Pattern hair loss
(Redirected from Female pattern baldness)
Common type of hair loss affecting the scalp
Pattern hair loss | |
---|---|
IMG-20190314-WA0000.jpg | |
Synonyms | Androgenic alopecia, androgenetic alopecia, male pattern baldness, female androgenic alopecia, female pattern baldness |
Pronounce | N/A |
Specialty | N/A |
Symptoms | N/A |
Complications | Psychological distress, reduced self-esteem |
Onset | Gradual, usually after puberty |
Duration | Chronic |
Types | Male-pattern hair loss (MPHL), Female-pattern hair loss (FPHL) |
Causes | Genetic predisposition, hormonal influences |
Risks | Family history, aging, hormonal changes |
Diagnosis | Clinical examination, dermatoscopy, scalp biopsy (if needed) |
Differential diagnosis | Telogen effluvium, Alopecia areata, Scarring alopecia |
Prevention | No proven prevention; early treatment may slow progression |
Treatment | Minoxidil, Finasteride, Hair transplantation, Low-level laser therapy |
Medication | Minoxidil, Finasteride (for men), Spironolactone (off-label for women) |
Prognosis | Not life-threatening; progression varies by individual |
Frequency | Affects ~50% of men and ~25% of women by age 50 |
Deaths | N/A |
Pattern hair loss (also known as androgenetic alopecia) is the most common form of hair loss, primarily affecting the scalp's top and front regions.[1]
- Male-pattern hair loss (MPHL): Characterized by hairline recession, vertex balding, or both.
- Female-pattern hair loss (FPHL): Typically involves diffuse thinning, particularly at the crown, without a receding hairline.[1]
Clinical Presentation[edit | edit source]
Male-Pattern Hair Loss (MPHL)[edit | edit source]
- Begins with hairline recession at the temples and thinning at the crown (vertex).
- Progresses into a "Hippocratic wreath"—hair remains on the sides and back.
- Rarely leads to complete baldness.
- Classified using the Norwood-Hamilton Scale.
Female-Pattern Hair Loss (FPHL)[edit | edit source]
- Leads to diffuse thinning, mainly at the midline and crown.
- The hairline remains intact in most cases.
- Categorized using the Ludwig Scale (Grades I–III).
- Less likely to cause total hair loss compared to MPHL.[2]
Causes and Risk Factors[edit | edit source]
Pattern hair loss results from a combination of genetics and hormonal influences, particularly androgens:
- Genetic predisposition – Strong hereditary link.
- Dihydrotestosterone (DHT) – A byproduct of testosterone, contributes to hair follicle miniaturization.
- Aging – Hair follicles become more sensitive to DHT over time.
- Other factors – Stress, nutrition, and health conditions (e.g., polycystic ovary syndrome in women).
Pathophysiology[edit | edit source]
Androgenic Influence[edit | edit source]
- Dihydrotestosterone (DHT) binds to androgen receptors in scalp follicles.
- This shortens the anagen (growth) phase and prolongs the telogen (resting) phase.
- Leads to progressive miniaturization—hair shafts become thinner and shorter.
Wnt Signaling Pathway[edit | edit source]
- Androgens may influence the Wnt signaling pathway, affecting hair growth and follicle cycling.[1]

Diagnosis[edit | edit source]
Diagnosis is clinical and often based on:
- Patient history – Family history of baldness, rate of hair loss.
- Scalp examination – Assessing patterns of hair loss.
- Dermatoscopy (Trichoscopy) – Reveals miniaturized hairs and increased scalp visibility.
- Scalp biopsy (if needed) – Helps differentiate from other hair disorders.
Treatment Options[edit | edit source]
Management strategies depend on patient preference and treatment goals.[1]
1. Medications[edit | edit source]
- Minoxidil (Rogaine) – Topical solution; promotes hair regrowth.
- Finasteride (Propecia) – Oral DHT blocker (for men only).
- Spironolactone – Off-label use in women with FPHL (anti-androgenic properties).
2. Surgical Treatments[edit | edit source]
- Hair transplantation – Moves DHT-resistant hair follicles from the back of the scalp.
- Scalp micropigmentation – Cosmetic tattooing to create an illusion of fuller hair.
3. Other Therapies[edit | edit source]
- Low-Level Laser Therapy (LLLT) – May stimulate hair follicles.
- Platelet-Rich Plasma (PRP) – Involves injecting growth factors to promote hair regrowth.
Epidemiology[edit | edit source]
- MPHL affects ~50% of men and FPHL affects ~25% of women by age 50.[1]
- More common in Caucasians, less prevalent in Asians and Africans.
Prognosis[edit | edit source]
- Not life-threatening, but can impact self-esteem and mental health.
- Early intervention may slow progression and improve hair density.
See Also[edit | edit source]
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