How to Cure Female Hair Loss

Female Hair Loss

If the patient is a woman whose hair loss has occurred while she is using oral contraceptives, recommend changing to a contraceptive whose progestin has a low androgenic index. All these agents require monitoring of side effects and frank discussions of the benefit/risk balance. Cerebrovascular and embolic disorders, myocardial infarction, loss of libido, and the whole familiar range of adverse contraceptive reactions may outweigh a patient’s need for alopecia treatment.

Female Hair Loss

Strangely, no national organization exists for persons with androgenetic alopecia, although many of them need at least as much psychosocial support as patients with alopecia areata. Some physicians have noted good results with informal support groups arranged at the local level. Don’t underestimate the level of concern among many patients who are losing hair; hair loss treatments for women place special emphasis on the need for respect and tact in the physican-patient relationship.

Female Hair Loss

Alopecia areata is the most common autoimmune hair disease, accounting for about 1-4% of all visits to dermatologic clinics. Like androgenetic alopecia, it runs in families, but unlike common baldness, it affects men and women in equal proportions and shows a predilection for the young (about 60% of affected persons are younger than 20).

Female Hair Loss

Multiple episodes are the rule; neither spontaneous regrowth nor successful treatment precludes relapse. The hair loss in alopecia areata is usually confined to round or oval patches, but loss becomes extensive in 10-30% of patients. About 5% go on to have alopecia totalis, and 1%, alopecia universalis. All these conditions can be traumatic to a patient’s self-image and social life, particularly when onset occurs during childhood. Counseling for both patients and family members is appropriate, and referral to a local branch of the National Alopecia Areata Foundation is often much appreciated.

Female Hair Loss

Clinicians have tried a wide range of hair loss treatments for women, ranging from intralesional or systemic corticosteroids to an investigational immunomodulator, inosiplex (Isoprinosine, also known as inosine pranobex). Although some regrowth has been noted with each method, none appears to protect against relapse. The most widely used approaches to date are intralesional injections of triamcinolone acetonide (Kenalog). Strong topical corticosteroids are sometimes effective; more often, intralesional and systemic therapy can produce regrowth in 2-4 weeks.

Female Hair Loss

Induction of contact dermatitis at affected scalp sites has also resulted in regrowth in some patients. Agents that have been used include dinitrochlorobenzene, anthralin (Anthra-Derm, Drithocreme, Lasan, etc.), squaric acid dibutylester, and diphency-prone. Dinitrochlorobenzene is a known mutagen, and the other irritants may thus be preferable. Anthralin, recognized as effective in many patients with psoriasis, is applied either in a high concentration for short periods daily or in a low concentration overnight. Mild to moderate irritation is necessary for any chance of regrowth with contact sensitizing agents, and they all carry a risk of severely irritating both affected and unaffected skin.

Female Hair Loss

Another approach that has yielded some benefit in alopecia areata is photochemotherapy with psoralens, usually methoxsalen (Oxsoralen), and ultraviolet light. Only dermatologists should administer this hair loss treatment for women because of the risks of severe burns and ocular damage with photosensitization. Topical minoxidil treatment in alopecia areata produces responses comparable to those found in androgenetic alopecia: regrowth in about 10% of patients, sustained only with continuous therapy. Thyroid disorders are associated with alopecia areata in about 1 in 4 patients, making thyroid function tests a standard part of the workup. Thyroid disease requires treatment in its own right, of course, but regulation of thyroid function does not reverse the hair loss.

Female Hair Loss