No Hair Loss
Hair is thick and even throughout the scalp.
Hair loss generally affects women starting in their 30s and reaches a peak in their 50s, when testosterone levels decrease. More than 50% of men experience male pattern baldness compared to 30% of women. The risk of hairloss increases with age, and is higher for women with a history of hair loss on either side of the family. As many as two-thirds of postmenopausal women experience hair thinning or bald spots.
Women experience stages of balding in a distinctly different manner than men. Men typically lose hair from the front and it gradually recedes over the top of the scalp, reaching the back of the head. They end up with a band of hair above the ears and around the back of the head. Women lose hair from the top of the scalp and experience reduced density, but usually retain their original hairlines in front.
Stages of Female Pattern Baldness
The Ludwig Scale is the only method of classification used for female pattern hair loss. Unlike the Hamilton-Norwood Scale used in men, female baldness is measured in just three stages (also called grades) and noted as mild, moderate, and extensive.
Hair is thick and even throughout the scalp.
This is the start of female pattern baldness, with some mild, evenly distributed thinning of the hair on the scalp. At this stage, hair loss is unnoticeable and minimal hair loss can be easily camouflaged with hair styling techniques.
Hair loss is moderate, but becoming more noticeable, with significant widening of the midline part and noticeably decreased volume. About 50% to 70% of hair is thinner and baldness is visible.
The most severe form of hair loss, extensive hair loss has caused more scalp to be visible than hair and treatment is necessitated.
The medical name for female pattern baldness is androgenetic alopecia. Androgenetic alopecia is related to hormones called androgens, which are essential to normal male sexual development and also regulate hair growth. The condition may be inherited and involve several different genes or result from an underlying endocrine condition. In men and women, hair loss from androgenetic alopecia is associated with a genetically determined shortening of anagen, the growing phase of hair, and a lengthening of the time between the shedding of a hair and the start of a new anagen phase. In simple terms, it takes longer for hair to start growing back after it is shed during the normal growth cycle. Unlike androgenetic alopecia in men, the precise role androgens play is harder to determine in women.
Follicular miniaturization is a progressive decrease of the hair shaft’s diameter and length in response to hormones. Under normal circumstances, follicular units (natural hair groups) are made of full-thickness, healthy terminal hair. When miniaturization occurs, one or more hairs within each group are replaced by shorter, thinner, non-pigmented hairs called "vellus" and eventually are lost.
Getting a Proper Diagnosis
An accurate diagnosis is important, especially when the hair loss is diffuse, because underlying medical conditions may be a contributing factor. Female pattern baldness can usually be diagnosed through medical history and examination of the scalp. The doctor will observe the pattern of hair loss, check for signs of inflammation or infection, and may order blood tests to investigate possible causes of hair loss.
A handheld instrument called a densitometer is used to diagnosis miniaturization. A small area of the scalp where the hair has been clipped to about 1mm in length is magnified. The presence of miniaturization in the areas of thinning usually confirms a diagnosis of androgenetic alopecia.
When hair loss is diffuse (thin all over) rather than following a typical female baldness pattern, diagnosis is more challenging. A number of underlying conditions must be ruled out, including:
Obstetric and gynecologic conditions (e.g. postpartum and postmenopausal states, PCOS or ovarian tumors)
Anemia (iron deficiency)
Syphilis, a sexually transmitted disease
Nutritional causes (e.g. crash diets, bulimia, protein/calorie deficiency, essential fatty acid or zinc deficiency, malabsorbtion, and hypervitaminosis)
Stress (e.g. related to surgical procedures, general anesthesia, or severe emotional problems)
Concealing Female Pattern Baldness
Phase 1 Hair Loss
Mild hair loss can often be concealed by modifying your haircut and styling techniques. Here are a few tips:
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