Women’s Hair Loss: Pathophysiological, Diagnostic and Therapeutic Aspects

October 2022 in “ Reproductive health of woman ”

Svitlana V Vozianova, L.A. Bolotna, O.I. Sarian

female pattern hair loss genetic factors hormonal factors systemic factors personalized treatment plans multidisciplinary approach

Studysummary This review discusses the pathogenesis, clinical features, and diagnostic approaches for female pattern hair loss, emphasizing the need for interdisciplinary management, but offers no new results.

Our plain-language summary. Not medical advice or a treatment recommendation. Consult a qualified healthcare professional before changing treatment. Full disclaimer

The document reviews the multifaceted causes of hair loss in women, such as genetic, hormonal, and systemic factors, and stresses the importance of accurate diagnosis and personalized treatment plans. It highlights the significant impact of hair loss on quality of life and discusses various therapeutic options. The review emphasizes the complexity of female pattern hair loss and the need for a multidisciplinary approach to its management.

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Research cited in this study

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research Morphogenesis, Growth Cycle, and Molecular Regulation of Hair Follicles

21 citations , May 2022 in “Frontiers in Cell and Developmental Biology”

This review covers the structure, development, cycle, and molecular regulation of hair follicles but does not report new results, aiming to offer insights for addressing hair follicle-related diseases.

research Alopecia in Patients with COVID-19: A Systematic Review and Meta-Analysis

25 citations , February 2022 in “JAAD International”

This review analyzed data on alopecia types associated with COVID-19, suggesting androgenetic alopecia may be a risk factor for severe COVID-19, while telogen effluvium often follows infection and alopecia areata tends to relapse in those with preexisting disease.

research Systematic Review and Meta-Analysis of the Association Between Metabolic Syndrome and Androgenetic Alopecia

3 citations , December 2021 in “Acta dermato-venereologica”

This meta-analysis found that patients with androgenetic alopecia had a significantly higher prevalence of metabolic syndrome and poorer metabolic profiles compared to controls, especially among females, those with early onset, and individuals of African ethnicity.

research Understanding Pattern Hair Loss: Hair Biology Impacted by Genes, Androgens, Prostaglandins, and Epigenetic Factors

3 citations , October 2021 in “Indian Journal of Plastic Surgery”

The authors concluded that pattern hair loss is a complex condition with limited treatment efficacy and two FDA-approved drugs, finasteride and minoxidil, to slow its progression.

research Male and Female Pattern Hair Loss: Treatable and Worth Treating

11 citations , March 2021 in “Cleveland Clinic Journal of Medicine”

In this overview, the authors note that both pharmacologic and nonpharmacologic treatments are effective for pattern hair loss, emphasizing early detection and intervention to maintain hair.

research Association of Early-Onset Androgenetic Alopecia and Metabolic Syndrome

5 citations , February 2021 in “JCPSP. Journal of the College of Physicians & Surgeons Pakistan”

This study investigated the relationship between early-onset androgenetic alopecia and metabolic syndrome in younger males, but the abstract does not report specific results.

research Age-Related Changes in Female Scalp Dermal Sheath and Dermal Fibroblasts: How the Hair Follicle Environment Impacts Hair Aging

14 citations , December 2020 in “Journal of Investigative Dermatology”

This study observed that aging leads to significant structural and biological changes in the scalp's hair follicle environment in women, which may affect hair growth.

research Hormonal Effects on Hair Follicles

102 citations , July 2020 in “International journal of molecular sciences”

This review discusses the effects of hormonal changes on hair follicles, concluding that hormones like androgens and estradiol significantly influence hair growth and cycle, while the roles of other hormones are still being researched.

research Androgen-Associated and Androgen-Independent Causes of Alopecia and Acne in Women: Literature Review

1 citations , May 2020 in “Reproductive Endocrinology”

This review discusses the pathogenesis and diagnosis of alopecia and acne, emphasizing the need for coordinated treatment approaches in conditions like FPHL/AGA and complex acne, but reports no new clinical results.

Pattern Hair Loss: Assessment of Microinflammation in Miniaturized and Terminal Hair Follicles Through Horizontal Histologic Sections

research Pattern Hair Loss: Assessment of Microinflammation in Miniaturized and Terminal Hair Follicles Through Horizontal Histologic Sections

11 citations , April 2020 in “Journal of The American Academy of Dermatology”

This commentary reviews the evidence for microinflammation's role in pattern hair loss and suggests that further studies with age- and sex-matched controls are needed to substantiate the findings.

research System Support in the Formation and Growth of Hair in Alopecias and Hair Shaft Disorders

1 citations , January 2020 in “Дерматологія та венерологія”

Natubiotin is effective for treating different hair loss conditions when used with other therapies.

research Diagnosis and Management of Female Pattern Hair Loss

1 citations , January 2020 in “Bioscientia medicina”

This review covers female pattern hair loss, outlining its progression, existing treatments like topical minoxidil and laser therapy, and notes that anti-androgen therapies need further investigation.

research Hyperandrogenism in Polycystic Ovarian Syndrome and Role of CYP Gene Variants: A Review

49 citations , November 2019 in “Egyptian Journal of Medical Human Genetics”

This review discusses the role of CYP gene polymorphisms in exacerbating hyperandrogenism in women with PCOS and reports no clinical results; further validation of this hypothesis is needed.

research Female Pattern Hair Loss and Androgen Excess: A Report From the Multidisciplinary Androgen Excess and PCOS Committee

49 citations , February 2019 in “The Journal of Clinical Endocrinology and Metabolism”

This review offers evidence-based recommendations for diagnosing and treating female pattern hair loss, emphasizing clinical assessment and starting treatment with minoxidil, while noting that measurement of certain hormones and vitamins is optional.

research Endocrine Therapy-Induced Alopecia in Patients With Breast Cancer

67 citations , April 2018 in “JAMA Dermatology”

This study found that endocrine therapy for breast cancer is associated with a pattern of hair loss similar to androgenetic alopecia, negatively impacting quality of life despite mild severity.

research Androgen Modulation of Wnt/β-Catenin Signaling in Androgenetic Alopecia

39 citations , March 2018 in “Archives of Dermatological Research”

This review describes the molecular interactions between androgens and Wnt/ß-catenin signaling in androgenetic alopecia but reports no new experimental or clinical findings; the authors discuss potential Wnt/ß-catenin-targeted treatments for hair growth.

research Review of Quality of Life Studies in Women with Alopecia

58 citations , January 2018 in “International Journal of Women's Dermatology”

This review discusses the psychological impact of alopecia on women and reports no new clinical findings, highlighting the effect on self-esteem and quality of life.

research 5α-Reductase Isozymes and Aromatase mRNA Levels in Plucked Hair from Young Women with Female Pattern Hair Loss

21 citations , November 2017 in “Archives of Dermatological Research”

This study found that women with female pattern hair loss had increased 5α-reductase isozymes and decreased aromatase mRNA levels, potentially affecting their response to treatment.

research Evidence-Based Guideline for the Treatment of Androgenetic Alopecia in Women and Men – Short Version

145 citations , November 2017 in “Journal of The European Academy of Dermatology and Venereology”

This guideline review by the European Dermatology Forum evaluates current treatments for androgenetic alopecia but reports no new research findings, aiming to assist dermatologists in selecting safe and effective therapies.

Androgens Trigger Different Growth Responses in Genetically Identical Human Hair Follicles in Organ Culture Reflecting Their Epigenetic Diversity in Life

research Androgens Trigger Different Growth Responses in Genetically Identical Human Hair Follicles in Organ Culture Reflecting Their Epigenetic Diversity in Life

19 citations , October 2017 in “The FASEB Journal”

This study established an androgen-responsive human organ culture model using hair follicles, demonstrating that women's intermediate facial follicles grow more hair in response to men's higher androgen levels.

research Androgens and Androgen Receptor Action in Skin and Hair Follicles

100 citations , September 2017 in “Molecular and Cellular Endocrinology”

This review discusses the molecular mechanisms of androgens and androgen receptors in skin disorders, particularly androgenetic alopecia, and reports no new clinical results; it highlights potential areas for future treatment development.

research Genetics and Other Factors in the Etiology of Female Pattern Hair Loss

43 citations , April 2017 in “Experimental Dermatology”

This review summarizes the genetic studies on female pattern hair loss, highlighting the lack of clearly identified susceptibility loci and suggesting distinct aetiological differences from male pattern hair loss.

research The Effectiveness of Treatments for Androgenetic Alopecia: A Systematic Review and Meta-Analysis

178 citations , April 2017 in “Journal of The American Academy of Dermatology”

This systematic review and meta-analysis found that minoxidil, finasteride, and low-level laser light therapy significantly improve hair growth in men with androgenetic alopecia, while minoxidil is also effective for women, compared to placebo.

research The Ovariectomized Mouse Simulates the Pathophysiology of Postmenopausal Female Pattern Hair Loss

6 citations , April 2017 in “Journal of Dermatological Science”

This study aimed to evaluate the potential use of ovariectomized mice as a model for postmenopausal female pattern hair loss, but it reports no new results.

research Meta-Analysis Identifies Novel Risk Loci and Yields Systematic Insights into the Biology of Male-Pattern Baldness

64 citations , March 2017 in “Nature communications”

This study identified 63 genetic loci associated with male-pattern baldness, uncovering genes and pathways that may help develop treatments and suggesting its connection to other human conditions.

research Interventions for Female Pattern Hair Loss

21 citations , May 2016 in “The Cochrane library”

This review found that while topical minoxidil is effective for treating female pattern hair loss, finasteride showed no more effectiveness than placebo, and low-level laser therapy increased hair count but with inconsistent results.

research Apoptosis in Follicles of Individuals with Female Pattern Hair Loss Is Associated with Perifollicular Microinflammation

30 citations , May 2016 in “International Journal of Cosmetic Science”

This study found that apoptosis was more prevalent in hair follicles of women with female pattern hair loss, particularly in miniaturized follicles, and was associated with follicular inflammation.

research Systemic Causes of Hair Loss

18 citations , May 2016 in “Annals of Medicine”

This paper reviews seven major systemic causes of hair loss and provides a clinical evaluation framework but reports no new experimental results.

research Towards a Consensus on How to Diagnose and Quantify Female Pattern Hair Loss – The Female Pattern Hair Loss Severity Index (FPHL-SI)

26 citations , December 2015 in “Journal of The European Academy of Dermatology and Venereology”

This article introduces a new grading system called the FPHL Severity Index to better identify and monitor early stages of female pattern hair loss using clinical criteria.

research Quality of Life in South African Black Women with Alopecia: A Pilot Study

16 citations , November 2015 in “International Journal of Dermatology”

This study found that alopecia significantly reduces quality of life among South African Black women, with subjective symptoms and self-image concerns having the greatest impact.

research Female Pattern Hair Loss: A Clinical and Pathophysiological Review

91 citations , August 2015 in “Anais Brasileiros De Dermatologia”

This review discusses the clinical, epidemiological, and pathophysiological aspects of female pattern hair loss, reporting no new research findings.

research Biology of the Hair Follicle and Mechanisms of Nonscarring and Scarring Alopecia

10 citations , June 2015 in “Seminars in cutaneous medicine and surgery”

This review discusses the biology of hair follicles and mechanisms behind various hair disorders, but it presents no new findings; the authors emphasize understanding these concepts to inform treatment development.

research Evaluation and Diagnosis of the Hair Loss Patient

86 citations , August 2014 in “Journal of The American Academy of Dermatology”

This article discusses the history taking and clinical examination process for diagnosing alopecia and outlines a diagnostic approach, noting that it reports no new clinical results.

research Destruction of the Arrector Pili Muscle and Fat Infiltration in Androgenic Alopecia

35 citations , March 2014 in “British Journal of Dermatology”

This study found that in androgenic alopecia, the arrector pili muscle degenerates and is replaced by fat, unlike in normal skin or telogen effluvium.

Prevalence of Androgenic Alopecia in Patients with Polycystic Ovary Syndrome and Characterization of Associated Clinical and Biochemical Features

research Prevalence of Androgenic Alopecia in Patients with Polycystic Ovary Syndrome and Characterization of Associated Clinical and Biochemical Features

48 citations , February 2014 in “Fertility and Sterility”

This study found that androgenic alopecia is present in 22% of women with polycystic ovary syndrome and is associated with acne and hirsutism, but not with increased biochemical hyperandrogenemia or metabolic dysfunction beyond PCOS.

research Pattern Alopecia During Hormonal Anticancer Therapy in Patients with Breast Cancer

9 citations , January 2014 in “Annals of Dermatology”

In this report, five female patients undergoing hormonal anticancer therapy for breast cancer prevention developed pattern alopecia, which the authors attribute to androgen-estrogen imbalance caused by antiestrogenic drugs.

research The Female Pattern Hair Loss: Review of Etiopathogenesis and Diagnosis

35 citations , January 2014 in “BioMed Research International”

This review examines the epidemiology, pathogenesis, clinical manifestations, and diagnosis of female pattern hair loss and reports no new results.

research Female Pattern Hair Loss: A Review Article

57 citations , October 2013 in “international journal of endocrinology and metabolism”

This review discusses clinical features, differential diagnosis, and treatments for female pattern hair loss, emphasizing the use of 2% topical Minoxidil and exploring alternative off-label therapies.

research Iron Plays a Certain Role in Patterned Hair Loss

40 citations , January 2013 in “Journal of Korean Medical Science”

This study found that serum ferritin levels were lower in premenopausal women with female pattern hair loss compared to healthy controls, suggesting a potential role for iron in hair loss.

research Factors Associated With Female Pattern Hair Loss And Its Prevalence In Taiwanese Women: A Community-Based Survey

33 citations , November 2012 in “Journal of The American Academy of Dermatology”

This study reported that female pattern hair loss was prevalent in 11.8% of women aged 30 and older and was associated with high fasting glucose, fewer childbirths, oral contraceptive use, and excessive ultraviolet exposure.

research S1 Guideline for Diagnostic Evaluation in Androgenetic Alopecia in Men, Women, and Adolescents

151 citations , August 2010 in “British Journal of Dermatology”

This guideline reviews the diagnosis of androgenetic alopecia and offers expert consensus recommendations tailored to males, females, and adolescents, but reports no new clinical results.