Can Women Have Male Pattern Baldness
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Dr. Dhananjay Chavan
General surgeon and Hair
Can A Woman Have Male Pattern Baldness?
For a woman, her hair is not only an element of vanity and pride but also of her identity. The loss of it can become disturbing and debilitating to her self-image and self-esteem. While men often are a sport about it, balding is downright scary for women. Female pattern baldness is the most common type of hair loss in women.
Studies reveal that about 40% of the women show signs of hair loss and start experiencing female pattern baldness by the age of 50, and less than 45% women reach the astute age of 80 with a head full of hair.
Most women start presenting its symptoms in their 30s and 40s itself; it is rare before for women to present with them before reaching midlife.
Baldness, in general, occurs when the hair follicle shrinks over time, resulting in shorter and finer hair; eventually, the follicle stops growing new hair.
While the exact reason for it is not understood, it is related to the following factors:
Female pattern baldness has a strong genetic predisposition, that is polygenic in nature. This means that there is more than one gene that contributes to it, which may be inherited from either parent or both.
So if you have a history of baldness in your family, you’re susceptible to experiencing it yourself.
Androgens are a group of hormones linked to male traits, but present in both males and females, and are thought to be the culprit responsible for changes in hair follicles leading to hair loss. These hormones include testosterone, and its derivative called DHT (dihydrotestosterone).
Ironically, DHT is essential for most hair growth, but it is damaging to head hair growth. DHT attaches to androgen receptors on hair follicles on the scalp and shrinks them, making it difficult for them to survive. The hair becomes smaller in diameter, shorter in length, and lighter in colour until the follicles stop producing hair altogether.
DHT hair loss in both men and women is referred to as ‘androgenetic alopecia’. Most women have normal levels of androgens in their bloodstream, though it is possible that scalp sensitivity to these hormones may be influential. But because the relationship is often uncertain, the term ‘female pattern hair loss/baldness’ is preferred over female androgenetic alopecia.
Hormonal imbalance seen in pregnancy may also affect the hair’s growth and shedding phases.
Since female pattern hair loss starts presenting only in midlife, aging and menopause are thought to play a role. The role of estrogen, too, is uncertain. Because though the symptoms increase after menopause when estrogen levels become low, suggesting that estrogen may indeed be stimulatory for hair growth, studies indicate otherwise.
- Medical conditions
Hormones sway the cycles of hair growth and loss, thus female pattern hair loss may also be observed in conditions exhibiting hormonal imbalance like ovarian cysts, menopause, use of high androgen index birth control pills, androgen-secreting tumors, thyroid disorders, use of certain medications etc.
The decrease in the number of hair is observed in both, men and women; but the pattern differs. Hair loss in men is at the front and sides of the scalp, progressing to the back (receding hairline), and also affects the crown. In women, the pattern of hair loss is as follows:
- It is more diffuse and less noticeable than in men.
- Hair thins mainly on the top and crown of the scalp.
- It usually starts with widening through the center hair part.
- The front hairline remains unaffected except for normal recession, as observed in everyone with aging.
- The hair loss progresses gradually and rarely does it progress to total or complete baldness, as it may in men.
Stages of female pattern baldness
Several scales measure hair loss, but the two most common standards are the Ludwig Scale and Savin Scale. The scales are almost identical, except that while Ludwig Scale measures only the overall thinning, Savin Scale measures overall thinning as well as the density in the hair.
Stage 1: Hair thins out all over the scalp, parting gets wider.
Stage 2: The thinning part is now obvious, and you may have lost half of your hair.
Stage 3: One can easily see through to your scalp with almost 70% of your hair thinned out.
The treatments for female pattern hair loss may take up to a year to start working and need to be continued long-term to maintain those results and prevent you from losing hair again.
This is the only drug approved by the FDA for treating female pattern baldness. Available as 2% or 5% topical solution, it needs to be applied to your scalp every day.
It stops or slows down hair loss in the majority of the cases, and also induces significant hair regrowth in half of them. But the treatment is expensive, and hair loss may recur once minoxidil is discontinued.
- Finasteride and Dutasteride
These drugs have been approved for use only in men, not women; but studies have shown them to be effective in stimulating hair regrowth in female pattern hair loss as well.
This drug acts by blocking androgen production and thus may help regrowth of hair.
- Platelet-rich plasma (PRP) therapy
PRP injections into the scalp can improve both, hair density and hair thickness by delivering a high concentration of growth factors, stimulating hair regrowth.
Deficiency in iron, vitamins and other nutrients can be responsible for hair loss, too.
Especially in the first stage of hair loss in women, your physician may prescribe iron supplements, and other supplements for biotin, folic acid, omega-3 fatty acids, omega-6 fatty acids, and antioxidants to promote hair growth; and also advise you on following a dietary plan that includes the recommended daily intake for proteins and calories.
- Conceal hair loss
In the early stages, you may attempt to conceal the hair loss by changing your hairstyle, trying out hair extensions and hair pieces, or using a spray hair product; wearing wigs is a common way to conceal it in the late stages.
- Laser combs and helmets
These are FDA-approved to treat hair loss by using light energy to stimulate hair regrowth. The efficacy is uncertain, though.
- Hair transplant
Hair transplant is a more permanent solution to solve your hair loss troubles. It consists of the removal of tiny plugs of hair from areas where hair is continuing to grow and placing them in the balding areas.
Only women who have stable hair on the back and sides of the scalp, that isn’t thinning at all, are candidates for hair transplant surgery.
Female pattern hair loss can neither be truly prevented nor cured, but it certainly can be treated using these measures.
Early diagnosis is encouraged as it allows you to get started on a treatment plan, as recommended by your physician so that you can potentially minimize future hair loss and preserve those precious locks.
Professionals from HairMD Clinic can guide you through this, using their experience and expertise, and help you win your lost hair back.
For any questions regarding female pattern baldness and its treatment, contact us at HairMD Clinic.