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Female pattern baldness involves a typical pattern of hair loss in women, due to hormones, aging, and genes.
Alopecia in women; Baldness - female; Hair loss in women; Androgenetic alopecia in women
A hair grows from its follicle at an average rate of about 1/2 inch per month. Each hair grows for 2 to 6 years, then rests, and then falls out. A new hair soon begins growing in its place. At any time, about 85% of the hair is growing and 15% is resting.
Baldness occurs when hair falls out and normal new hair does not grow in its place. The reason why new hair does not grow in female pattern baldness is not well understood, but it may be related to:
Hair loss can occur in women for reasons other than female pattern baldness, including the following:
Hair thinning is different from that of male pattern baldness. In female pattern baldness:
Itching or skin sores on the scalp are generally NOT seen.
Female pattern baldness is usually diagnosed based on:
The doctor will examine you for other signs of too much male hormone (androgen), such as:
A skin biopsy or other procedures or blood tests may be used to diagnose skin disorders that cause hair loss.
Analyzing the hair itself does not accurately diagnose nutritional or similar causes of hair loss, although it may reveal substances such as arsenic or lead.
The hair loss in female pattern baldness is permanent, if not treated. In most cases, hair loss is mild to moderate. You do not need treatment if you are comfortable with your appearance.
The only drug or medication approved by the United States Food and Drug Administration (FDA) to treat female pattern baldness is minoxidil, used on the scalp.
In women who do not respond to minoxidil, oral spironolactone may be added.
Hair transplants remove tiny plugs of hair from areas where hair is thicker, and place them in areas that are balding. This can cause minor scarring where the hair is removed, and carries a slight risk for skin infection. Many transplantation sessions are usually needed, which can be expensive. However, the results are often excellent and permanent.
The use of hair implants made of artificial fibers was banned by the FDA because of the high rate of infection.
Stitching (suturing) hair pieces to the scalp is not recommended. It can result in scars, infections, and abscess of the scalp.
Hair weaving, hairpieces, or a change in hairstyle may disguise hair loss and improve your appearance. This is often the least expensive and safest way to deal with female pattern baldness.
Complications are psychological stress and a loss of self-esteem due to change in appearance.
Call your health care provider if you experience hair loss and it continues, especially if you also have itching, skin irritation, or other symptoms. There might be a treatable medical cause for the hair loss.
There is no known prevention for female pattern baldness.
Habif TP. Hair diseases. In: Habif TP, ed. Clinical Dermatology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2009:chap 24.
Mousney AL, Reed SW. Diagnosis and treating hair loss. Am Fam Physician. 2009;80:356-362.