WHAT IS FEMALE PATTERN BALDNESS?

Female pattern baldness, or androgenetic alopecia, causes hair loss. The exact cause is unknown, although medical experts believe it is because of genetics and heredity. It is also thought to be from androgen hormone production changes in the body, such as in menopause when as many as two-thirds of women begin to lose their hair. Here are the facts that you need to know about it.

Signs Of Female Pattern Baldness?

A woman normally loses as many as one-hundred hairs a day. The scalp then begins to renew itself by entering the anagen stage, which lasts for five years. During the catagen stage, the hair transition into a resting phase, which takes about three weeks. Finally, the hairs enter the telogen stage where the hair falls out. The cycles should start again, but this begins to change for some.

Unlike in men where the growing pattern tends to recede on the hairline area and bald on the crown, women tend to see a slowing of growth and thinning along the center parting line. The growing phase also slows tremendously making the hair follicles become smaller in size. The hair strands that eventually become thinner and more susceptible to split ends and shedding. 

After the thinning at the center, some women tend to also experience hair thinning and loss at the temple area, although a balding pattern similar to male pattern baldness is highly unlikely. Recent studies by Harvard found that three types of female pattern baldness exist: thinning at the parting line, a widening of the part line from thinning, and visible scalp at the center of the scalp.

About 55% of women will experience hair thinning and female pattern baldness in their lifetimes. Studies show that twelve percent of women between twenty and twenty-nine will have female hair loss. By the age of eighty, more than fifty percent of women will experience thinning or FPB hair loss stages. Only about one percent of these women will reach the most severe stage. 

How Is Female Pattern Baldness Diagnosed?

Nine-out-of-ten men inherit male pattern baldness when they suffer from hair loss, so diagnosing it is much simpler than for women as a doctor can do a pull test, physical inspection, or testing. With women, there could be a number of causes, so doctors must carefully weigh the symptoms and perform a series of exams, biopsies, and laboratory tests before making such a diagnosis. 

The first responsibility of a doctor is to check for medical conditions where hair thinning and loss are symptoms. Testing for these conditions includes thyroid disorders, hormonal imbalances, autoimmune disorders, scalp conditions, PCOS, or anemia. Doctors also look at hair loss as a trigger rather than the condition, so diagnostic testing helps narrow the scope of probable causes. 

Doctors tend to first start with an examination of the affected area and request family history. Additional testing that may take place after initial consultation includes a hair pull of about one hundred hairs to calculate how many come out and a scalp biopsy of about four millimeters in diameter to measure hair loss amount. Densitometry can also check for shrinkage of hair shafts.

Diagnostic Testing For Female Pattern Baldness

  • Thyroid Levels
  • Bacterial Infections
  • Complete Blood Count
  • Total Iron Binding Capacity  (TIBC)
  • Hyperandrogenism (Adrenal and Ovarian)
  • Gender Specific Issues Like Pregnancy Or Socially Transmitted Diseases
  • Hormone Levels (Androstenedione, Dehydroepiandrosterone, Follicular)
  • Once other medical conditions have been ruled out, professionals can then use two classification systems, the Ludwig Scale and the Savin Scale, to identify crown density and thinning. The testing will help identify if a woman’s hair is thinning or to what degree the female pattern baldness is progressing. These two tests also measure the severity of female pattern baldness. 

What Is The Ludwig Scale?

The Ludwig Scale is a female pattern hair loss classification system that was established in 1977 to measure how much hair has been lost, the potential for future damage, and the best method of treatment. There are three stages of female pattern hair loss to differentiate between progression.

  • Stage One: The hair loss is minute and slow. During this stage, a woman may not notice the hair loss, which is why many do not seek treatment so early on. The hairline also does not appear to have any change, and even though the hair is thinning, it is not yet visible unless parted in the center. On the Ludwig Scale, the image shows a woman with little hair loss to allow medical professionals to compare it to those with more severe shedding.
  • Stage Two: During the second stage, women begin to experience moderate shedding and hair loss. There is also a considerable change in volume, texture, and thickness. Women suffering from female pattern baldness will also visibly notice the thinning is worsening along the center parting line, which friends, family, or co-workers will likely observe. Some women seek proper diagnosis and treatment, such as medicine or hair transplants. 
  • Stage Three: A woman who is in stage three has lost a severe amount of hair along the mid-scalp and crown. The remaining hairs along the occipital area will appear normal and still within the growing phase. The hair will thin and follicles will undergo shrinkage. Only about one percent of women reach stage three, so it is very uncommon to have this type of hair thinning and balding that men with male pattern baldness experience.

The Ludwig Scale is used to diagnose anyone, regardless of gender, because both men and women will experience hair loss and pattern baldness during their lifetimes. The exact same measurements and symptoms of the Ludwig Scale as chart examples are similar in stages. It is often the best way to document the changes between normal shedding and FPB abnormalities.

The Savin Scale

Dr. Ronald Savin developed the Savin Scale in 1994, and it is typically used as a secondary source for measuring thinning and female pattern baldness. The stages are very similar to the Ludwig Scale, but the Savin Scale measures the hair loss in the front center scalp area as well as the temporal or crown sections. The Ludwig scale did not include it in female pattern hair loss. 

Unlike the Ludwig Scale, the Savin Scale chart assesses the most common FPH, but it also is used to evaluate the thinning stages. Using the Savin Scale, doctors would be able to diagnose a woman with hair loss much sooner since it calculates density, unlike the Ludwig Scale chart. This measurement is also used interchangeably as females or males can have FPML or MPHL.
The Savin Scale uses a coding system to identify each stage. The Frontal Loss measures the temples and hairline with a rating between F1 and F6 (minimal to substantial recession). The Midscale calculates the middle area with a rating of M1 and M5 (normal to patchiness). The Crown stage ranges from V1 to V7 (circular patches on top and posterior hair loss on the scalp).  

Scalp Health and Female Pattern Baldness

There is a correlation between scalp health and female pattern baldness as the condition of the skin greatly affects hair growth and loss. Everything from age and gender to health and styling patterns dictates the texture and amount of hair a woman has, although follicle numbers are similar to those of men. The type of hair care routines will, therefore, help elevate scalp health. 

If you notice an abnormal amount of thinning or shedding, you may decide to change your hair care routine to include products for defending against hair thinning or reviving and treating hair loss. You should include styling products specially formulated for volumizing and nourishing the scalp. You can also see a dermatologist for diagnosis or consult with a hair restoration specialist.

Treatment For Female Pattern Baldness

Women often tend to change up their hairstyles when thinning occurs. This is a temporary fix as the thinning and shedding will continue, which is consistent with female pattern baldness. The earlier you begin treatment, the likelier you are to prevent or lessen future hair loss. There is one medication approved by the FDA for female pattern baldness, but these are the options available.

  • Minoxidil

    Minoxidil (Bosley for women) is the only medication approved as a treatment for female pattern balding and the only medication approved on the market for usage by women. As women generally do not lose as much hair as men, the minoxidil in regrowth treatments usually has about two percent in the formulas. With daily usage, a person will begin to see some regrowth within six weeks to two months, which is why it is an effective option.

 

  • Spironolactone 

    Spironolactone is a medication that is prescribed as a diuretic. It can also be used to treat androgenic alopecia, although it can take as long as one year to see regrowth of hair. The side effects are also problematic as women on a diuretic can experience irregular menstruations and spotting, fatigue, sensitivity in breasts, and electrolyte irregularities.

 

  • Laser Treatments or Hair Transplants

    Women may choose laser treatments or Bosley Hair Restoration to revive growth cycles.
    There are also a number of non-surgical hair loss treatment that you could consider. 

    It is important to keep in mind that female pattern baldness is not reversible, but it is
    possible to prevent symptom advancement by implementing a regular Bosley haircare routine
    that is especially formulated for your scalp health and vivacious hair strand restoration.