FPHL, also referred to as Androgenetic Alopecia, is a type of diffuse hair loss that cannot be reversed. It typically starts around the temples and gradually progresses towards the top of the head, eventually resulting in baldness. It primarily affects the scalp, leading to a gradual thinning and loss of hair. Without proper treatment, hair regrowth is unlikely.

Similarly, male pattern baldness also referred to as androgenic alopecia, shares similarities with female pattern baldness. However, it predominantly affects individuals assigned male at birth, causing hair loss and thinning in a characteristic pattern.

Classification:

According to the Ludwig Classification, FPHL is categorised into three types:

Type I: Minimal thinning.

Type II: Reduced volume and widening of the midline.

Type III: Diffuse thinning and a visible see-through appearance on the top of the scalp.

Stages of female pattern baldness

Female pattern baldness progresses through five stages as defined by the Sinclair scale:

Stage 1: Minimal or no hair loss is observed.

Stage 2: A small gap emerges in the central hair part.

Stage 3: The central hair part widens further, accompanied by the hair loss on both sides of the part line.

Stage 4: Bald patches become visible near the front of the hairline.

Stage 5: Severe hair loss has occurred, indicating an advanced stage.

Causes:

Female pattern baldness is primarily attributed to genetic or hormonal factors, resulting in hair thinning and reduced hair growth. While multiple factors can contribute to this condition, here is a comprehensive list of the key factors associated with FPHL:

Hormones: Elevated levels of androgens can lead to hair loss and thinning.

Genetics: If you possess genetically determined shorter anagen phases, it means there is an extended period between hair shedding and the growth of new hair. Additionally, follicular miniaturisation occurs, wherein thicker hair is replaced by shorter and finer hair.

Deficiencies: Iron deficiency anaemia affects over 50% of females, leading to hair loss and diminished hair growth.

Age: Hair loss becomes more prevalent after menopause due to a decrease in the production of oestrogen and progesterone, which are responsible for promoting hair growth and prolonging the hair's lifespan on the scalp.

Stress: The experience of stress can elevate levels of corticosterone, which in turn induces hair follicles to enter a resting phase by rendering the dividing stem cells inactive, thus hindering hair regeneration.

Certain Internal Diseases: Such as diabetes, hypertension, and chronic conditions like cancer, can contribute to hair loss by impeding the flow of oxygen and nutrients to the hair follicles. In autoimmune disorders like alopecia areata, the body's immune system mistakenly attacks the hair follicles, resulting in hair loss.

Scalp Diseases: Hair loss can be triggered by scalp diseases such as fungal infections like ringworm, psoriasis, or conditions like dandruff (seborrheic dermatitis).

Treatment Options 

Female pattern baldness can be treated through various methods. The following treatments are commonly recommended:

Medications: Applying over-the-counter medications directly to the scalp is often the initial approach for treating female pattern baldness. Minoxidil is a popular choice in this category. Additionally, a prescription oral medication called finasteride  can be effective in treating female pattern baldness. In some cases, healthcare providers may recommend combining finasteride with ketoconazole 2% shampoo for optimal results.

Hair Transplant: A medical professional harvests healthy hair follicles from areas of your body and transplants them to bald or thinning areas on your scalp.

Platelet-rich Plasma: Blood is drawn from your body, processed to concentrate platelets, and then injected into your scalp to promote hair growth.

Red Light Therapy: Using low-wavelength red light, your healthcare provider applies treatment to your scalp to enhance hair growth.

Styling Techniques: Certain hairstyles, wigs, or hair weaves can be utilised to conceal female pattern baldness.

Not all treatments work universally. Your healthcare provider will assist you in finding the most suitable treatment option for your specific needs.

Preventing female pattern baldness

While female pattern baldness can be influenced by genetics and may not always be preventable, there are measures women can take to maintain healthy hair and minimise breakage and damage.

Here are some hair care suggestions to consider:

1. Reduce the use of treatments that can cause hair damage, such as perming, straightening, and hair extensions

2. Ensure your diet includes an ample amount of protein, essential vitamins, and iron

3. Shield your hair from sun damage by wearing a hat or using protective products

4. Refrain from brushing wet and fragile hair; instead, use a wide-toothed comb or your fingers for gentle detangling

Conclusion

Female pattern baldness is a prevalent condition that impacts numerous women following menopause. While many women with this condition consider it a natural part of ageing and choose not to seek medical attention, it can have adverse effects on mental well-being. If you observe any signs of female pattern baldness, particularly if it causes distress, anxiety, or depression, it is crucial to promptly consult your healthcare provider. 

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