Female Pattern Baldness: Diagnosis and Treatments

Clinical features of pattern baldness in women usually occur during early teens and late middle age. This is shown by the gradual thinning of hair over the frontal area. Usually, pattern baldness in women is not accompanied by increased shedding of hair, but unlike telogen effluvium, hair loss may be seen from the start. The scalp becomes more and more visible as the disease progresses.

Most of the time, the central part of the head widens due to diffused reduction of the hair"s density, which involves the frontal scalp and crown. Some women may experience hair loss on some small areas of the frontal scalp while others may experience the effect on the entire scalp including the areas of parietal and occipital. During hair loss, women usually retain a rim of hair along the frontal hairline.


Laboratory Evaluation

Most women with pattern baldness have normal menstruation, normal fertility, and normal endocrine function, including correct levels of circulating androgens. Therefore, they would only need extensive hormonal testing when symptoms and signs of androgen excess become really visible. Laboratory measurement of serum total or free testosterone, dehydroepiandrosterone sulfate and prolactin are appropriate when hirsutism, severe unresponsive cystic acne, virilization, or galactorrhoea are present. Measurement of serum thyrotropin, serum iron and ferritin, and complete blood count may eliminate common causes of hair loss.


Differential Diagnosis of Androgenetic Alopecia

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