Hair Loss Treatment for Women
The most common type of hair loss seen in women is androgenetic alopecia, also known as female pattern alopecia. Alopecia means baldness, but just as in men, it does not have to be complete hair loss. This is seen as hair thinning predominantly over the top and front of the head. It affects approximately one-third of all susceptible women, but is most commonly seen after menopause.
In female pattern hair loss some excess loss of hair is noted, but gradual thinning is what usually brings the woman to the hair specialist doctor. Normal hair shedding is approximately 100-150 hairs per day. A lower number of hairs lost would apply to those whose hair is already thin. In female pattern hair loss, when the affected hair is shed, the root grows one in its place that is shorter. Eventually it becomes invisible “peach fuzz”. Genetically, hair loss can come from either parent’s side of the family.
Female pattern hair loss may begin as early as puberty. In these cases if there are signs of hormone imbalance, such as excess facial or body hair, a hormone evaluation should be done. Hormonal changes are a common cause of female hair loss.
As compared to male the baldness and hair loss problem is less common in females but it has more devastating effects not only cosmetically but also psychological. Whilst male hair loss is seen as inevitable for a large proportion of men in the community, female hair loss is far less common and therefore less culturally acceptable, which only adds to the stigma for those experiencing it. In many cases the damage to a woman’s self-confidence can affect her whole quality of life. As a general rule female hair loss is quite different to male hair loss. Females experience a thinning out of mid scalp and crown hair and usually retain their frontal hairline.
Causes of female hair loss
- Androgenetic alopecia
- Hormonal imbalances and particularly after childbirth
- During the menopause
- Post-effects of a serious surgical procedure
- Emotional stress
- Sudden weight loss
- Hormonal treatments
- Polycystic ovaries
- Thyroid problems
- Medication side effects
- Emotional shock
- Anemia
- Iron deficiency anemia
- Smoking,alcohol
- Trichotillomania
- Alopecia areata
- Traction alopecia
- Autoimmune disorders
Androgenetic Alopecia in Women
Androgenetic alopecia in women is also referred to as androgen dependant hair loss or female pattern baldness.
Causes and Symptoms
Just like androgenetic hair loss in men this type of hair loss is genetically determined. It is a very complex type of hair loss which is hugely dependant on hormones and is also age related.
The genes cause certain hair follicles in the affected areas to become oversensitive to male hormones which are known as androgens. Once the hair follicles have been exposed to enough androgens they will become smaller and thinner. The healthy terminal hairs that they once produced will gradually be replaced by thin vellus hairs which are no longer thick enough to block out light rays thus allowing the scalp to show through.
The hair loss is different from that of male pattern baldness in that it is characterised by a diffuse type of thinning. Sufferers of the female type of hair loss will often complain that they can see their scalp through the thinning hair and if there is a parting this will often look wider. The hair thinning is usually restricted to the top and crown of the scalp but in some case all areas of the scalp are affected.
The frontal hairline normally remains intact.
Other factors which cause changes in hormones may aggravate the condition even more. These factors include excess androgens, polycystic ovarian syndrome and certain oral contraceptives. Also many women see further thinning during and after the menopause due to a marked decrease in the female hormones which previously acted as a barrier and thus blocked a certain amount of the androgen hormones.
Diagnostic Tests
- Serum iron
- Serum ferritin
- Total iron binding capacity (TIBC)
- Thyroid stimulating hormone (T3, T4, TSH)
- Complete blood count (CBC)
- Hormone levels (DHEAs, testosterone, androstenedione, prolactin, follicular stimulating hormone, and leutinizing hormone) – if required
Classification For Hair Loss In Women
Ludwigs Classification
- Type I (mild)
- Type II (moderate)
- Type III (extensive)
In all three Ludwig stages, there is hair loss on the front and top of the scalp with relative preservation of the frontal hairline. The back and sides may or may not be involved. Regardless of the extent of hair loss, only women with stable hair on the back and sides of the scalp are candidates for hair transplant surgery.
Myths Related to Hair Loss in men and women
- Frequent shampooing contributes to hair loss.
- Hats and wigs cause hair loss
- Wearing helmet causes baldness.
- 100 strokes of the hair brush daily will create healthier hair.
- Permanent hair loss is caused by perms, colors and other cosmetic treatments.
- Women are expected to develop significant hair loss if they are healthy.
- Shaving one’s head will cause the hair to grow back thicker.
- Standing on one’s head will cause increased circulation and thereby stimulate hair growth!
- Dandruff causes permanent hair loss.
- There are cosmetic products that will cause the hair to grow thicker and faster.
- Hair loss does not occur in the late teens or early twenties.
- Hair loss affects only intellectuals.
TREATMENT of hair loss in women
- Medical Treatment
- Stem cell treatment / PRP
- Mesotherarpy
- Hair Transplant
- Combination of Medical and Surgical Treatment
Treatment with medications
The most important decision you can make is early medical intervention when you first detect hair loss. Early medical intervention is a very important step you make in order to maintain and keep your existing hair. If you delay treatment, Female Balding Pattern hair loss can lead to permanent loss of your hair follicles.
The use of anti-androgen medication after prolonged hair loss will help prevent further hair loss and encourage some hair regrowth from dormant hair follicles. Common sense and healthy lifestyles are also important like diet, weight loss, and exercise that are required to keep your body in good health. Maintaining your nutritional support and monitoring your vitamin and mineral levels helps while you’re on anti-androgen medications.
Minoxidil 2% and 5 % Topical Treatment
Once you decide to have medical treatment, the most common medical product prescribed is Minoxidil. Currently, Minoxidil 2% and 5 % is the only FDA approved treatment for female pattern hair loss. The effectiveness of these medicines varies from person to person, but most women have found using these treatments have made a positive difference in their hair and their self-esteem.
Clinical trials of topical Minoxidil in male and female hair loss show an increase in hair growth, measured by hair counts or hair weight. This increase is apparent within 6–8 weeks of starting treatment and generally peaks by 12–16 weeks.
Since Minoxidil does not appear to have either a hormonal or immunosuppressant effect, it believed Minoxidil induces cell division on epidermal and hair cells. Minoxidil stimulates the hair follicle during the latent part of the Telogen phase to enter the Anagen or growth phase of the hair cycle sooner than normal. This the hair cell spends less time in the resting phase and more time in the growth phase.
In medical studies, it has been shown that women with diffuse Androgenetic Alopecia can use Minoxidil, and it appears to be more effective for women than men.
Ketoconazole Shampoo
Available as a topical treatment by prescription, Nizoral or it generic form Ketoconazole, is used as an antifungal agent but its anti-androgenic effects reduce the production of testosterone and other androgens by the adrenal gland and by the male and female reproductive organs.
Ketoconazole has been seen to cause 5 -reductase inhibition. Additionally, in humans Ketoconazole has also been shown to inhibit the binding of 5 -reductase to sex hormone globulins. Clinical studies suggest that Ketoconazole may inhibit the production of DHT thus reducing the pathway that leads to the characteristic miniaturization of hair follicles in Androgenetic Alopecia.
In the case of Androgenetic Alopecia treatment, the only tissue that requires a relative high concentration of Ketoconazole is the hair follicles, and local application of Ketoconazole in the form of a shampoo is the best way to administer treatment. Topical administration avoids systemic toxicity and the agent can be directly delivered to the affected area
Iron supplements.
In some women, iron deficiency could be a cause of hair loss. We will advise to test your iron level, particularly if you’re a vegetarian, have a history of anemia, or have heavy menstrual bleeding. Iron supplements are recommended if a woman’s iron level is less than 70 nanograms per milliliter
Androgen Receptor Inhibitors
Aldactone / Spironolactone
Tagamet / Cimetidine
Oral Contraceptives
Finasteride
Finasteride is the generic name for Propecia/Proscar. This medication was original made to treat prostate disease. It works primary by inhibiting an enzyme that harms the hair follicle. This enzyme is called 5-alpha reductase. It is well known that testosterone is converted to Dihydrotestosterone (DHT) in the Dermal Papillae region of the hair follicle. It is the DHT that inhibits the normal growth cycles of the hair follicle.
Finasteride is a prescription medication often used for men, but it can be used in women who have Polycystic Ovarian Disease and Hirsuitism caused by elevated androgen levels. Finasteride is not recommended for women primarily because it is often associated some birth defects if the patient is in their child bearing years. For women in child bearing years two forms of contraception is necessary if this medication is going to be used.
Recent studies have shown Oral Finasteride at a dosage of 2.5 mg may be effective in treating women
Stem cell/ PRP treatment
The stem cell treatment shows good results in women who has experienced hair thinning and decrease in density . it can restore the hair and can activate the roots which are inactive. It require 3 session at interval of 1 month. It has no side effect or downtime. The total procedure time is around 1 hour and after the treatment can resume work immediately
Mesotherapy
Now the women who are not candidate for hair transplant can be successfully treated with the stem cell treatment given by roller scalp system. Those who have thinning, hair fall, very less density, visible scalp through the hairs can be treated by stem cell extracts which has no side effects and its totally painless procedure. This treatment is without any side effects and totally painless.
Vitamin supplements
Saw Palmetto Gamma Linolenic Acid, Multivitamin, Multimineral & Natural Extracts Tablets, biotin supplements
These vitamin supplements are generally recommended for women with hair loss. It contains most of the essential nutrients for healthy hair growth..
Benefits
- Decreased Hair fall
- Hair regrowth
- Increase in hair and nail strength
- Faster hair growth
- Can be supportive treatment for Alopecia
- Improves General ability
- Nutritive supplement
Camouflage Techniques
Using cosmetic camouflage is a common way of hiding ones hair loss and is often used by persons who are just starting to thin, especially in the crown. A number of over the counter products are now available that can make the hair look thicker. They come primarily in powders, sprays and creams such as Toppik , hair building fibers etc. The main limitation of these products is that, unless the person has a significant amount of hair to hold the cosmetics in place, it doesn’t look natural.
Hair wigs, hair bonding , hair fixing , lace system , hair glues, hair extension , hats, and scarves are all used to hide one’s balding. In recent years, elaborate hair systems, attached by glue or sewn to the patient’s existing hair, have evolved into a major industry. The problem with these systems is that they must be periodically adjusted, requiring repeated visits to the salon and significant expense. Because they can’t be removed at night, they cause traction hair loss, making the user even more dependent on the hair piece. They are also difficult to clean and often give the wearer the appearance of having too much hair.
FUE hair transplant
Not only in males, is hair transplant also possible and commonly done in females. With improvements in hair transplantation techniques have meant that we can now reassess female patients who in the past would have been rejected as unsuitable for the procedure. The new techniques of AUTOMATED MaX FUE have allowed transplanting any number of grafts for coverage of baldness in women too. On an average we can transplant around 1500 grafts by unshaven fue technique. It takes around 6 to 9 months to see the full grown results. There is simple post procedure similar to male need to be followed. The results are natural and without any side effects .With our technique the women baldness will be treated with following advantages:
- No admission or stay required
- Can resume work from next day
- Procedure is done under local anesthesia and recovery is fast
- Maintaining the natural angle and direction to give absolutely natural look in women also is possible as we are using special technique and special instruments for plantation.
- Thicken thinning areas while avoiding damage to or removal of existing hair follicles.
- Utilise the dense packing procedure to achieve a relatively high density in treated areas.
- Minimize scarring in both donor and recipient sites.
- Unshaven fue technique is done in females
Synthetic hair transplant
Both biofiber or nido synthetic hair implant can be considered after evaluation of advantage and side effects of the synthetic hair transplant. The synthetic hair transplant can be done in case where the donor area is insufficient.it give instant and immediate results. First 100 hairs are transplant and if there is no reaction or rejection then rest of the hair can be implanted after 3 weeks
Faq For Hair Loss In Women
Q: Why am I losing my hair?
A: There can be many causes for women to lose their hair. Unlike men, where it is more commonly a hereditary cause, women can have many underlying factors. Thyroid conditions, auto-immune disease, stress, hormonal imbalance, pregnancy, anemia (iron deficiency), crash dieting, stress and many other conditions can cause hair loss in women. Some of this hair loss can be reversed by correcting the underlying cause. If there is a genetic component, and a woman is a candidate, hair restoration surgery may be considered.
Q: What is Telogen Effluvium?
A: Telogen Effluvium is a condition that can be easily confused with genetic female hair loss if it is misdiagnosed. Telogen Effluvium, is a condition where hair is pushed into its resting phase and then several months later is shed. This can be caused by several medications and many different medical conditions. Fortunately, telogen effluvium is usually reversible.
Q: Is women’s hair loss different from men’s?
A: The most common type of hair loss in women occurs in a diffuse pattern. Thinning occurs “all over the scalp” rather than in a localized area. Diffuse hair loss is most often hereditary, but it can also be caused by underlying medical conditions or other factors. This is in contrast to male pattern baldness which is general hereditary and in a definitive pattern, balding from the top of the scalp and slowly having the pattern increase until there is only a circumference of hair around the scalp. Read more about the causes, classification and diagnosis of hair loss in women.
Q: What can I expect at a consultation?
A: All consultations included a thorough medical history and physical examination of your hair and scalp. In addition, an evaluation with a hair densitometry will be conducted to measure your density and track miniaturization. During your evaluation, potential underlying medical or genetic causes of your hair loss will be evaluated and a formal diagnosis will be given. Once the diagnosis is determined a personalized treatment plan will established to best address your hair loss.
Q: Do I need blood tests?
A: These tests may include CBC (complete blood count) – for anemia, blood loss and certain vitamin deficiencies; a Serum iron and iron binding capacity – for anemia, T3, T4, TSH – for thyroid disease
Q: Can medications cause hair loss in women ?
A: Blood pressure medications, cholesterol lowering medications, oral contraceptives and diet pills are among a myriad of drugs that can cause hair loss in women. One of the things we will do at your consultation is look into your current medical history and determines if any medications you may be taking are exacerbating your hair loss