Female pattern hair loss or androgenetic alopecia is the most common cause of hair loss in women and is generally more common than expected. Hair loss is seen in 25% of women aged 35-40 years and in 50% of women over 40 years of age. 20% of women who have lost their hair have a positive family history. In the genetic type of hair loss, the woman may have inherited the genes from her father or the mother. The aromatase enzyme and 5 alpha reductase enzymes play an important role in these genetic spills.
The 5 alpha reductase enzyme, which is the number one responsible for the loss in men, is found in smaller amounts in women. Aromatase enzyme is involved in the production of female hormones estron and estradiol and it reduces the amount of DHT. . Because of the aromatase enzyme activity, there is no shedding in the anterior hair line in women differently from men.
Although hair loss is thought to be rare in women, 30% of women have thinning hair at least once during their lifetime. . In women, this condition is commonly seen on all hair and does not cause complete baldness like in men. Therefore female type shedding (thinning and thinning) is rarely perceived. This situation is thought to be rare but affects 1/3 of women, the unwanted and feared complete baldness is unacceptable by the social environment, and it can often lead to a major morale breakdown even in the early stages of hair thinning. Women often want to cover and hide their hair that is shed and tapered; they do not even share their problems with their fellow men. All these misunderstandings and behaviors make female-type spills more difficult.
Androgenetic female pattern hair loss takes the first place, among the causes of hair loss in women. Other common causes of hair loss are: Hypo and hyperthyroidism (hair loss may be one of the early symptom of thyroid dysfunction and hair loss stops after treatment); polycystic ovary syndrome (an hereditary ovarian disease that can be seen in about 10% of women in the reproductive age); hormonal changes due to pregnancy (temporary hair loss during pregnancy, then improves); hormonal changes due to menopause (hair loss can be seen with the onset of menopause and drug treatments that correct menopause syndromes are reduced and disappeared). About 80% of menopausal women may have thinning hair.
Hair fractures in women can be misunderstood as thinning or shedding of hair. The causes of breakage may be hair straighteners, hair softeners, frequent hair coloring and permanent blow dryers (such as brazilian blowers, etc.). In addition, too tightly tying the hair, braiding, tightly shaped in the form like corn weave and stretching the back to tie the hair follicles due to pulling permanently and causes hair loss. (traction alopecia). Should be avoided this type of hair by creating stress on hairstyles.
- Blood thinners such as warfarin and heparin
- Epilepsy drugs, especially dilantin
- Gout medications, allopurinol and colchicine
- Antihypertensive drugs, diuretics, beta blockers
- Antiinflammatories, especially prednisone
- Cholesterol and lipid lowering agents
- Mood-altering drugs such as prozac, lithium, tricyclic antidepressants
- Thyroid drugs
- Oral contraceptives, especially those with high progestin levels
- Diet pills, street drugs such as cocaine, high-dose vitamin A intake
Although hair loss is thought to be rare in women, hair thinning is observed in 30% of women at least once during their lifetime. Shedding, thinning and thinning are perceived in the late period as shedding is common in all hair and the anterior hairline is generally well maintained in women. Shedding is common in 90% of women and is seen in all hair strands; 10% may have side-opening as in men; but it does not create complete baldness as in men.
As we explained earlier, there are 3 types of shedding in women:
- Diffuse, common pine tree-like appearance on all scalp;
- Localized, sometimes thinning of hair;
- Rarely patterned (male type) hair loss.
The most common type of hair loss in genetic hair loss, depending on the amount of hair loss ”Ludwig” classification is as follows:
Type 1 Mild Hair Loss: Early period spill. Hair loss can be easily camouflaged with a good comb.
Type 2 Middle Level Hair Loss: There is serious opening in the middle of head and reduction in hair volüme.
Type 3 High Level Hair Loss: When viewed from the top of head, the skin is visible and the anterior hairline is affected by hair loss. Thinning of hair is extremely common. In this case, the person's social self-relance was greatly distrusted and his psychology was negatively affected. Prosthetic hair applications will surely give the most natural and aesthetic results in order to eliminate these problems.
Another classification of hair loss types in women is the Savin classification: Here, total thinning of the hair is taken into consideration and is a more detailed classification. In the first 8 schemes, thinning and opening of hair are classified from less to most. Male type hair loss as seen in the 9th Picture and widespread hair loss in the upper side as seen in the 8 th Picture are very rare hair loss types.
The hair usually grows 1 centimeter a month and leads for 2-6 years, then enters the rest phase before the hair is shed. Soon afterwards, grows up new strands from the empty space. In a normal head, 85 percent of hair is growing phase and 15 percent is at rest. Baldness occurs when there is no replacement of the shedding hair.
The average rate of incidence of female type hair loss is less than that of men. Nevertheless, although it has similarities with male type shedding, it is different in many aspects. . In fact, it is more accurate to say hair thining rather than hair loss because women meet rare to completely hair loss like men. Although female type hair loss is associated with hormones, it does not start immediately with adolescence as in men. Hair loss come across elder than men. Menopause is a period of intense shedding. Drug use and pregnancy are the two main preparatory causes of early hair loss. It is worth noting that birth is an important period that increases hair loss in women.
Opening of the forehead is a very rare condition in female type hair loss.
Classification is usually done in 3 (Ludwig Classification) and sometimes 5 stages.
Stage 1: The spill has just begun and the patient has no idea whether the spill is reversible or permanent. Since women apply to doctors earlier, they start to receive treatment for hair loss during this period. Mostly these treatments are shampoos and home care cures.
Stage 2: Hair loss has advanced. Hair loss at sides and back of head is not expected much compared to male type shedding. It is the most frequently used period of medical clinical applications. If patients do not benefit from home care cures, they may prefer to have clinical applications more.
Stage 3: Menopause type hair losses are these types of spills. Women who wear a headscarf are more likely to experience hair loss. . The increase in the number of strands to be obtained with clinical applications and the number of strands per cm2 are insufficient.
Stage 4: The first stage of progressive type female hair loss is considered. Because in many women hair loss remains in the third stage. . In some patients it progresses to stage 4. In this stage, hair prosthesis is the most natural and aesthetic result. It is easy and handy.
Stage 5: The last stage of diffuse (progressive) hair loss. At this stage, where cosmetic precautions (prosthesis) are more appropriate options than medical treatments, the patient knows that treatment options are limited.