Hereditary hair loss in women
Hereditary hair loss (androgenetic alopecia) is the most common form of hair loss in women, and according to statistics, 5 to 10% of women suffer from hair loss. Hereditary hair loss occurs very differently in both sexes: while in men it begins in the so-called “entrances” and then extends from the forehead to the nape of the neck, in women the hair becomes thinner as long of the crest and the scalp is glimpsed. In women, total baldness is very rare.
The hair loss in women can be especially annoying because it is much less socially acceptable than in men. In addition, in man, it does not go against current beauty ideals.
The cause of hereditary hair loss is, as in the case of man, an inherited hypersensitivity to the male sex hormone testosterone, or to its breakdown product, dihydrotestosterone (DHT). Both hormones are also found in the woman’s body. The DHT can damage the hair root and shorten the phase of hair growth. As a result, the hairs become shorter and thinner, and in the affected areas the hair remains only as a down of fine, short hairs and few pigments.
The hereditary hair loss is also called congenital–hormonal hair loss or androgenetic alopecia. In women, it is usually presented in bursts, interrupted by periods of rest. Hair loss usually progresses only moderately fast. The number of hair that is lost increases with age, but between one third and half of the affected women develop a clearly visible hair loss from the age of 20 to 30 years.
Often, hair loss only appears after menopause. The cause is usually not so much an increase in testosterone levels in women, but the fact that the balance between male and female sex hormones shifts in favor of male sex hormones.
In addition to hair loss, symptoms such as skin spots and increased sebaceous secretion often arise.
How to stop hair loss?
After the summer, it is normal to lose more hair than before. At this time, all the hair synchronized its fall cycle, so it seems that there is more loss than at other times of the year. Here are some tips from expert dermatologists so that this physiological loss is not excessive.
Hereditary hair loss in women: Causes
Androgenetic alopecia or endogenous hair loss has the same cause in women as in men: it is due to genetic changes in the hair follicles that make them more sensitive to male sex hormones (androgens).
The hair follicles with the corresponding predisposition have a high number of connection points, the so-called receptors, for the male hormones testosterone and dihydrotestosterone (DHT). The DHT is formed under the influence of the enzyme 5–alpha-reductase from testosterone. Acts on the hair follicle receptors and causes the growth phase of the hair cycle to shorten. This shortened period of growth accelerates the full hair cycle. As a result, the hair and hair follicles are becoming thinner and thinner; Ultimately the hair follicles are reduced to a certain extent during this process, creating the so-called miniaturization of the hair follicles.
There is a difference with the typical baldness of man because in women the role of enzymes (specific proteins) that convert certain hormones: while in man the enzyme 5-alpha–reductase is very important, in women it has great importance the so-called aromatase, which converts male hormones into female hormones (estrogens). Aromatase is less active in women with androgenetic hair loss. As a result, the concentration of androgens increases in the hair follicles “preloaded” genetically, male hormones cause damage to the follicles and thus lead to hair loss.
There is another difference between hereditary hair loss in women and men: in women, not all hair follicles in a hair region are affected, but only a part. Therefore, no woman ends up completely bald, because the hair only becomes thinner, making the scalp visible.
Symptoms of hereditary hair loss in women
The hereditary hair loss ( androgenetic alopecia, loss of hair endogenous ) affects not only men as is commonly supposed, but also women often struggle with hair loss and its consequences. Just like men normally suffer this form of hair loss.
The women lose hair in most cases mainly in the area of the middle stripe. They usually have only a few bald spots, and the hair becomes thinner and thinner until the scalp is visible. A bald head is very rare in women.
During this time, hormonal changes arise that accelerate hair loss. Some women who previously had a moderate loss of hair normally not visible experience a kind of acceleration at menopause that finally makes thinning visible.
If a woman ‘s hair loss is sudden onset or follows a male pattern, accompanied by other manifestations of hyperandrogenism (hirsutism, acne, changes in the voice …) we must think of a virilizing disorder and even androgen-producing tumor (adrenal or ovarian tumor). In these cases a serum evaluation of total and free testosterone, DHEAS and prolactin are necessary. Differential diagnosis may be necessary with diffuse hair loss due to iron deficiency, thyroid alterations and, in very rare cases, syphilis.
Treatment for hereditary hair loss in women
The hair loss hereditary ( androgenetic alopecia, loss of hair andógena ) in women require treatment when women suffer from hair loss. Hair loss is not a disease in the literal sense.
The treatment of hereditary hair loss includes several active agents and approaches:
- Minoxidil 2% solution
- Hormonal preparations (tablets)
Several studies have shown that a 2% solution of minoxidil has good effects: in most women hair loss stops, and in about half the hair density is recovered with treatment. Minoxidil is considered the preferred treatment.
For women who suffer from early strong congenital alopecia, a treatment with hormonal preparations is recommended, which usually consists of two components (for example, the pill ): a component, a gestagen, acts against the male sex hormones (androgens) and protects the hair roots against damage. The second component, an estrogen, acts preventively, among others. The prevention is necessary for fertile women, as during treatment with antiandrogens should necessarily avoid pregnancy, it could lead to poor fetal development.