Can Female Pattern Hair Loss be Reversed?

Women have a reputation for being fixers. When something goes wrong, the first thing we want to do is fix it.  So it’s not surprising that when we lose our hair, we want to take action and figure out if there’s anything we can do to make it grow back.  Fortunately, female pattern hair loss can be reversed with treatment. It doesn’t happen overnight, but women start to see improvement within six months to a year. If you have questions about what products are most effective and if there are any side effects, you’ve come to the right place. Here’s everything you need to know.

Female Pattern Hair Loss Is Common

Female pattern hair loss, also called androgenetic alopecia, is the most common type of alopecia among women. Over 21 million women in the United States experience hair loss due to the condition. Besides normal recession that happens to most people as they age, the front of the hairline isn’t usually affected. There is a very distinct, recognizable pattern, though. The process usually starts with a widening of the center hair part and thins on the top and crown of the scalp, making a Christmas tree pattern. Women usually don’t become near or totally bald the way men do.  

Too Much DHT Causes Hair Loss

The exact cause of female pattern hair loss isn’t completely understood. Experts believe that there are genetic and hormonal connections.  If one of your parents or grandparents lost their hair due to androgenetic alopecia, there’s a chance that you may too.  

What we do know is that an androgen called Dihydrotestosterone (DHT) is to blame. Just as men have small amounts of estrogen, women have small amounts of Testosterone. Hair loss begins when some or a lot of that Testosterone is converted to DHT. DHT interrupts your hair’s growth cycle. The androgen miniaturizes the hair follicles, which means that the hair follicles shrink.  Existing hair in miniaturized follicles thins or falls out. New hair can’t break through. Fortunately, Happy Head’s board-certified dermatologists have a topical treatment specifically made for women that helps curb hair loss and boost regrowth with our custom Topical Spironolactone. 

Myths About Female Pattern Hair Loss

Many myths about what causes female pattern hair loss exist. Let’s discuss three common topics that women often blame for their hair loss:

•  Vitamin Deficiencies 

Vitamin deficiencies, especially iron and Vitamin D, are linked to hair loss. However, they don’t cause androgenetic alopecia.  Vitamin deficiencies cause a temporary condition called telogen effluvium. Once the deficiency is identified and treated, hair loss typically stops and new hair grows. 

• Birth Control Pills 

Research indicates that during initial use of oral contraceptives, women may experience more shedding than usual. However, after a few months, the hair grows back on its own. (01)  The same is true when women who are stable when taking oral contraceptives go off of the medication.  

• Antidepressants

There is a lot of talk in various Facebook and support groups about whether antidepressants are the root of women’s hair loss. If you think that your antidepressants are causing an issue, it’s important not to change your dosage or stop taking your medication without first consulting with your doctor. Yes, it’s true that some antidepressants can cause medicine-induced alopecia, although it’s rare. The type of alopecia induced is typically a temporary form of telogen effluvium. However, if hair loss due to antidepressants concern, be sure to consult with your dermatologist. Effective hair loss medications can often be used in conjunction with antidepressants.  

There’s No Age Limit 

Women of all ages can experience female pattern hair loss. Although most women start to notice their hair thinning in midlife, meaning ages 40 through 60, hair loss due to androgenetic alopecia can start any time after puberty.  

Patterns of Hair Loss Are the Key to Diagnosis

There isn’t one specific test that dermatologists use to determine whether or not you have female pattern hair loss.  Dermatologists can typically make a diagnosis based on a visual evaluation since androgenetic alopecia has such specific patterns in women. Other information that he or she will use includes:

• Medical history
• Blood tests to check vitamin levels
• Pull test to see if strands fall out easily
• Visual inspection of hair follicles to check for miniaturization

Your dermatologist may also do a biopsy to rule out other forms of alopecia.

Treatments for Female Pattern Hair Loss

If you are diagnosed with female pattern hair loss, medications are available and have been proven to be effective.  One is over-the-counter, and the others are only available by prescription.  

• Minoxidil (Rogaine)– Available over-the-counter in two and five-percent foams. Although the five percent is designated for men, women often use the five percent formula. Stronger liquid formulas are available by prescription. Oral pills are also available, but carry a very small risk of hirsutism.  
• Finasteride (Proscar, Propecia)– A DHT blocker FDA approved for men, prescribed off-label for women. An effective topical formula is also available.  
• Dutasteride (Avodart) – Another DHT blocker that is prescribed as a second-line of treatment after Finasteride.  Dutasteride blocks two enzymes, while Finasteride blocks one.  Finasteride is effective for most women, so Dutasteride isn’t prescribed as often.
• Spironolactone (Aldactone) – A DHT blocker that is prescribed when women’s treatment has plateaued using other treatments.  

Potential Side Effects from Hair Loss Medications

Potential side effects of taking oral hair loss medications are different for women than for men. Minoxidil can cause a temporary, initial shedding among some women because it speeds up the resting phase of your hair.  This makes your hair fall out faster than normal when you first start using the medication. Minoxidil also makes the growth phase last longer. If you use Minoxidil and experience irritation, you may want to test a formula without propylene glycol. Research indicates that the culprit is often the propylene glycol, not the Minoxidil. (02)

Finasteride, Dutasteride, and Spironolactone are not typically prescribed for women of child-bearing ages. Aside from that, side effects are usually rare and mild, if present at all. If you are concerned about side effects, or interactions with other medications you are taking, topical hair loss treatments may be a better option for you. Topicals are proven to work as effectively as oral medications without the same risk of side effects since topicals are not systemic. (03) You can also combine topical treatments with oral treatments.  

Treatment for Female Pattern Hair Loss Isn’t One-size-fits-all

Treating female pattern hair loss may take some experimenting. Different treatments are effective for different women. Whereas five percent topical Minoxidil may work for some, others may need ten percent. The same is true for Finasteride and the other DHT blockers. Also, remember that combinations of medications with different objectives are often used. For example, Minoxidil and Finasteride are often used at the same time. Retinoids are also often used to enhance the absorption of other medications.

If you have female pattern hair loss and would like more information on treatment options, we’re here to help. Our board-certified dermatologists are happy to review your case and recommend the hair loss medication that would be best for you. Best of all, our prescription medications can be customized and will be delivered directly to your front door.

 

Resources:

(01) https://pubmed.ncbi.nlm.nih.gov/4736624/

(02) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2684510/

(03) https://onlinelibrary.wiley.com/doi/10.1111/jocd.14895?af=R