Female Pattern Hair Loss

Female Pattern Hair Loss is more common than people think. With men, the hair loss is quite obvious. For women, Female Pattern Hair Loss presents with general thinning across the top of the scalp and may take years before it is quite evident.

What causes Female Pattern Hair Loss?

The exact cause of Female Pattern Hair Loss has not been delineated. Unlike Male Pattern Hair Loss, where excess of Dihydrotestosterone (a male hormone) has been shown to be the main causative factor, there has been no direct association with hormonal imbalances in women. In fact, most women with this condition have normal levels of androgens (male hormones). Female Pattern Hair Loss does worsen after menopause, giving some the theory that there could be a role for a relative decrease in oestrogen, and consequently relative rise of androgens, cause hair loss.

There is, however, an inheritance pattern. Like men, women can inherit Female Pattern Hair Loss from either their mother or father. The number of genes inherited will determine how thin the hair becomes.

 

Presentation of Female Pattern Hair Loss

For most women, they will find that their centre part will be wider than usual. In general, they will find that the top and crown of their scalp is quite thinned out. For some they may have a more “Male Pattern” type of hair loss, with thinning and recession to the temples. The staging system used is the Ludwig Classification:

ludwig

 

Next month : Treatment

 

 

 

 

 

October’s QOM- What causes sores or cysts on the scalp?

questiontext
Greetings hair Doctor,. I recently shaved my hair bald due to hair loss. I’m experiencing painful sores or cysts on the scalp and they are tough to regrow patches. What should I do? I really want healthy hair.

answertext

Hi there,
It sounds like you could be having Dissecting Cellulitis, a very stressful and painful scarring type hairloss with recurrent sores or cysts on the scalp. Sometimes these sores or cysts on the scalp can ooze when they form sinuses or tracts. When they heal, they form scars which prevents regrowth of hair. Hence why you say it is tough to regrow hair in the affected areas.
You may have to be on long term antibiotics or other medications to help stop the progress of the condition. The best thing to do is to go to a dermatologist in order to be examined and have tests done including  a scalp biopsy so that you can find out what is wrong with your scalp. A fungal infection of the scalp can present in a similar manner, which can be easily cured with a course of antifungal medication.  Once you have determined the exact cause of your #hairloss, then hopefully you can get the best treatment for your condition.
Here’s a link showing what Dissecting Cellulitis looks like:
http://dermnetnz.org/acne/scalp-folliculitis.html
Here’s an article by the British Association of Dermatologists detailing the management of the condition:
http://ow.ly/Tiaj4

Hair Loss Disorders

So, after discussing the basic properties of hair, the next in the blog series will be on Hair Loss Disorders. There are two main types:

1. Non Scarring

These hair loss disorders may be due to hormonal or inflammatory processes which causes hair loss with hair follicles not being affected. Once the process resolves, or is treated, the hair will grow back. Examples of non-scarring hair disorders include: Female and Male Pattern Hair Loss (Androgenetic Alopecia), Alopecia areata, and Telogen Effluvium. Traction Alopecia is also non-scarring in its early stages.Extremely inflamed Psoriasis, Seborrhoeic Dermatitis and Contact Dermatitis have been causes of temporary non-scarring hair loss.

 

2. Scarring Alopecia

Scarring type alopecias usually result from an inflammatory process whereby the body, for whatever reason, attacks the hair follicle, destroying it in the process. The hair follicle is replaced by scar tissue, and as such, hair will not grow back. Most of these scarring hair loss disorders, if treated from very early, can have favourable outcomes with the hair growing back. Examples include: Traction alopecia, Lichen Planopilaris, Central Centrifugal Cicatricial Alopecia, Dissecting Cellulitis, Folliculitis Decalvans, Chronic Discoid Lupus Erythematosus.