Androgenetic (androgenic) alopecia in women

Female pattern hair loss is characterised by the gradual shedding and thinning of hair, particularly at the crown. This condition significantly impacts self-confidence and quality of life, which is why timely diagnosis and appropriate therapy are crucial for treatment. Modern non-surgical treatments such as PRP and hair mesotherapy can slow down hair loss and improve hair density, especially when started early. 

Unlike male-pattern baldness, which usually manifests as total hair loss, androgenetic alopecia is less common in women and typically does not lead to complete baldness. However, around 40% of women by the age of 50 show some sign of this type of hair thinning.

What is female pattern hair loss?

Hair plays a very important role in every woman's life; it is important to us that it is nourished, voluminous and healthy. However, due to various factors, it can undergo accelerated hair loss and thinning, which women experience very emotionally and lose self-confidence. Female androgenetic alopecia is conditioned by genetic and hormonal factors, i.e. the action of androgenic hormones, primarily dihydrotestosterone (DHT). 

In women, hair loss manifests as diffuse thinning across the entire head, most commonly at the crown and top of the scalp. The hairline usually remains intact, although in some cases this line may also recede. The result is thin, weak and sparse hair, and the scalp often becomes visible through it.

This process of female-pattern hair loss can occur at any time and may appear in female patients as early as their twenties, most commonly during their 40s and 50s. Hair loss can also occur in phases, meaning it can last for several months and then reappear later. In addition to aesthetic issues, it can also cause psychosocial problems, interfering with daily activities due to feelings of depression or unattractiveness.

Causes of female pattern hair loss

Each hair sits in a small opening in the skin called a follicle. Baldness occurs when the hair follicle shrinks, which leads to the shortening and thinning of the hair. Over time, the follicles stop producing new hair, but they nevertheless remain alive and it is therefore possible to stimulate the growth of new hair.  

The natural hair growth cycle has four main phases: anagen, catagen, telogen and exogen. During the anagen phase, the hair grows. During the catagen phase, it goes through a simple transitional phase lasting just over a week. In the telogen phase, the hair no longer grows and usually rests in the follicle for a few months. Then, in the exogen phase, the hair falls out, making way for the cycle to repeat itself.

In female pattern hair loss, the growth phase becomes shorter and the follicles gradually shrink. The hairs become thinner and shorter, and over time some follicles stop producing visible hair.

The most common causes of androgenetic alopecia in women are:

• changes in the levels of androgens, hormones that can stimulate male characteristics, primarily dihydrotestosterone (DHT). This is the hormone that has the greatest impact on regulating hair growth, so an increase in its level can cause hair loss in individuals with a genetic predisposition to baldness. DHT shortens the active growth phase of the hair, follicles shrink and eventually disappear, and individual hairs become increasingly thinner and shorter until the follicle stops producing hair altogether. The greatest sensitivity to DHT is in the crown and frontal regions, as well as at the top of the scalp, which is why hair in these regions is most commonly lost;
• hormonal imbalance that can occur due to the use of hormonal medications and contraceptive pills, as well as during pregnancy, after childbirth and in the menopause;
• genetics and family history of female pattern baldness;
• aggressive chemical hair treatments and the use of inadequate products can encourage hair loss;
• diseases and medical conditions that cause a drop in immunity and weakening of the body, such as thyroid diseases or autoimmune disorders, can affect hair health and lead to its sudden thinning;
• severe stress or trauma.

Symptoms of female pattern hair loss

Hair thinning in women differs from male-pattern baldness, and total hair loss rarely occurs; instead, the hair becomes thinner and loses its fullness. In female-pattern hair loss:

• hair is thinning at the top and crown of the head, which most frequently begins with the widening of the parting in the middle;
• the front hairline generally remains preserved, apart from the normal recession that occurs in all people over time;
• hair loss rarely progresses to total or near-total baldness, as happens in men;
• if the cause is an increased level of androgens, the hair on the head becomes thinner, while facial hair becomes coarser;
• Itching or sores on the scalp do not usually occur.

How is a diagnosis made

It is best to consult a doctor as soon as you notice the first symptoms of excessive hair loss. It is completely normal to lose between 50 and 100 hairs a day, but when you notice that your hair is starting to thin rapidly, that you are pulling out more hair with your brush than before, and when it becomes dry and fine, make sure to consult a dermatologist. Timely diagnosis is crucial for determining the appropriate therapy and the effectiveness of treating alopecia. The doctor arrives at a diagnosis through several steps:

• The patient's case history includes a discussion of the course of the illness, genetic predispositions, hormonal or other medical conditions;
• Scalp examination;
• Trichoscopy It is a painless and non-invasive diagnostic procedure used to detect the smallest changes in the hair and scalp. Using a dermatoscope that magnifies up to 300 times, the doctor examines the follicle openings, blood vessels and defines the appearance and shape of the hair fibre;
• Laboratory tests are often needed to determine hormone levels and other parameters (vitamin and mineral levels) in order to make a clearer diagnosis and rule out other possible causes;
• Scalp biopsy It is necessary in some cases when the doctor is unsure of the diagnosis or wants to further examine the patient's condition. It is a medical procedure in which a small tissue sample is taken from the scalp for microscopic examination and a precise diagnosis, and it is performed under local anaesthesia.

What will you get at the examination?

During the examination, you will receive an explanation of the findings, a recommendation for the necessary analyses and a treatment plan. If additional analyses are required, the doctor will specify which ones you need to have done. PRP and mesotherapy can be a supplement to the treatment according to your findings.

How is androgenetic alopecia treated in women?

Left untreated, female pattern hair loss is permanent. Depending on the patient's condition, the degree of hair loss and other important factors, the doctor decides on the treatment and management. 

Treatment often begins with therapy prescribed by a dermatologist. These can be topical preparations that prolong the hair growth phase or medications that reduce the effect of hormones on the follicles. The choice depends on the findings, age, and pregnancy plans, so the treatment is always determined by a doctor.

The permanent solution is hair transplantation, a surgical procedure during which follicular hair units are transplanted from the donor region to the site of hair loss.

Fortunately, the field of dermatology has advanced significantly and led to breakthroughs in hair restoration that do not solely involve surgical procedures. When it comes to non-invasive medical treatments for hair loss, at our polyclinic we perform PRP treatment and hair mesotherapy, either independently or in combination.

PRP treatment for female pattern hair loss

During the PRP treatment, platelet-rich plasma is isolated from your blood and introduced into the scalp. Growth factors strengthen weakened follicles, so the effect is best in the early and middle stages of thinning. Read about what the treatment looks like and how many treatments are needed on the page PRP hair treatment.

Hair mesotherapy for female pattern hair loss

With mesotherapy, a cocktail of vitamins, amino acids and other ingredients that support follicle nourishment is introduced into the scalp. It is carried out in a series of treatments, either on its own or alongside PRP. Read more on the page hair mesotherapy.