Spironolactone →

    powerful topical and oral anti-androgen used mostly by women

    Cyproterone →

    a synthetic anti-androgen and weak progestogen that inhibits DHT binding to androgen receptor

    Minoxidil →

    An essential vasodilator with some anti-androgenic effects

    Studysummary This article reviews the clinical assessment of female pattern hair loss and discusses up-to-date treatments, highlighting oral minoxidil combined with oral spironolactone as a promising novel therapy. It emphasizes the crucial role of general practitioners in diagnosis, treatment planning, and managing associated psychosocial issues.
    Our plain-language summary. Not medical advice or a treatment recommendation. Consult a qualified healthcare professional before changing treatment. Full disclaimer
    Female pattern hair loss (FPHL) affected 49% of women, with a prevalence of over 32% among adult Australian women of European descent, characterized by hair follicle miniaturization due to genetic and androgen influences. It caused significant psychological and social issues and could indicate systemic illnesses. Risk factors included age, family history, smoking, and high fasting glucose. Diagnosis was clinical, with a characteristic hair thinning pattern. Topical minoxidil was effective in 60% of women but required continuous use. An Australian study of 100 women found that a daily combination of oral minoxidil 0.25 mg and spironolactone 25 mg reduced hair loss and shedding, with some side effects. Spironolactone and cyproterone acetate were effective in promoting hair regrowth, though cyproterone acetate had significant side effects. 5-alpha reductase inhibitors were less effective. The study emphasized the importance of medical history, lab tests, and the psychological impact of FPHL, noting low-dose oral minoxidil as a significant treatment advancement.
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