Causes And Treatment Of Hair Loss In Women

Female pattern baldness and Hair loss in female occurs quite often. It can affect over one in four women when compared to men. Its also one of the most discussed and searched topic. Many women experience general thinning while others have a pattern of temple recessions. A detailed education about the causes of Hair fall in women is important to understand. Reason can range from a simple to temporary or more complex cases. They are proven medical methods and hair transplant treatment to fight with hair loss.

Causes of hair fall in women:

1. Post partum period [after child birth]
2. After discontinuing of OC pills
3. Post-febrile period [3 months after fever episode]
4. Crash diets
5. Psychological stress [loss of dear ones]
6. Anemia [most common cause in India]
7. Certain drugs [anti metabolites]
8. Dermatologic diseases.[Alopeciaareata]
9. Trichotillomania [self induced plucking of hair]
10. Hormonal disturbances. [Thyroid problems like hypothyroidism and Pcod etc..]
11. Vitamin deficiencies like VIT D and VIT12 etc..
12. Hyper vitaminosis of VIT A

When & why do women lose the hair?

Diffuse hair loss on the scalp occurs due to many causes in women like due to Telogen effluvium, Anagen effluvium, Hypothyroidism, Iron deficiency anemia, debilitating disease, serious emotional stress and may be due to certain drugs.

In women, there are two natural stages of increased hair loss seen. They are around 30 to 35 years age and post menopausal age. In this post menopausal stage there is a gradual thinning of individual hair strands is seen due to lack of estrogen.

Telogen effluvium-women are more prone for this type of hair fall. This type of loss follows after acute or chronic illness, sudden hormonal change, crash diets, deficiency of proteins and vitamins along with Iron and certain drugs like anti epileptics,[sodium valproate] beta blockers,anticoagulants,lithium and oral retinoids.

Fevers and Post surgical periods :

After 2-3 months of the episode heavy hair fall is noticed in most of the people. Generally the recovery starts from 5-6 months. Of course good nutrition and adequate rest are important along with proper medication.

Anagen effluvium- This occurs due to anti-metabolite drugs(chemotheraphy drugs) used to treat some cancers. Sudden complete loss of scalp hair occurs with total regrowth of the same after discontinuation of the medication. These chemotheraphy drugs acts on the Mitotic cell division.

A proper Diagnosis can be done with doctor’s examination only for the hair loss.

Stress and Nervous Disorders:

• The stress triggers a large number of hair follicles to enter the resting stage, so a few months after the stressful event; those follicles shed hair at about the same time.
• Sometimes self-induced hair plucking problem is noticed due to extreme stress. With proper psychological counseling and medication re growth occurs. This condition is called TRICHOTILLOMANIA. Mostly young women suffer with this problem.

Dermatologic Diseases:

Sometimes due to skin diseases permanent hair root destruction occurs with no regrowth on medication. These are called Cicatricial alopecia or scarring alopecia.

Example: Pseudo pelade, lichenplanus, lichenplanopilaris.etc..

Sometimes reversible hair loss occurs. Spontaneous or with medication hair will re grow. These are called Non-cicatricial or Non-scarring alopecia.

Example: Androgenic alopecia, Alopecia areata, Tinea etc.

Crash diets :

Some times people go for extreme weight loss in short time periods. These conditions leads to gross thinning and diffuse loss of hair over the total scalp. In these conditions total recovery is impossible even with proper diet and medication.

FPHL – Female Pattern baldness starts with thinning of the frontal tuft region then expanding to vertex. In most of the cases frontal hairline retains due to the Aromataze enzyme protection. This is the most widespread type of hair thinning and hair loss in females these days.

Treatment available for female pattern baldness

Medication:

Androgen receptors blockers for women

These are for AGA in women. It competes with DHT or Testosterone for the specific AR [androgen receptor] by inhibiting the androgen mediated process.

These are contraindicated in men.

Cyproterone acetate

It acts by blocking the binding of DHT to receptors. It can be combined with ethinyl estradiol for treating severe acne and hirsuitism. The dose generally to prevent hair loss is 2mg but upto 50 mg can be used per day. The hair loss prevention and increased hair thickness occurs by 1 year.

Side effects- weight gain, breast tenderness, depression etc

Spiranolactone

It is a Aldosterone antagonist and weak anti androgen. Generally used to treat hypertension.

It blocks AR and also inhibits the production of androgens from Adrenals. It only stops the further progression of hair loss, no regrowth seen.

Cimetidine Generally used to treat gastric acidity. It also prevents the binding of DHT to receptor.

Anti androgens – Ketoconazole is an anti androgen that can be safely used in both men and women. It is an anti fungal, antibiotic. It can be applied topically to the scalp. It does not show systemic effects.It prevents hair loss and dandruff also.

Minoxidil (For Women )

Minoxidil lotion-It is the first FDA approved topical lotion for hair regrowth. 2% lotion is initially approved for women but 5 % lotion also can be tried with excellent result.

It is a piperidinopyramidine derivative, which is a potassium channelopener and vasodilator and initially used as anti hypertensive agent.

This is a non specific biologic response modifier with an unknown mechanism of action.

• It converts intermediate follicles to Terminal hair.
• It halts the fall of miniaturized hairs by prolonging the life cycle.
• It stimulates the dormant hair follicles to regrowth.
• It should be continued for minimum of 6-8 months to notice the results. By the end of 3 months the hair fall will be arrested. In first 4-8 weeks fall of vellous hair is noticed. To prevent the existing hair from further damage the lotion must be continued longer time