Female pattern hair loss

Abstract

Female pattern hair loss (FPHL) is a common cause of hair loss in women characterized by diffuse reduction in hair density over the crown and frontal scalp with retention of the frontal hairline. Its prevalence increases with advancing age and is associated with significant psychological morbidity. The pathophysiology of FPHL is still not completely understood and seems to be multifactorial. Although androgens have been implicated, the involvement of androgen-independent mechanisms is evident from frequent lack of clinical or biochemical markers of hyperandrogenism in affected women. The role of genetic polymorphisms involving the androgen and estrogen receptors is being increasingly recognized in its causation and predicting treatment response to anti-androgens. There are different clinical patterns and classifications of FPHL, knowledge of which facilitates patient management and research. Chronic telogen effluvium remains as the most important differential diagnosis. Thorough history, clinical examination, and evaluation are essential to confirm diagnosis. Patients with clinical signs of androgen excess require assessment of biochemical parameters and imaging studies. It is prudent to screen the patients for metabolic syndrome and cardiovascular risk factors. The treatment comprises medical and/or surgical modalities. Medical treatment should be initiated early as it effectively arrests hair loss progression rather than stimulating regrowth. Minoxidil continues to be the first line therapy whereas anti-androgens form the second line of treatment. The progressive nature of FPHL mandates long-term treatment for sustained effect. Medical therapy may be supplemented with cosmetic concealment in those desirous of greater hair density. Surgery may be worthwhile in some carefully selected patients.

Association of metabolic syndrome with female pattern hair loss in women: A case–control study

“…The pathophysiology of FPHL is still not completely understood and seems to be multifactorial. 1 Previous studies have demonstrated an association between AGA and chronic diseases, including hypertension, 2 abnormal serum lipid profile, 3 obesity, 4 insulin resistance, 5 cardiovascular disease (CVD), 6 prostate cancer, benign prostatic hyperplasia, 7 and some environmental factors, such as smoking. 8 However, other studies failed to confirm such positive associations.…”

Current issues on the genetic implications and treatment of androgenic alopecia

“…Aproape toţi pacienţii cu alopecie au calitatea vieţii scăzută, scăderea stimei de sine având un impact major. În funcţie de impactul emoţional şi de stadiul alopeciei, se poate interveni prin consiliere, psihoterapie sau terapia cu anxiolitice în cazurile severe (11,12,13).…”

“…Nu există dovezi clare care să sprijine utilizarea suplimentelor orale de aminoacizi, biotină, zinc şi alţi micronutrienţi în căderea părului de orice origine (11).…”

Female pattern hair loss

“…Testosteron veya DHEA-s yüksekliğinde konjenital adrenal hiperplazi için tarama uygun olur. SHBG düzeyleri de yol gösterici olabilmektedir 1,2,9 . Yapılan çeşitli araştırmalarda KTSD olan kadınlarda normal popülasyona göre bozulmuş glükoz toleransı, insülin ve c-peptid düzeyleri, insülin direnci, aterom plakları saptanmıştır.…”

“…Yapılan çeşitli araştırmalarda KTSD olan kadınlarda normal popülasyona göre bozulmuş glükoz toleransı, insülin ve c-peptid düzeyleri, insülin direnci, aterom plakları saptanmıştır. Erken başlangıçlı KTSD'de bile hastaların koroner arter hastalığı ve insülin direnci riskleri açısından araştırılması gerektiği bildirilmektedir 9 .…”