In general, when women develop alopecia they typically have a diffuse thinning (less hair all over), in contrast to men who more frequently have a "patterned" type (hair loss that spares the back and sides of the head). Like men, women also suffer from androgenetic alopecia (genetic female balding), but unlike male pattern baldness women often maintain their frontal hairline. In contrast, men characteristically lose a significant amount of hair in the front part of their scalp from the very beginning. Androgenetic Alopecia is a common cause of female balding and the most likely reason for excessive hair loss.
There are a number of reasons to explain why hair loss in women presents differently than in men (although all of the factors are still not completely understood). The most important reason for difference in hair loss pattern is the difference in steroid metabolism; the metabolism of hormones, hormones which play an important role as the cause of hair loss both in women and men. It is because of this reason that the management, treatment and medication of androgenetic alopecia in women is different than The Hair Loss Medication for male pattern baldness.
The number and distribution of androgen receptors in the hair follicles, the enzymes 5 alpha reductase type I and II, and the local concentrations of dihyrotestosterone around hair follicles are the factors which are responsible for Male Androgenetic Alopecia. It is presumed that in women there are additional factors which come into play such as the concentration of Cytochrome P-450-aromatase near hair follicles as well as the distribution of androgen receptor proteins. The cytochrome enzyme metabolizes androgens to estrogens, and modifies the ratio of androgens to estrogens by having a protective role by antagonizing the effects of androgens.
Differing concentrations of androgen metabolizing enzymes and androgen receptors have been identified in hair follicles from women compared to men. The concentration of Cytochrome P-450-aromatase is six times higher in women's frontal hair follicles compared to men's frontal hair follicles. Women also have around 3 times less alpha-5-reductase type I or type II enzyme in their frontal hair follicles compared to men. Conversely, androgen receptor content in frontal hair follicles from men are 40% higher than for hair follicles from women. These differences between men and women most likely account for the overt clinical differences in patterns of hair loss.
Hair loss in women is most often very gradual, with the rate accelerating during pregnancy and at menopause. It is more often cyclical than in men, with seasonal changes that reverse themselves, and it is more easily affected by hormonal changes, medical conditions, and external factors. Hormone imbalance can also play some role in the manifestation of androgenetic alopecia and as the cause for excessive hair loss. Women after menopause may have a net drop in the androgen antagonist estrogen and are much more susceptible to the onset of pattern baldness or female balding. Other women who produce high levels of androgens are those who suffer from polycystic ovary syndrome (PCOS) which makes them more susceptible to hair loss.
Besides genetic hormonal imbalancse that may be responsible for androgenetic alopecia, most cases of androgenetic alopecia in women are idiopathic in nature, i.e, there is no detectable hormone imbalance causing the onset of hair loss and blood tests show nothing out of the ordinary. Because of this, some dermatologists are very reluctant to treat androgenetic alopecia with hormone based treatments. They may regard such treatments as beyond their "domain" and more endocrinological than dermatological. This attitude is not helpful for those seeking treatment.
Some dermatologists, particularly in Europe, are more positive about using hormone therapies to prevent and treat hair loss caused by female balding. There are Systemic Antiandrogen Treatments or hormone supplements available for women, but they are not generally suitable for men to use because of severe side effects.
Besides conventional hormone replacement therapy, there are many Natural Herbal Supplements which can be tried. There are herbal supplements which are available which are particularly helpful as Herbal Remedies for Women. These herbal hair loss treatments are often antiandrogenic in nature or they are similar to estrogens which counteract the effects of androgen hormones.
Many factors must be considered in the treatment of androgenetic alopecia. Probably the best option for women with androgenetic alopecia Ludwig stage I and II is minoxidil 2-5% solution, the drug is used alone or as a combination therapy for Female Hair Loss Restoration. If it is not effective after 1 year, Antiandrogens can be tried as a systemic treatment, but some dermatologists claim they are usually not very efficacious and can have considerable adverse effects. For unresponsive patients, a Hair Transplantation can be offered if the occipital donor area is sufficient. Another alternative for these patients is a hairpiece as they can give excellent results. In some cases a partial hairpiece may also tried.