In Today’s article, we will look into the stages of female pattern baldness and the best treatment options for hair loss in women. In my previous article, we discussed on the causes and mechanism of female hair loss and hair thinning and the telogen effluvium.
The pattern of hair loss in women is different from that in men. We have discussed male pattern baldness and its stage wise treatment in earlier episodes. Now we will discuss stages wise treatment of female pattern baldness – that’s again androgenetic alopecia.
The male pattern hair loss is typically seen at the front of the hairline and at the crown of the head, whereas women with androgenetic hairloss more often have diffuse thinning on all areas of the scalp but thinning starts typically at the front portion of the scalp. Remember the reduction in hair thickness and density leads to a reduction in the overall hair volume. But complete baldness in women is very rare.
The stages of hair loss in women is measured by different scales. One simple and the conventional scale used is the Ludwig’s scale. This scale has three stages. In all three stages, the hair line is preserved unlike the male pattern baldness, where hair line recedes and then completely lost.
Stage – 1: There is minimal thinning of hair at the front portion of the scalp as you can see in the illustration. This type of hair loss can be easily covered or hidden by hair styling techniques. But this does not mean that you should not start treatment at this stage. We will discuss treatment options later.
Stage – 2: There is moderate thinning and noticeable widening of the mid-line part.
Stage – 3: There is much more diffuse thinning, with a see-through appearance on the top of the scalp or the thinning is seen over the entire scalp.
Now lets discuss on the treatment options for hair loss in women.
Firstly you need to confirm this is androgenetic alopecia and rule out other causes of hair loss like PCOS, thyroid disease and other causes as discussed in my previous article.
The first line of treatment for female pattern baldness is:
- MINOXIDIL solution: This is the first and foremost medication used for the treatment of hair loss in females as well as males and easily available over the counter medication without any prescription. This is an FDA approved medication for hairloss. In women generally 2 % or 5 % minoxidil applied on the affected area of scalp once or twice daily is used. 2 % is used for the treatment of Stage 1 and 5% solution is used for stage 2 and 3 . This is important to prevent you from going into stage 2. The higher the stage, the more difficult the treatment is. And remember minoxidil is not a miracle drug. You need to consistently apply it for alteast 3 to 6 months to see some obvious improvement. If minoxidil works for you, then you need to keep using it daily to maintain those good results. If you stop abruptly, you’ll start to lose hair again. Also You must know how to properly use minoxidil solution. Use the dropper or the spray pump and apply on a dry scalp on the affected area and gently massage with your fingers in a circular movement. Do not over do it and also prevent it from going into your eyes. Then wash your hands thoroughly after use. Do not shampoo you hair for at least four to six hours after application. If this is causing irritation on you scalp, then its more likely a contact dermatitis. You might need to consult your doctor. It actually not caused by minoxidil, but the alcohol content in minoxidil solution causes this irritation.
- Anti Androgens: This type of treatment has to be taken by consulting your doctor. Some women who don’t respond to minoxidil are prescribed with the anti-androgen drug spironolactone for treatment of androgenic alopecia. This is usually prescribed to women with polycystic ovary syndrome (PCOS) because they tend to make excessive androgens that cause hairloss as discussed in my previous episode.
- Hair transplantation: This is the final option, if no treatment works.