Hair Loss in Women: Medical and Cosmetic Approaches to Increase Scalp Hair Fullness

The December 2011 document outlines the prevalence, impact, and treatment options for female pattern hair loss (FPHL), noting that it affects approximately one-third of adult Caucasian women and has a significant psychological impact. It introduces a hypothesis that FPHL is due to a reduction in terminal fibers per follicular unit and baldness occurs when all hairs within the unit are miniaturized. Treatments discussed include androgen receptor antagonists like spironolactone and cyproterone acetate, the 5α-reductase inhibitor finasteride, and minoxidil, which is effective regardless of menopausal status or hyperandrogenism. The paper emphasizes the importance of early treatment initiation and mentions that 2% topical minoxidil is FDA-approved for FPHL, with a recommendation to use it for at least 12 months. It also notes that while finasteride did not show benefits in a study of 137 postmenopausal women, there was an anecdotal case of hair loss reversal. Hair transplantation and cosmetic products are also viable options for managing FPHL. The document concludes that FPHL can be treated with a combination of medications, surgery, and cosmetic products, taking into account the psychological effects on patients.