Hair Loss in Women
- Olsen, Elise A. M.D.
Key Clinical Points
Hair Loss in Women
Female-pattern hair loss is common and increases with age. Distinguishing between early-onset and late-onset female-pattern hair loss and establishing the presence or absence of hyperandrogenism or hyperandrogenemia may identify subpopulations of patients with varied etiologic factors and response to treatment.
The major clinical features of female-pattern hair loss are a pattern of central-scalp hair loss with or without frontal accentuation, preservation of follicular ostia, and variation of hair-shaft diameter. A scalp biopsy can confirm the disorder and determine the potential for regrowth.
One treatment strategy for female-pattern hair loss is to start with either 5% topical minoxidil twice a day or a low dose of oral minoxidil and escalate the latter if no unacceptable side effects occur (e.g., symptomatic low blood pressure, peripheral edema, or hypertrichosis).
Antiandrogen agents or 5α-reductase inhibitors are effective treatments in women with female-pattern hair loss and are useful in combination with minoxidil.
For patients with female-pattern hair loss who prefer to avoid medications or wish to augment their medical therapy, microneedling, platelet-rich plasma, nonablative fractional laser treatment, and low-level light therapy may be useful.
Hair Loss in Women
Female-pattern hair loss increases with age and varies according to age at onset and hormone status. Treatments include minoxidil, antiandrogens, and nondrug options such as platelet-rich plasma or light or laser therapy.