Margit Kohler

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Causes and types of hair loss among women

Androgenetic alopecia

Similar to the situation among men, the predisposition for hair loss among women can be inherited from the father as well as from the mother. In this case, it is referred to as androgenetic or constitutional hair loss, which usually leads to a thinning of hair on the front or top side of the head. Just because a person carries genes for hair loss or baldness does not mean that this characteristic will be exhibited. The ability of a gene to express characteristics in a certain individual is called expression. It depends on quite a few factors. The most important of them are hormones and age, but stress and other factors can also play a role.

Dispositional hair loss occurs less frequently among woman as among men – but the cause is the same: the sex hormone testosterone. This male androgen is formed among women in the ovaries and the adrenal cortex. It is to a much lesser extent than among men, but through the bloodstream it reaches the hair roots, where it is taken up and transformed into effective dihydrotestosterone. The first signs of androgenetic alopecia are generally first exhibited at an older age, in most cases after menopause.

Diffuse hair loss

The causes of this form of hair loss frequently,  occurring among women are usually of a medical nature or medicinally conditioned. They can lead to a restriction of hair growth, a resting phase lasting up to one year and subsequently to loss of hair. In contrast to the genetically conditioned form, diffuse hair loss is reversible in most cases,  if it is possible to successfully remedy the cause. Diffuse hair loss can appear on the entire head and occurs more frequently among women than among men.

Medical causes include those of a gynaecological nature (pregnancy, menopause), a thyroid disease or connective tissue disease and improper nutrition (anorexia, crash diets, deficiency symptoms with zinc and iron or an oversupply of vitamin A).

Among those medications which are known to cause diffuse hair loss are thyroid medicines, cholesterol-lowering agents, blood thinners (e.g. heparin, warfarin), antidepressants, blood pressure medications (e.g. beta blockers, Inderal®, diuretics) as well as agents for treatment of epilepsy and gout. This also includes medications which are employed with chemotherapies, and several diet pills and drugs such as cocaine.

Localised hair loss

This form of hair loss can be clearly differentiated from diffuse hair loss by specialists. In which case there are two types, scarring and non-scarring. For instance, alopecia areata – during which circular bald spots are formed on the head – is attributable to an autoimmune disease. It is a non-scarring type and can be treated through injection of steroids/cortisone.

However, certain medicinal problems cause a scarring type of localised hair loss. The causes can be injuries after accidents or face/forehead lifts, also local radiotherapy or dermatological causes are possible. In these cases, own hair transplantation is usually the only effective treatment for a permanent solution of the problem.


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