Female pattern hair loss

Ingrid Herskovitz, Antonella Tosti

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Context: Female pattern hair loss (FPHL) also known as female androgenetic alopecia is a common condition afflicting millions of women that can be cosmetically disrupting. Prompt diagnosis and treatment are essential for obtaining optimal outcome. This review addresses the clinical presentation of female pattern hair loss, its differential diagnosis and treatment modalities. Evidence Acquisition: A) Diffuse thinning of the crown region with preservation of the frontal hairline (Ludwig's type) B) The "Christmas tree pattern" where the thinning is wider in the frontal scalp giving the alopecic area a triangular shaped figure resembling a christmas tree. C) Thinning associated with bitemporal recession (Hamilton type). Generally, FPHL is not associated with elevated androgens. Less commonly females with FPHL may have other skin or general signs of hyperandrogenism such as hirsutism, acne, irregular menses, infertility, galactorrhea and insulin resistance. The most common endocrinological abnormality associated with FPHL is polycystic ovarian syndrome (PCOS). Results: The most important diseases to consider in the differential diagnosis of FPHL include Chronic Telogen Effluvium (CTE), Permanent Alopecia after Chemotherapy (PAC), Alopecia Areata Incognito (AAI) and Frontal Fibrosing Alopecia (FFA). This review describes criteria for distinguishing these conditions from FPHL. Conclusions: The only approved treatment for FPHL, which is 2% topical Minoxidil, should be applied at the dosage of 1ml twice day for a minimum period of 12 months. This review will discuss off-label alternative modalities of treatment including 5-alfa reductase inhibitors, antiandrogens, estrogens, prostaglandin analogs, lasers, light treatments and hair transplantation.

Original languageEnglish
Article numbere9860
JournalInternational Journal of Endocrinology and Metabolism
Volume11
Issue number4
DOIs
StatePublished - Oct 1 2013

Fingerprint

Alopecia
Differential Diagnosis
5-alpha Reductase Inhibitors
Minoxidil
Galactorrhea
Estradiol Congeners
Synthetic Prostaglandins
Hyperandrogenism
Alopecia Areata
Therapeutics
Androgen Antagonists
Hirsutism
Menstruation
Polycystic Ovary Syndrome
Acne Vulgaris
Scalp
Crowns
Hair
Infertility
Androgens

Keywords

  • Alopecia, physiopathology
  • Alopecia, therapy
  • Androgen antagonist, therapeutic use
  • Female
  • Polycystic ovary syndrome
  • Sminoxidil

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism

Cite this

Female pattern hair loss. / Herskovitz, Ingrid; Tosti, Antonella.

In: International Journal of Endocrinology and Metabolism, Vol. 11, No. 4, e9860, 01.10.2013.

Research output: Contribution to journalArticle

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