WOMEN’S HAIR LOSS

Alopecia in women

When we hear the word “baldness” the most common is to relate this condition to middle-aged men. However, teenagers as well as middle-aged women also suffer from alopecia, and its effects are equally traumatic as silky, long, shiny and abundant hair are synonymous with feminine beauty.

Hair loss affects men and women equally; although it is less frequent in women, female pattern alopecia has received little attention from society and science, probably because they have more options for hairstyles, wigs and accessories such as hats to disguise hairless spaces. However, bald men are socially recognized and accepted, while bald women are often discriminated.

What is alopecia?

Alopecia means hair loss; although it is usually related to the word baldness, this term is not correct, since it excludes conditions that cause loss of capillary density, but not a situation of obvious fall, as in the case of female alopecia.

Women androgenic alopecia is known as female pattern alopecia (FPA) because it has its own characteristics, etiological and clinical peculiarities, evolution and treatment that differentiate it from the conditions that affect men.

FPA is a type of non-scar alopecia, which occurs in women slowly and progressively, affecting capillary density and the scalp. In this condition, the anagen-telogen cycle is minimized, so that follicular cycles produce shorter, smaller-diameter hair because the follicles are miniaturized and, in more advanced stages, invisible. That is, the follicles are still present in the female scalp, but in an atrophic state.

In female alopecia, genetic factors and hormonal alterations are involved due to male hormones known as androgenic, which gives the name of androgenic alopecia. However, the genetic relationship and the presence of androgens is not clear, since both factors are not present in all cases.

FPA is the most frequent hair loss form in women, affecting more than 50% throughout their lives being more frequent starting at 50 years of age, although in some cases the process begins at puberty or around 30 years.

Types of alopecia in women

Androgenic alopecia. It is estimated that about 30% of women with FPA have signs of hyperandrogenism, an excess of male hormones, with other clinical manifestations such as facial hair or hair in areas such as the chest or arms, acne resistant to treatment, galactorrhea, infertility or menstruation alterations.

Telogen effluvium or “stress hair loss”. Diffuse and abundant hair loss in localized and generally circular areas that may be due to poor diet, stress, depression, due to the action of certain medications that are consumed constantly (heparin, antiretrovirals, aspirin, among others), chronic diseases such as diabetes and autoimmune pathologies.  Although this type of alopecia affects men and women, it usually has a higher incidence in women, although it can be completely reversed with the appropriate treatment.

Alopecia areata. This condition is related to autoimmune diseases, in which the body attacks and destroys healthy hair follicles; in women it is very common after a pregnancy, where a cycle of hair loss in strands begins, but that ceases on its own after a few months, and the hair grows back, although slowly.

Fibrosing frontal alopecia. It is a type of scar alopecia, which causes hair follicle destruction and usually occurs in the postmenopausal stage, mainly affecting the headband area.

Traction alopecia. Hair loss that occurs due to a constant overstretching of the hair, which happens when wearing grabbed hair and tightened hairstyles, which can cause permanent hair loss by damaging the hair follicles.

What are alopecia causes in women?

FPA causes are similar to those affecting men; hormonal and genetic factors are considered; the hereditary component is important since a gene related to alopecia has been found in the chromosomes.

Regarding the hormonal factor, women produce androgens in three organs: adrenals, ovaries and non-endocrine tissues such as the skin. The testosterone produced by the female organism is transformed into dehydrotestosterone, which exerts a reducing action of estradiol, a female hormone and forms an activated complex that enters the cell nucleus and causes the sebaceous glands to increase in size as well as increasing their secretory activity, while causing the miniaturization of the follicle. In short, this process causes an increase in fat in the scalp, which subtracts nutrients from the follicles, weakens them and kills them little by little.

Therefore, menopause is a stage in which female alopecia occurs due to hormonal imbalances caused by low estrogen and an increase in male hormones or androgens.

Other FPA causes are: chronic stress, autoimmune diseases, lupus, diabetes, anemia, a nutrient-poor diet and vitamin deficits.

Symptoms of alopecia in women

• Gradual hair loss on the top of the head. This is the most common form in women, and usually occurs in women after menopause, who notice a widening in the hairline, or a receding hairline on the forehead.
• Irregular or circular patches. Some women lose their hair in patches, a situation that is usually accompanied by itching or pain in the skin before it falls out.
• Hair loosening. This is usually caused by stress or depression situations: women notice that hair strands fall out when combing or bathing, even when pulling it gently.
• Hair loss from other parts of the body. On some occasions, hair loss is accompanied by loss of eyebrows, hair on arms or legs, even eyelashes.

Diagnosis

It is essential to go to a specialist to diagnose the cause of alopecia in women: either temporarily after childbirth, due to an autoimmune disease, or detect FPA in time and treat it before it leaves serious consequences.

The specialist will make an extensive medical history and may require hormonal, blood chemistry, and thyroid factors to rule out other conditions.

Treatment

FPA treatment involves a multidisciplinary action in which etiological factors, cosmetic care and hair strengthening are considered. The most common are:

Topical treatments. Drugs such as minoxidil, cyproterone acetate or finasteride stimulate hair growth but must be administered by professionals as some are contraindicated in pregnancy or lactation cases. In addition, these treatments do not always give results when applied without medical indication and can worsen hair loss.

Vitamin supplements. In some cases, iron, zinc, biotin, vitamin B supplementation among others, helps treat nutritional deficits, in addition to strengthening the hair and improving the skin appearance.

Hair transplant in women. The definitive and proven solution to combat the effects of alopecia. It is an invasive method that requires professional attention with follicles micro grafting techniques containing one to three hairs to cover the affected areas.

Others. Hair mesotherapy, Platelet Rich Plasma, growth factors are some treatments that nourish the follicles, stimulate growth and strengthen the hair to restore its health and shine.

If you suffer the consequences of hair loss, at HairFix we can help you. Remember that a good diagnosis is essential for good treatment. Contact us and let us assess your situation at no cost.

Alopecia in women