Dermatologists Help Women Fight Common Forms of Hair Loss

For women unexplained hair loss can take a psychological toll on their overall outlook and quality of life. From changing their hairstyles to hide the thinning to scaling back their hair care treatments in an effort to stop further hair loss, women try numerous ways to cover-up this problem — and the results are not always successful. A much better option is to consult a dermatologist, a doctor trained in the care of skin, nails and hair, who can diagnose and, in most cases, successfully treat hair loss in women.

Speaking at the Annual American Academy of Dermatology Meeting, dermatologist Mary Gail Mercurio, MD, FAAD, an associate professor of dermatology and director of Dermatology Residency at the University of Rochester in Rochester, New York, discussed common forms of hair loss in women and the available treatment options.

“In the past, many women experiencing hair loss would suffer in silence, not knowing where to turn for help and trying their best to hide the problem,” said Doctor Mercurio. “But now, I see more and more women in my practice seeking treatment for hair loss and actively addressing this condition. That’s encouraging, as the sooner hair loss is diagnosed, the better our chances of successfully treating it.”

Female Pattern Hair Loss: Very Common and Very Treatable

The most common form of hair loss for women is known as female-pattern hair loss and is usually from genetic inherited from either the father or mother. Also known as androgenetic alopecia, this kind of hair loss can begin as soon as the late teens — and the sooner it starts, the more severe the hair loss tends to be.

While pattern hair loss affects both women and men, it is very different in women. For example, female pattern hair loss does not involve a bald spot on top of the scalp or a receding hairline as is common in men. In women the hairline in front is usually maintained, but there is visible thinning over the crown. In addition, in both men and women, hairs are shorter due to a shorter growth cycle where the hair stays on the head for a much shorter period of time. These wispy hairs, which resemble forearm hairs, are not able to achieve their usual length.

“For women, the first sign of hair loss that they often notice is a widening of their part or their ponytail is smaller,” said Doctor Mercurio.

The Food and Drug Administration (FDA) has approved these topical medications: Minoxidil 2% for female-pattern hair loss and minoxidil 5% for male-pattern hair loss. However, Doctor Mercurio said that minoxidil 5% has been found to be very effective in treating women.  She encourages women to consult a dermatologist before starting the treatment as it can sometimes increase facial hair growth. Both the two percent and five percent solutions are available over the counter in liquid form, and the five percent is also available in a foam. Minoxidil does not grow new hair, however, it works by prolonging the growing phase of hair – this allow more time for hair to grow out to its full density.  Women must be patient with the treatment because noticeable results usually takes atleast three or four months and the product must be used two times per day.

Since there are no structural problems with the hair women with female-pattern hair loss, should continue their normal hair styling regimen. “Sometimes women experiencing hair loss think they should stop washing, coloring or perming their hair, but these things won’t impact the course of hair loss or speed up the process,” said Doctor Mercurio.

In some cases, Doctor Mercurio explained that a hormonal imbalance such as androgens (excess male hormones), may be responsible for hair loss in women. A clue that hormones are involved is if the hair loss pattern resembles that of a man’s hair loss. Female pattern hair loss caused by a hormonal imbalance is usually treated with prescription medications including spironolactone or oral contraceptives, but women must see their dermatologist for professional diagnosis and treatment.

Doctor Mercurio added that another hair loss treatment option is hair transplantation, whereby tiny hair follicles are taken from one area of the scalp are transplanted into the affected areas. This approach to restoring lost hair can be effective and produce permanent results that are very natural looking.

“I would urge women who are considering hair restoration surgery to find a dermatologist who is very experienced with hair transplants for women, and as a result, will be more aware of the nuances of female hair loss,” said Doctor Mercurio.

Hyperandrogenism: The Root of this Medical Condition

Hyperandrogenism, is a medical condition characterized by excessive production of male hormones (androgens) and can cause hair loss in affected women. The most common cause of female hyperandrogenism is polycystic ovary syndrome, also known as functional ovarian hyperandrogenism. Other signs of this female endocrine disorder, besides hair loss, include acne, obesity and irregular menstruation, and it is one of the most common causes of infertility.

Occassionally women affected by hair loss due to functional ovarian hyperandrogenism may also develop metabolic syndrome, a combination of medical conditions that can lead to an increased risk of cardiovascular disease and diabetes. In these instances, Doctor Mercurio explained that dermatologists may diagnose a serious systemic problems where hair loss was the first visible signs of a problem.

“Dermatologists know that hair loss could be an important clue that something else is going on inside the body, such as a hormonal abnormality, lupus, or thyroid disease,” said Dr. Mercurio. “That’s why I can’t stress enough the importance of getting an accurate, and early, diagnosis for hair loss.”

Hair loss caused by hyperandrogenism can be treated with minoxidil, however, Doctor Mercurio said that the final treatment depends on what other conditions are involved and how those ailments are being treated.

Scarring Alopecia: Preventing Further Hair Loss is Key

Cicatricial alopecia (scarring alopecia)is a form of hair loss in men and women marked by scarring of the scalp when the hair follicle is destroyed. Unlike other forms of hair loss, cicatricial alopecia causes scattered patches of hair loss and is usually includes redness and / or irritation on the scalp. While there is no known cause for scarring alopecia, it occurs often when patients have either an immune system disorder, lichen planus, lupus or an inflammatory skin disease.

“Unfortunately, with this type of hair loss there is no potential for the affected hair to grow back,” said Dr. Mercurio. “The goal with treatment is to catch the condition as early as possible to prevent further hair loss.”

Doctor Mercurio added that the inflammation can be reduced with injectable, topical or oral medications, such as anti-malarial drugs or corticosteroids, and minoxidil is not used for cicatricial alopecia. Treatment depends on the severity of the conditions, and patients with this form of hair loss must be closely monitored by a dermatologist throughout the treatment.

“Hair loss is an important concern for a large number of women, and ongoing research in this area will continue to produce effective treatments,” said Doctor Mercurio. “Some of the new laser and light-based therapies used for hair loss show promise in preliminary studies. We hope that these technologies will allow dermatologists to further expand our treatment options for all forms of hair loss in the future.”

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