While hair loss can take place in men as well as women, the character of both is different. Conditions that can cause hair loss in men, might not affect women the same way. This is why, in order to treat hair loss in women effectively, it is important to judge it properly first. In this article, we will look at one particular type of hair loss in women, commonly known as androgenetic alopecia in women.

Let’s first gain a clear understanding of what androgenetic alopecia in women actually is:

In men, when there is male pattern baldness or androgenetic alopecia, there are only certain spots where the hair loss is prominent. There are also sites on the head, which are stable and will always provide a source of donor hair. In these areas, the hair follicles are not affected by DHT or dihydrotestosterone, which is what causes for the hair follicles to shrink on other parts of the head. In most cases, the men will start losing their hair from the front part of their head, while the hair on the sides and back will remain somewhat intact.

However, in women who are suffering from pattern baldness, the so called donor areas it is unstable. The hair thins all over the head, and while there might be no obvious bald patches, the scalp will become very visible. In women, such a condition is often caused due to low oestrogen levels. Unlike men, women do not lose as much hair in the front part of the head as men. However, in them, the hair shafts start to become thinner by the day, and while the hair might not be losing in length; there is a very visible loss of hair volume.

It is because of reasons such as these that a hair transplant is much easier in men, as it is in women. In men, there are normally clear divisions between the donor areas and the recipient sites. However, with women, since there are no obvious bald spots, covering the same up is complicated. In most cases, women require a creation of volume on the top of the scalp, which is most often, difficult to achieve.

Now let’s take a look at how androgenetic alopecia in women actually works:

When a woman is said to be effected with androgenetic alopecia, it means that follicles have become sensitive to the androgens or hormones that are already existent inside the body. Inside each follicle there are androgen receptors and the androgens relay the message to the receptors that they should produce lesser hair. What this results in is that since the growing cycles are reduced, the remaining hair becomes thinner and loses volume as well. So, even there is no loss of follicles, hair production will come to an eventual stop.

Here is why pattern hair loss happens in women:

There is an enzyme which is known as 5 alpha-reductase – this enzyme exists within the hair follicle. When the hormone (normally testosterone, but also oestrogen in certain cases) attaches itself to the androgen receptor, the enzyme converts the hormone into DHT and it is this DHT that slowly destroys the production of new hair. This is why, any procedure or medication that prohibits the creation of DHT would be considered a legitimate method of tackling hair loss.

Some of the most prominent causes of androgenetic alopecia in women are:

The word androgenetic means that there is an underlying genetic reason for the condition. Some of the other reasons that could lead to this condition include irregularities in the menstrual cycle, acne, hirsutism and even a high level of testosterone, which could happen naturally in the body.

There are certain birth control pills that are known to accelerate hair loss, and then there are some birth control pills, which play havoc once you stop taking them. This is why it is crucial that you talk to your doctor, before starting or stopping any such medicines. However, it is pregnancy that is the most common cause of pattern hair loss in women. The stress that the body goes through, right before and after menopause also leads to the condition.

Moving onto how the condition can be handled and in certain cases, even treated:

Since there are numerous causes that could lead to pattern hair loss in women, most doctors will not suggest a hair transplant or restoration procedure immediately. In most cases, they will recommend medications that will stimulate hair growth, and if those do not work, they will move onto anti-androgens or DHT inhibitors. At times, the doctor might prescribe a combination of anti-androgens and growth stimulants, because it might help handle two issues at the same time.

However, it is important that the exact cause of the hair loss be determined, because the precise course of treatment can be decided only after that.

There are certain blood tests that might be prescribed in order to determine the exact cause of the hair loss:

Some of the most commonly prescribed tests include:

  • Complete blood count to determine haemoglobin/haematocrit levels
  • Total Iron Binding Capacity (TIBC) as well as iron and serum ferritin
  • DHEA and DHEA Sulphate
  • Follicle Stimulating (FSH) and Thyroid Stimulating Hormone (TSH)
  • Thyroid tests, such as T-3 and T-4
  • Androstenedione, Prolactin and Leutinizing Hormone
  • Total and free testosterone

Here are some of the most commonly used treatments, meant for women suffering from pattern hair loss:

  • Growth stimulants – In order to ensure that there is growth of new hair, most doctors will prescribe growth stimulants. If the hair loss has been caused due to imbalances in thyroid or due to pregnancy, the stimulants should take care of the same.
  • Anti-androgens and androgen blockers – Androgen blockers will ensure that over activity of the same does not play truant with your hair growth.
  • Anti-inflammatories – It is important that the scalp is always relaxed, because only then will there be proper hair growth. If there is any inflammation, such medicines will take care of the same.
  • Combining all three – In severe cases, the doctor might prescribe a combination of all three.

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“Hi, I am Mr. Goel, 32 year old male, I am Suffering from alopecia. Can you please tell me what and why I am suffering from this condition”.

Hi, Mr. Goel First of all, I would like to thank you for mailing us to know more about alopecia. The hair loss or Alopecia has got many causes and the most common cause is Androgenic alopecia.

It is a type of hair loss which is carried through the genes and is known to affect both men and women. In non-medical terms, this condition is known as male pattern baldness and female pattern baldness respectively. In such a scenario, the hair loss can start at a very early age, and there is minimal chance for regrowth. We are able to diagnose the same by observing the receding hairline and the loss of hair from the front part of the scalp. In women, this condition occurs post their 40s and for them, we have observed that there is general thinning, as opposed to men, in whom there is localised balding.

Apart from this, there are numerous other types and categories of the same. For instance, involutional alopecia is a naturally occurring condition, in which the hair starts to thin with age. This happens most often, because of more hair going into the resting phase, which leads to reduced numbers and length.

On the other hand, there is alopecia areata, which attacks the hair of young people, mostly children. In rare cases, there is something called alopecia totalis, wherein there is complete baldness with loss of entire scalp hair. However, in most cases, the hair regrows in some time. There is also a more severe version of alopecia known as alopecia universalis, wherein the hair from all parts of the body are also lost, including the eyebrows and lashes.

Then there is the condition that in medical terms is known as  telogen effluvium and is a thinning of hair, that is short lived. This happens during the transition periods between the anagen-catagen or catagen-telogen phases. Since hair is in a rest period, there is thinning and shedding, but this is generally not an elongated phase.

It will be better if you can send your pictures to us from the front top, Sides and back to give us a better picture and then we can suggest to you the treatment for the same.

Line diagram with age on X axis, percentage of baldness Y axis…

20 years 20%
30 yrs 30%
40yrs 40%
50 yrs 50%
60 yrs 60%
70 yrs 70%

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Hair loss has a major effect on every one in many ways. It dents our physical attractiveness if we experience thinning. When hair loss is noticeable, the person will try and search for the thinning causes in relation to the hair shedding. In the normal hair cycle, hair grows about half an inch per month, though this tends to slow a little as you get older. As hair gets older, it may enter a resting stage in which it remains on your head but doesn’t grow.

At the end of this stage, the hair usually fall out. The follicle replaces it in about six months. During this time, your hair is in its resting stage. The result can be that your hair falls out early or isn’t replaced. It is the degree of thinning that defines whether loss is a problem that can be addressed. There are many factors that can be attributed to hair loss besides aging, such as pregnancy, poor nutrition, hair pulling disorder, scalp infections, medical conditions, stress, hormonal changes, hereditary loss and prescription medications. There are a number of causes which may contribute to hair loss.

Androgenetic Alopecia

Androgenetic alopecia, also known as male-pattern baldness, is the main reason for thinning hair. It causes 95 percent of all loss. Male-pattern baldness happens when large, active hair follicles change to smaller, less active ones under the effect of dihydrotestosterone, or DHT. If an individual has androgenetic alopecia the overall levels of testosterone may be normal however the activity of 5 alpha reductase is greater than normal which results in increased amounts of dihydrotestosterone in the follicle.

Alopecia Areata

Alopecia areata is an autoimmune disease with unknown causes that typically affects people who are in otherwise good health. An environmental trigger such as a virus may set it off in people who have a genetic predisposition for the condition. With alopecia areata, your hair will usually grow back, although you may lose and re-grow it several times. White blood cells called T-lymphocytes attack the follicle which causes the hair to stop growing and enter into the telogen (resting) phase, then about 3 months later, when the resting phase is over the will then fall out. Only when T-lymphocytes stop attacking the hair follicle will new hair grow.

Cicatricial Alopecia

Cicatricial or scarring alopecia occurs when a skin condition such as lupus erythematosus or lichen planus causes inflammation that scars the hair follicle, preventing new hair from growing. The condition is permanent.

Telogen Effluvium

Telogen effluvium occurs when there is an emotional or physical stress that causes the hair roots to prematurely enter a resting state. In this a sudden or stressful event can cause the follicles to prematurely stop growing and enter into a resting phase. This occurs when there is a change in the number of follicles growing hair. If the number of follicles producing hair drops drastically for any reason during the resting, or telogen phase, there is a significant corresponding increase in dormant, telogen stage hair follicles. Accordingly the result is shedding, or effluvium hair loss. This will then appear as diffuse thinning of hair on the scalp, which may not be even all over.

Other Causes

Pulling disorder can cause thinning too and is called as Traction alopecia. If the pulling is stopped before permanent damage to the root occurs, the hair will usually grow back normally. Chemicals used for bleaching, dying, tinting or straightening cause hair to thin if they are used incorrectly. Excessive brushing can also damage the shaft, causing loss. Poor nutrition, eating disorders and diets lacking protein or iron can cause thinning and loss. The important nutrients for healthy hair include calcium, vitamin D, biotin, sulfur, folic acid, essential fatty acids (flaxseed oil, primrose oil, fish oil), inositol, magnesium, zinc and B vitamins, particularly B5 (pantothenic acid), B3 (niacin) and B12 (coblamin). Most of these vitamins and minerals can be found in a multi-vitamin. High protein foods include eggs, seafood, red meat, dairy food, legumes, nuts and seeds. Foods rich in iron include red meat, dates, prunes, dark-green leafy vegetables, tofu, certain whole grains, oat bran, wheat germ and fortified cereals. Certain medicines which are taken to treat depression, high blood pressure, arthritis or gout can also cause thinning. Birth control pills for women and diseases such as lupus, scalp infections and diabetes can cause loss as can chemotherapy and radiation treatments. Hormonal changes such as pregnancy, menopause and childbirth may cause temporary loss in some women.

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