An overview of female pattern hair loss. (June 2011) - Patel, Mansi
Female pattern hair loss (FPHL) is the most common cause of hair loss in women at any age. Clinical presentation of FPHL differs from its male counterpart, male pattern baldness. Women tend to present earlier with a reduction in hair volume from diffuse thinning over the crown and rarely with fronto-temporal recession. The diffuse hair thinning results from androgen-mediated miniaturization of hair follicles in addition to decrease in hair fiber length. Histologically, hair follicle miniaturization and a decrease in terminal-to-vellus hair ratio are diagnostic features of FPHL, and are also identical to that seen in male pattern baldness. The role of androgens in FPHL has not been clearly established, and most women with androgenetic alopecia have normal serum androgen levels; however, antiandrogen medications can still be effective in the treatment. Several medical treatments are available for the management of FPHL, with variable efficacy. Other measures to camouflage hair loss are popular. Increasingly, for many women hair transplantation is a suitable option. While an association between female androgenetic alopecia and cardiovascular disease risk factors has recently been suggested, the morbidity associated with this condition is mostly psychosocial and clinicians need to be aware of it to address it appropriately.