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Hair Loss News Archives
March 2006
Hair Loss In Women: More Than Meets The Eye
March 2006
At least half of women in the U.S. will experience some form of hair loss by the
time they are 50 years old.
The most common types often occur with greatest
frequency at a time in life when women are experiencing other life stressors
such as menopause, empty nest syndrome and the aging of their parents.
Hair loss can be frightening for women since it is often unclear how much hair
will be lost when it begins. Hair may cease being a "crowning glory" for the
affected woman and may require an adjustment in how she perceives herself and
how she presents herself. Fortunately, help is available through an appointment
with a dermatologist, a physician trained in the diagnosis and treatment of hair
loss.
Speaking today at the 64th Annual Meeting of the American Academy of
Dermatology, dermatologist Elise A. Olsen, M.D., professor of
medicine/dermatology at Duke University in Durham, N.C., discussed the three
most common types of hair loss in women.
"Women are generally unclear as to why they are experiencing hair loss and often
go to the Internet searching for remedies, most of which are ineffective and
unnecessarily expensive," stated Dr. Olsen. "Women need to see a dermatologist
when they develop hair loss to make sure that it is not coming from an
undiagnosed medical problem and a dermatologist can educate them on ways to
minimize or reverse hair loss."
Hair Loss in Caucasian Women
Different ethnic groups experience different types of hair loss. One of the most
common types of hair loss in Caucasian women is telogen effluvium, which is
characterized by increased shedding of hair over the entire scalp. Hair is lost
when combing, brushing and washing the hair. This type of hair loss may be
caused by thyroid, hormonal, nutritional or age-related factors, as well as
medications being taken or underlying disease.
This also is the type of hair
loss that pregnant women experience following the birth of their baby. "The
treatment and cure for telogen effluvium is to find the underlying problem which
initiated the hair loss," said Dr. Olsen.
Another common type of hair loss experienced by Caucasian women is female
pattern hair loss. This condition can begin early (teenage years to the early
20s) or late (early 40s to 50s) and is characterized by the loss of hair on the
top of the scalp, but not the back of the scalp. The hair becomes finer because
the individual hairs are smaller or "miniaturized."
The overall density may
decrease so dramatically that women may notice that their ponytail is smaller or
that they can now easily see their scalp when they style their hair. Some women
with female pattern hair loss also have hirsutism, which is the growth of hair
in the beard or moustache area, or persistent acne or irregular menstrual
cycles.
Some women with female pattern hair loss, particularly those with other medical
conditions, may have androgen -- a male hormone such as testosterone-
sensitivity causing these problems. Women with this pattern of hair loss should
be evaluated with special blood tests to determine their androgen levels. In
some cases, female pattern hair loss may be the first sign of an underlying type
of diabetes that is more frequent in women with elevated androgens in the blood.
"Women with female pattern hair loss should see a dermatologist to determine if
their hair loss is associated with underlying hormonal or endocrine problems,"
said Dr. Olsen. "If these are present, then the hair loss will require
addressing these problems first."
Topical minoxidil is one treatment for women with female pattern hair loss, but
it must be applied to the scalp twice a day for at least four months before the
patient will see results. "Minoxidil actually works by stimulating hairs that
are not functioning well or actively growing to have more robust active growth,"
described Dr. Olsen.
Topical minoxidil is currently the only hair regrowth
treatment for women approved by the U.S. Food and Drug Administration (FDA).
"In general, female pattern hair loss is a potentially reversible problem, but
in a small population of women, it can proceed to irreversible hair loss, or
cicatricial pattern hair loss," said Dr. Olsen. "Early diagnosis by a
dermatologist and treatment are the keys to successful results when dealing with
female pattern hair loss."
Hair Loss in African-American Women
Women of African descent have a different, but just as common, type of hair loss
called central centrifugal cicatricial alopecia (CCCA). This type of hair loss
also results in loss on the top of the scalp, while sparing the back of the
scalp. It is different than female pattern hair loss as the hair follicles have
a tendency to be destroyed, not just miniaturized.
Once a hair follicle is
destroyed, regrowth is not possible. Thus, women with this type of hair loss are
at risk for, and frequently develop, cicatricial or permanent hair loss and
should seek evaluation by a dermatologist as soon as possible.
Patients with CCCA will usually need a biopsy of their scalp, a simple office
procedure done in a dermatologist's office, to make the diagnosis.
Treatment for CCCA usually begins with treating any infection and using
anti-inflammatory medications to decrease or eliminate the inflammatory cells
that are attacking and destroying the hair follicle. Topical minoxidil also may
be used to stimulate the growth in any unscarred hair follicles.
It is currently unknown what causes this type of hair loss, but there is current
research being conducted to determine if hair care practices may be involved.
African-American women use relaxers, hot combs, heat and ointments on their
scalps and frequently wear tight braids or use heavy extensions that Caucasian
women do not.
Whether these hair care practices cause or merely contribute to
the process is uncertain. Other causes that are being researched are different
types of infection or hereditary factors that may be more common in
African-American women.
"A dermatologist is the expert to best diagnose the underlying cause when hair
loss occurs and will perform a thorough history, examine the scalp and may in
some cases do blood work or a scalp biopsy in order to determine the treatment
options that will maximize results for the patient," said Dr. Olsen. "I
encourage anyone with concerns about hair loss to schedule an appointment with a
dermatologist."
Headquartered in Schaumburg, Ill., the American Academy of Dermatology
(Academy), founded in 1938, is the largest, most influential, and most
representative of all dermatologic associations.
With a membership of more than 15,000 physicians worldwide, the Academy is committed to: advancing the diagnosis and medical, surgical and cosmetic treatment of the skin, hair and nails; advocating high standards in clinical practice, education, and research in dermatology; and supporting and enhancing patient care for a lifetime of healthier skin, hair and nails.
For more information, contact the Academy at 1-888-462-DERM (3376) or http://www.aad.org.