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Female pattern hair loss.
Indian J Dermatol Venereol Leprol. 2013 Sep-Oct; 79(5):626-40.IJ

Abstract

Female pattern hair loss (FPHL) is a common cause of hair loss in women characterized by diffuse reduction in hair density over the crown and frontal scalp with retention of the frontal hairline. Its prevalence increases with advancing age and is associated with significant psychological morbidity. The pathophysiology of FPHL is still not completely understood and seems to be multifactorial. Although androgens have been implicated, the involvement of androgen-independent mechanisms is evident from frequent lack of clinical or biochemical markers of hyperandrogenism in affected women. The role of genetic polymorphisms involving the androgen and estrogen receptors is being increasingly recognized in its causation and predicting treatment response to anti-androgens. There are different clinical patterns and classifications of FPHL, knowledge of which facilitates patient management and research. Chronic telogen effluvium remains as the most important differential diagnosis. Thorough history, clinical examination, and evaluation are essential to confirm diagnosis. Patients with clinical signs of androgen excess require assessment of biochemical parameters and imaging studies. It is prudent to screen the patients for metabolic syndrome and cardiovascular risk factors. The treatment comprises medical and/or surgical modalities. Medical treatment should be initiated early as it effectively arrests hair loss progression rather than stimulating regrowth. Minoxidil continues to be the first line therapy whereas anti-androgens form the second line of treatment. The progressive nature of FPHL mandates long-term treatment for sustained effect. Medical therapy may be supplemented with cosmetic concealment in those desirous of greater hair density. Surgery may be worthwhile in some carefully selected patients.

Authors+Show Affiliations

Department of Dermatology and STD, University College of Medical Sciences and GTB Hospital, University of Delhi, Delhi, India.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

23974580

Citation

Singal, Archana, et al. "Female Pattern Hair Loss." Indian Journal of Dermatology, Venereology and Leprology, vol. 79, no. 5, 2013, pp. 626-40.
Singal A, Sonthalia S, Verma P. Female pattern hair loss. Indian J Dermatol Venereol Leprol. 2013;79(5):626-40.
Singal, A., Sonthalia, S., & Verma, P. (2013). Female pattern hair loss. Indian Journal of Dermatology, Venereology and Leprology, 79(5), 626-40. https://doi.org/10.4103/0378-6323.116732
Singal A, Sonthalia S, Verma P. Female Pattern Hair Loss. Indian J Dermatol Venereol Leprol. 2013 Sep-Oct;79(5):626-40. PubMed PMID: 23974580.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Female pattern hair loss. AU - Singal,Archana, AU - Sonthalia,Sidharth, AU - Verma,Prashant, PY - 2013/8/27/entrez PY - 2013/8/27/pubmed PY - 2014/3/26/medline SP - 626 EP - 40 JF - Indian journal of dermatology, venereology and leprology JO - Indian J Dermatol Venereol Leprol VL - 79 IS - 5 N2 - Female pattern hair loss (FPHL) is a common cause of hair loss in women characterized by diffuse reduction in hair density over the crown and frontal scalp with retention of the frontal hairline. Its prevalence increases with advancing age and is associated with significant psychological morbidity. The pathophysiology of FPHL is still not completely understood and seems to be multifactorial. Although androgens have been implicated, the involvement of androgen-independent mechanisms is evident from frequent lack of clinical or biochemical markers of hyperandrogenism in affected women. The role of genetic polymorphisms involving the androgen and estrogen receptors is being increasingly recognized in its causation and predicting treatment response to anti-androgens. There are different clinical patterns and classifications of FPHL, knowledge of which facilitates patient management and research. Chronic telogen effluvium remains as the most important differential diagnosis. Thorough history, clinical examination, and evaluation are essential to confirm diagnosis. Patients with clinical signs of androgen excess require assessment of biochemical parameters and imaging studies. It is prudent to screen the patients for metabolic syndrome and cardiovascular risk factors. The treatment comprises medical and/or surgical modalities. Medical treatment should be initiated early as it effectively arrests hair loss progression rather than stimulating regrowth. Minoxidil continues to be the first line therapy whereas anti-androgens form the second line of treatment. The progressive nature of FPHL mandates long-term treatment for sustained effect. Medical therapy may be supplemented with cosmetic concealment in those desirous of greater hair density. Surgery may be worthwhile in some carefully selected patients. SN - 0973-3922 UR - https://www.unboundmedicine.com/medline/citation/23974580/Female_pattern_hair_loss_ L2 - http://www.ijdvl.com/article.asp?issn=0378-6323;year=2013;volume=79;issue=5;spage=626;epage=640;aulast=Singal DB - PRIME DP - Unbound Medicine ER -