- UNDERSTANDING HAIR
Female Pattern Hair Loss (Androgenetic Alopecia) usually occurs in a recognizable pattern or stages, partially caused by male hormone DHT binding to Androgen Receptors (AR) on certain hair follicles and other factors.
Female Pattern Hair Loss (FPHL) is measured on the Ludwig scale as depicted below:
Where Are You on the Scale?
Type 1 Hair Loss
Ludwig type I hair loss pattern.
Hair Loss Ludwig type III hair loss pattern.
Hair Loss Ludwig type II hair loss pattern.
Female Pattern Hair Loss Androgenetic Alopecia is caused by genetic predisposition – hair follicles containing Androgen Receptors are targeted by male hormones that cause the hair follicles to miniaturize, resulting in loss of hair shaft caliber and hair volume and ultimately causing various degrees of hair thinning.
Androgenetic Alopecia is passed on via genetic predisposition from ancestors on both the father and mother’s side.
Female Pattern Hair Loss (FPHL) Women don’t usually become completely bald. It is more related to miniaturization of the hair shaft thickness and not shrinking of the hair. So, there is loss of hair shaft caliber resulting in loss of hair volume which is mainly seen centrifugally on top of the head. There are 3 basic stages according to the Ludwig Type I, II, or III severity of hair volume loss.
Female pattern hair loss has two age peaks, in the twenties and in the forties. All female patients with hair loss have to undergo blood tests to exclude other causes not related to FPHL, such as checking the endocrine system, excluding systemic illnesses, checking for shortages in spoor elements. In some cases, abdominal, pelvic ultrasound is required to exclude Polycystic Ovarian Syndrome with Hirsutism. The blood tests also check for heavy metals in blood, which can adversely affect hair. Stress factors also have to be excluded.
The most common form of hair loss in women is Telogen Effluvium. This occurs when more than the average 10% of hair follicles shift into the resting phase (Telogen). This causes increased shedding of hair shafts.
Causes of Telogen Effluvium include:
• Early stage FPHL
• Prolonged high fever
• Acute blood loss
• Acute psychotic illness
• Drug therapy
• Crash dieting
• Significant emotional or physical illness
• Widespread disease
• Discontinuation of the contraceptive pill
• General Anaesthesia
• Hypothyroidism or Hyperthyroidism
• Surgical interventions