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Alopecia in women

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Alopecia is the medical term for hair loss or baldness. There are several different types of alopecia, such as androgenetic alopecia and alopecia areata, which cause different kinds of hair loss. Most kinds of alopecia affect the head, but some kinds also affect hair on the face and the body.

Though men are more commonly associated with hair loss, women can also be susceptible to certain forms of alopecia. If you’re a woman concerned about losing your hair, read on for a guide to alopecia in women.

Signs of alopecia in females

Alopecia in women can affect the scalp and other areas of the body including eyebrows. One of the first signs of alopecia is a small bald patch, it could be as small as a coin and can go unnoticed depending on your hair style. Alopecia tends to develop quickly, so it’s important to speak to a doctor if you think you’re experiencing hair loss.

Symptoms of alopecia in women

The main symptoms of alopecia in women is sudden, patchy hair loss on the scalp or other areas of the body where hair grows. These patches can grow larger and join up to cover most of your scalp. Some women may find that their hair loss happens so fast that they don’t get patches.

Other symptoms of alopecia areata include:

  • Changes to colour and thickness of nails
  • Hair loss accompanied by tingling, burning or itching scalp
  • Hair loss with headaches or pain in the scalp

What is the most common form of alopecia in women?

It’s thought that the most common form of alopecia in women is androgenetic alopecia, which is usually referred to as female pattern baldness. In women, androgenetic alopecia causes widespread thinning on the scalp; normally it becomes noticeable at the parting before spreading gradually across the crown.

Unlike male pattern baldness, female pattern baldness is not normally associated with a receding hairline. Androgenetic alopecia in women does not typically cause widespread baldness or rapid hair loss; the hair loss associated with female pattern baldness is gradual and moderate, and worsens over a period of many years.

Typically, androgenetic alopecia begins to affect women in later life, and particularly once they have been through the menopause. It’s estimated that female-pattern baldness affects half of all women over the age of 65. Young women can also be affected by this type of alopecia in their 20s and 30s.

What is alopecia areata?

Alopecia areata is a type of hair loss associated with the immune system. It causes patchy hair loss on the head and is usually temporary, with hair growing back within a year. In severe cases, alopecia areata can develop into alopecia totalis (full loss of hair on the head) or alopecia universalis (full loss of hair on the body).

This type of hair loss is more common in younger people and those who live with autoimmune conditions such as diabetes or hyperthyroidism.

Treatment for alopecia areata

There are a few different treatments available for alopecia areata which can help hair regrowth.

These include:

  • Topical corticosteroids – Creams, foams of lotions that are applied to the scalp to help calm skin inflammation.
  • Steroid injections – Steroids are injection into the skin of affected areas.
  • Steroid tablets – Taken orally as a short-term treatment, systemic corticosteroids supress the immune system to help hair to re-grow.
  • Immunosuppressants – Used for inflammatory skin conditions such as eczema, these suppress the immune system allowing hair regrowth.
  • Minoxidil – A foam or liquid that is applied to the scalp. The popular brand Regaine is available to buy online and at your local pharmacy without a prescription.

What is androgenetic alopecia?

Androgenetic alopecia also known as pattern hair loss can affect both men and women. Female pattern baldness and male pattern baldness can be recognised by the scalp being visible through your hair. Your hair grows in tufts on your scalp of 3-4 hairs, androgenetic alopecia causes these tufts of hair gradually shrink. You can find out more about the causes of male pattern baldness and female pattern baldness in our guides.

Treatments for androgenetic alopecia

There is no permanent cure for androgenetic alopecia, however there are some treatments that can halt hair loss and even promote hair growth in the short term.

In men, androgenetic alopecia can be successfully treated with finasteride (a tablet taken daily) or minoxidil (a lotion or foam applied to the scalp daily). In women, androgenetic alopecia can only be treated with minoxidil, as finasteride is not licensed for use in women.

One study has shown that, when applied to the scalp as instructed twice a day, minoxidil prevents hair loss in 88% of women and, in a number of cases also promotes new hair growth.

If you are considering using minoxidil to treat androgenetic alopecia, you should be aware that it must be used every day on an ongoing basis. If you stop using minoxidil, your hair loss will resume within a few months.

Other types of alopecia in women

Along with androgenetic alopecia, women can also be affected by:

  • Alopecia areata, which leads to patchy hair loss (usually temporary) and is thought to be caused by the immune system attacking the hair follicles
  • Alopecia totalis and alopecia universalis, which are severe forms of alopecia areata causing total baldness on (respectively) the head, and the body
  • Scarring alopecia, which is associated with certain skin conditions and the permanent damage of the hair follicles
  • Anagen effluvium, a type of widespread hair loss (usually temporary) associated with medical treatments such as chemotherapy
  • Telogen effluvium, a type of widespread thinning on the head (usually temporary) associated with illness, hormonal changes, stress, and certain medications

Certain medical conditions can lead to hair loss, particularly those associated with the immune system e.g. hyperthyroidism. One condition associated with hair loss that only affects women is polycystic ovary syndrome (PCOS); this is caused by harmless follicles developing on the ovaries. Women with PCOS have higher levels of male hormones in their bodies and this is thought to be the cause of the hair loss.

Temporary alopecia vs permanent alopecia in females

If you have noticed that you are experiencing some hair loss, you may be concerned that it is of a permanent nature. The good news is that many types of alopecia are temporary. Women may be more susceptible to temporary alopecia during or after pregnancy; as described above, medical treatments, medication, illness and stress can also be responsible.

To find out whether your alopecia is likely to be temporary or permanent you should visit a doctor. In some cases they may recommend that you wait to see whether your hair grows back before seeking treatment.

What causes alopecia in women?

Many different things can cause alopecia in women. The most common cause of female hair loss is androgenetic alopecia, which is also known as female pattern baldness. This is a genetic condition that causes gradual thinning across the top of the head.

Other causes of alopecia include medical treatments such as chemotherapy, hormonal changes, stress, polycystic ovary syndrome and certain conditions affecting the skin or the immune system.

How is alopecia in women treated?

In women, androgenetic alopecia can be successfully treated in the short term with minoxidil. This is a foam or lotion that is rubbed into areas of the scalp with thinning hair every day. If it is used correctly it can have a positive impact upon hair loss and begin to promote hair growth within three or four months.

References 

www.alopeciaonline.org.uk/
www.nedermatology.com/blog/how-to-spot-the-early-signs-of-alopecia
www.alopecia.org.uk/alopecia-areata
www.alopecia.org.uk/Pages/FAQs/Category/treatments-for-alopecia-areata
www.alopecia.org.uk/androgenetic-alopecia-pattern-hair-loss