Female pattern Baldness


   

Female pattern hair loss (FPHL) is a distinctive form of hair loss that occurs in women with androgenetic alopecia. Many women are affected by FPHL. In fact, around 40% of women by age 50 show signs of hair loss and less than 45% of women actually reach the age of 80 with a full head of hair.

In FPHL, there is diffuse thinning of hair on the scalp due to increased hair shedding or a reduction in hair volume, or both. It is normal to lose up to 50-100 hairs a day. Another condition called chronic telogen effluvium also presents with increased hair shedding and is often confused with FPHL. It is important to differentiate between these conditions as management for both conditions differ.

FPHL presents quite differently from the more easily recognizable male pattern baldness, which usually begins with a receding frontal hairline that progresses to a bald patch on top of the head. It is very uncommon for women to bald following the male pattern unless there is excessive production of androgens in the body.

What causes female pattern hair loss?
FPHL has a strong genetic predisposition. The mode of inheritance is polygenic, indicating that there are many genes that contribute to FPHL, and these genes could be inherited from either parent, or both. Genetic testing to assess risk of balding is currently not recommended, as it is unreliable.

Currently, it is not clear if androgens (male sex hormones) play a role in FPHL, although androgens have a clear role in male pattern baldness. The majority of women with FPHL have normal levels of androgens in their bloodstream. Due to this uncertain relationship, the term FPHL is preferred to ‘female androgenetic alopecia’.

The role of oestrogen is uncertain. FPHL is more common after the menopause suggesting oestrogens may be stimulatory for hair growth. But laboratory experiments have also suggested oestrogens may suppress hair growth.

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