Hair Loss in Women
March 2009
in “Seminars in Cutaneous Medicine and Surgery”
TLDR Effective hair loss treatment in women requires correct diagnosis and can include medications like minoxidil, antiandrogens, and treatments for underlying conditions like PCOS.
In the 2009 document, Francisco M. Camacho-Martínez provided a comprehensive overview of hair loss in women, including Female Pattern Hair Loss (FPHL) and its subtypes, such as female androgenetic alopecia (FAGA) and FAGA with male pattern (FAGA.M). The document detailed the clinical presentation, diagnosis, and treatment options for these conditions, including the use of topical minoxidil, systemic antiandrogens, and other specific treatments for associated conditions like polycystic ovary syndrome (PCOS) and hyperprolactinemic SAHA. It also covered the epidemiology of FAGA, noting a prevalence of 36% in Spain and similar rates in the United States, and the importance of a correct diagnosis for successful treatment. Diagnostic methods such as epiluminescence microscopy, scalp biopsy, and biochemical tests were discussed, along with various treatment options, including systemic treatments for hormonal imbalances and local therapeutics. The document also reviewed the effectiveness of antiandrogens like flutamide, drospirenone, cimetidine, finasteride, and dutasteride, as well as ovarian suppression therapies. A study involving 31 women with PCOS treated with finasteride and topical minoxidil showed a 74.1% clinical improvement in hair loss. Additionally, metformin was highlighted for its benefits in improving insulin resistance and inducing ovulation in anovulatory women. The document emphasized the genetic sensitivity to androgens in FPHL and the range of treatments aimed at modifying the biological response or altering androgen action. Dermatocosmetic concealment and lifestyle changes, such as weight loss, were also mentioned as part of the management of hair loss in women.
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