Female pattern hair loss refers to the type of hair loss women get as they age, although it is usually determined by heredity. This pattern is also called androgenetic alopecia; the hair on the center of the top of the head gets thin before the other areas. This may be accompanied by a receding hairline and is usually occurs gradually. The first sign of female pattern baldness may be that the part becomes wider. It can be genetic from either the mother or father’s side of the family. Occasionally this can be caused by hormone imbalance or polycystic ovarian syndrome (PCOS).
It is important to distinguish this from another form of hair loss common in women called telogen effluvium. The pattern of telogen effluvium is usually hair loss that is all over the scalp. This usually occurs more suddenly, possibly 3-8 months after a major stressor (illness, hospitalization, childbirth or death in the family). Other causes of telogen effluvium include medications, thyroid disorders and low iron stores. We find the most common cause is low iron stores, measured by a blood test called ferritin, which is not usually checked in regular physical examinations. Most of these can be checked with blood tests and this type of hair loss is usually reversible.
There are currently very few successful treatments for androgenetic alopecia. At Advanced Dermatology, we have found the most successful treatment is combining 5% minoxidil (so-called "Male Rogaine") with a topical steroid in a solution to be used on the scalp once a day. There are publications that do show that using 5% minoxidil (as opposed to 2% minoxidil, so-called “Female Rogaine”) used once daily is more effective in women than using 2% minoxidil twice per day.