Female hair loss can be a deeply distressing issue, affecting approximately one-third of women. Postmenopausal women face an even higher risk, with up to two-thirds experiencing thinning hair or bald spots. Society’s expectations can magnify the emotional impact of this issue on women, affecting their overall well-being. Understanding the primary type of hair loss in women, known as androgenetic alopecia, is essential. Unlike male pattern hair loss, female hairlines generally do not recede, making baldness rare.
Various factors contribute to female hair loss, including underlying medical conditions, medications, and physical or emotional stress. If you notice unusual hair loss, consulting your primary care provider or a dermatologist for a thorough evaluation and potential treatment options is crucial. Seeking support from therapists or support groups can also help address the emotional challenges associated with this issue. Coping with female hair loss can be frustrating, but there are resources available to help manage it better.
Patterns of Female Hair Loss
Clinicians use the Ludwig Classification to delineate female pattern hair loss, which ranges from minimal thinning (Type I) to reduced volume and a wider mid-line part (Type II) to diffuse thinning with a translucent appearance on the crown (Type III).
What is Androgenetic Alopecia?
Get ready ladies, because female pattern hair loss is something that will affect almost every one of us at some point in our lives. And when menopause hits, you won’t be able to ignore those thinning locks anymore. Age plays a role too, especially if your family has a history of hair loss. This whole issue revolves around hormones called androgens – they’re responsible for sexual development and regulating hair growth. But here’s the kicker: understanding how these hormones work in women is way more complex than in men. So if you’re experiencing signs of female pattern hair loss, it’s crucial to check your androgen levels and rule out any tumors. This condition causes changes in our follicles, making them smaller and producing thinner hairs – it’s like they’re shrinking! And as a result, we end up with shorter non-pigmented hairs instead of those luscious thick ones we used to have.
Life Cycle of a Hair
Each hair originates from a follicle, a slender pocket within the skin, and undergoes a progression through three distinct growth phases:
- Anagen (Active Growth Phase): Lasting two to seven years.
- Catagen (Transition Phase): About two weeks, during which the hair shaft migrates upward toward the skin’s surface.
- Telogen (Resting Phase): Typically around three months, concluding with hair shedding.
When diagnosing female pattern hair loss, a clinician thoroughly examines the scalp and reviews the patient’s medical history. They closely observe the specific pattern of hair loss for any signs of inflammation or infection. Sometimes, blood tests are ordered to investigate potential causes like hyperthyroidism, hypothyroidism, or iron deficiency. However, hormonal assessments are typically unnecessary unless there are clear indications of increased androgen levels such as irregular periods, acne, or excessive unwanted hair growth.
How to Address Thinning Hair: Hair Loss Solutions for Women
The most common approach to treating hair loss in women involves medications, which encompass the following options:
1. Minoxidil (Rogaine, generic versions)
Originally developed as a remedy for high blood pressure, minoxidil garnered attention when users noticed hair growth in areas previously affected by hair loss. Research studies have verified that applying minoxidil directly to the scalp can stimulate hair regrowth. Initially, the FDA approved an over-the-counter 2% minoxidil solution for treating female hair loss. Subsequently, a stronger 5% solution became available for cases requiring more potent treatment.
Minoxidil isn’t a magic cure. While it can promote hair growth in some women, it won’t fully restore lost density. Results take time, usually becoming noticeable after two months and peaking around four months. But don’t expect miracles overnight – you’ll need to commit for six to 12 months for a fair trial. And remember, ongoing use is crucial to maintain those results; stopping could lead to hair loss again.
To apply minoxidil: Make sure your hair and scalp are dry. Use the dropper or spray pump provided with the solution and apply twice daily to thinning areas. Gently massage it into your scalp so that it reaches the follicles. Let your hair air dry, wash your hands thoroughly, and wipe off any excess solution on your forehead or face. Avoid shampooing for at least four hours.
Now let’s talk side effects: Minoxidil is generally safe but may have discomforting side effects unrelated to alcohol irritation. Occasionally, new hair may differ in color and texture from the rest of your mane – just something to keep in mind! There’s also a chance of hypertrichosis – excessive growth in unintended areas like cheeks or forehead (more common with 5% solution). So be aware! Here’s an important consideration: Rogaine’s patent has expired! That means generic products with the same concentration of minoxidil are available now – they might even have additional ingredients that could trigger allergies.
Androgens, like testosterone and other male hormones, can speed up hair loss in women. If minoxidil doesn’t work for you, adding spironolactone (Aldactone), an anti-androgen medication, could help treat androgenic alopecia. This is especially important for women with polycystic ovary syndrome (PCOS) because they often have high levels of androgens. Doctors might prescribe spironolactone along with birth control pills for women of reproductive age (who shouldn’t get pregnant while taking these drugs because they can harm the genitals of male fetuses). Possible side effects include weight gain, decreased sex drive, sadness, and tiredness.
3. Iron Supplements
Iron deficiency can cause hair loss in women. If you’re a vegetarian, have a history of anemia, or experience heavy menstrual bleeding, your doctor will check your blood iron levels. Supplementation can stop hair loss if iron deficiency is found. But taking extra iron when your levels are normal can lead to stomach upset and constipation.
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Recent Trials & FDA approval
In 2014, two groundbreaking trials were conducted to assess the effectiveness of 5% minoxidil foam in treating hair loss in women. These trials were meticulously designed, using randomized and double-blind methods to ensure accurate results. The first trial involved dividing participants into two groups. One group received a daily treatment of 5% minoxidil foam, while the other group was given a placebo foam. Over a period of 24 weeks, changes in hair count and scalp coverage were measured at weeks 12 and 24. The results showed significant improvements in both areas for those treated with minoxidil compared to the placebo group. In the second trial, participants were given either a once-daily treatment of 2% minoxidil solution or twice-daily application of 5% minoxidil foam for an entire year. Remarkably, there was no notable difference between the two groups when it came to improving hair count. These findings provided compelling evidence that supported the approval by FDA for once-daily use of 5% minoxidil as an effective treatment option for female pattern hair loss starting from 2014 onwards. With its proven efficacy and practical advantages, such as convenience and improved aesthetics, this breakthrough treatment has revolutionized how we address hair loss in women.
Minoxidil is considered relatively safe and has minimum side effects which can include dryness, redness, and itching. Sometimes, the new hair differs in color and texture from surrounding hair. Another side effect is excessive hair growth in undesirable places — hypertrichosis — such as the cheeks or forehead
Recent Trials & FDA approval
In 2014, two randomized, double-blind, and parallel trials of 5% minoxidil foam were completed. Both trials assessed the efficacy of once-daily use of 5% minoxidil foam in female participants aged 18 years and older.
In the first trial, half of the participants were given once a day treatment with 5% minoxidil foam and the remaining half were given placebo foam for 24 weeks. Efficacy was assessed at weeks 12 and 24 and safety and adverse events were monitored every 6 weeks. At weeks 12 and 24, changes in target area hair count (TAHC) from baseline were significantly higher in the minoxidil-treated group than the placebo group. Also at 24 weeks, the patient-reported assessment of scalp coverage was determined to be significantly higher with minoxidil treatment compared to placebo.
In the second trial, participants were given once a day treatment with 2% minoxidil solution or 5% minoxidil foam twice daily for 52 weeks. The change in TAHC from baseline in the 5% minoxidil group was shown to be similar to that of the 2% topical minoxidil solution group.
Since both regimens are equally efficacious, treatment with 5% Minoxidil is associated with several aesthetic and practical advantages. Thus with the availability of compelling evidence, the FDA approved the once-daily use of 5% minoxidil for female pattern hair loss from 2014 and onwards.
Minoxidil is considered relatively safe and has minimum side effects which can include dryness, redness, and itching. Sometimes, the new hair differs in color and texture from surrounding hair. Another side effect is excessive hair growth in undesirable places — hypertrichosis — such as the cheeks or forehead.
Female pattern hair loss (FPHL) is rather a more common disease affecting women; with more than half of them having some extent of baldness in their 60s. Amidst a lot of treatment options available, topical foam application of 5% minoxidil remains the mainstay of treatment with the research proving to be in favor of once-daily dosing. This results in better compliance with treatment and superior clinical outcomes. But the hair loss may return after a person stops using the product.