Dr. Bertram Medical Hair Transplant 眉 髮 醫 學 移 植 中 心 ( 香 港 )
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Hair Loss in Women - Hormone Related Female Pattern Hair Loss
Classification of FPHL
There are three main patterns of hair loss.
1. Male Pattern
Thinning of the hairline and the crown similar to men. Classification is by the Norwood System.
2. Centrifugal Pattern
Central and possibly lateral thinning with sparing of the hairline. Classification is by the Ludwig System.
3. Christmas Tree Pattern
Accentuation of frontal Loss breaching the frontal hairline. The loss is widest in front tapering towards the crown. Classification is by the Olsen's System.
Incidence
FPHL affects 5% of the female population accounting for 65% of all hair loss. Thinning begins in late 20s and peak after menopause. Those with earlier onset tend to develop more severe degrees of alopecia.
Causes
FPHL is a form of androgenetic alopecia with a multi-factorial, genetically determined trait. Both androgen-dependent and androgen-independent mechanisms plus a biologically normal aging process is involved. Female and male members of the family may both be affected.
Majority has normal type II 5-α reductase levels and normal DHT level in scalp skin. Elevated androgen level were seen in 16% of women with hair loss alone, and 79% if associated with hirsutism or menstrual disturbance.
Recommendation Investigation
Baseline
Complete Blood Count
Ferritin ( Iron storage )
Thyroid Hormone Profile ( T4, TSH )
Hirsutism or Menstrual Disturbance
Androgen Profile ( DHEA, Total Testosterone ) and
Pelvic Ultrasound
Treatment
Minoxidil 2-5% applied twice daily
Anti-androgen medication may be prescribed for hirsutic or postmenopausal female
Finasteride is contraindicated in female of child-bearing age. Its efficacy after menopause is controversial
Hair transplant to restore hairline or fill in small areas
Hairpieces and hair additions may be the best option
