What is it?

• Also called androgenetic alopecia it is a common type of hereditary hair thinning.  Over time the hairs become smaller in size (miniaturization of hair follicles) either in response to the normal male hormone testosterone and/or genetics. Smaller hair follicles produce hair that is finer and shorter. There is still the possibility to reverse this process and re-enlarge the hair follicles.

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How common is it? 

• At least 50% of women are affected by this type of thinning but it tends to be milder than in men.   Women tend to be more self conscious and embarrassed about hair issues because of societal pressure to have thick, full hair and do not talk about it freely when it starts to thin out.

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Is it inherited from mother or father’s side of the family?

• Contrary to popular belief it can be inherited from both sides, not just the mothers side.

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What are the Symptoms?

• Usually the condition has no symptoms

• In the early stages there may be an increase in hair shedding in the bathroom and on brushes.  The ponytail becomes smaller and thinner and the scalp becomes more noticeable.

• It starts thinning in the central part of the scalp first and there is slow widening of the central part and can lead to overall thinner hair throughout the scalp but often does not lead to balding like with men. 

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Do I need to do any tests as part of the diagnosis?

• In most cases the answer is NO

• However, if there are certain findings on your history or hair examination your doctor may order these tests.  This includes irregular periods, infertility, excess facial hair, severe acne, and milky breast discharge.

Do women with female pattern hair loss have too much male hormone?

• NO – normal levels of male hormone are present in most cases (85% or more)

• The difference is that the hair follicles are MUCH MORE SENSITIVE to the male hormone.

 

What are the treatment options available?

• The treatment options are often frustrating for both patients and their doctors as there is no ideal treatment available and if an over the counter product claims this, it is likely too good to be true !! (otherwise Dermatologists would be recommending it to everyone!)

• Most treatment options are aimed at maintaining the hair you have and are considered indefinite – meaning if you stop the treatment, the hair loss will continue to progress.
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1.    Minoxidil 5% foam (Rogaine) 
•    This is the first approved treatment for promoting hair growth.  Although the effect is not very strong, if applied properly, the effect can be beneficial.  Many studies have shown that it produces a substantial increase in partially thicker and longer hairs and if your scalp is noticeable this should help minimize this.  It does not completely reverse the thinning process however, and must be applied at least once a day for one year before judging if it is working or not.  

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2.    Vitamins/supplements (Viviscal)
•    Daily dietary supplement containing marine proteins and polysaccharides, and vitamins like biotin and minerals essential for hair growth taken daily for 8-12 months.  75.3% of patients observed a significant decrease in hair loss and 14.6% of patients showed partial regrowth. 

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3.    Hormone blocking medications
•    In certain cases, these may be helpful and are all available by prescription only.  These are typically never given to premenopausal women and are contraindicated in pregnancy and/or if you’ve had female related cancers.
o    Finesteride tablets – taken daily
o    Spironolactone tablets – taken daily
o    Oral contraceptive agents – taken daily

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4.    Hairpieces and Camouflage techniques 
•    Wigs, toupees, hair extensions, camouflage products like sprays and hair fibers, tattooing techniques/microblading
•    There is a large variety of products available and they are safe and do not harm the hair or accelerate the thinning process in any way.  

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5.    Hair Transplantation 
•    Surgery available out of province (out of pocket expenses).  Hair is removed from the back of the scalp and individually placed into the front and top of the scalp where there is thinning.  Hairs grow out as normal over the next 6-12 months.

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6.    Platelet Rich Plasma (PRP) therapy
•    A newer treatment that is still in the experimental stages where your own blood is removed, spun down in a centrifuge and the platelet rich blood is extracted that contains many growth factors is injected into your scalp over several treatments (minimum of 3) over several months.   This is not covered and thus out of pocket expenses will occur.