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Expert Q and A: Fighting Hair Loss in Women

An interview with Mary Gail Mercurio, MD.
By
WebMD Feature
Reviewed by Laura J. Martin, MD

Many women with hair loss suffer in silence, altering their hairstyle to hide thinning or patches. But the sooner you seek care, the better the chances of successfully treating it, says Mary Gail Mercurio, MD, associate professor of dermatology at the University of Rochester in Rochester, N.Y.

It's not as uncommon as you may think: As many as 5% of women under 30 and 60% of those older than 70 are affected, she says. At the recent meeting of the American Academy of Dermatology in Miami Beach, Fla., Mercurio discussed common forms of hair loss in women and treatment options.

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What's the most common form of female hair loss?

Female-pattern hair loss, which usually has a strong genetic component that can be inherited from either the mother or father. Also referred to as androgenetic alopecia, this type of hair loss can start as early as the late teens -- and the earlier it starts, the more severe the hair loss tends to be.

Most women with pattern hair loss don't get a receding hairline or bald spot on top of the scalp as is common in men. Instead, there is visible thinning over the crown. In men and women, hairs are miniaturized because of a shortened growth cycle where the hair stays on the head for a shorter period of time. These wispy hairs, which resemble forearm hairs, do not achieve their usual length.

The first sign of hair loss that most women notice is often widening of their part or that their ponytail is smaller.

How is female hair loss treated?

Minoxidil 2% is the only topical medication approved by the FDA for female-pattern hair loss. I find that the stronger minoxidil 5%, approved only for male-pattern hair loss, is very effective in women as well. But it can sometimes increase facial hair growth.

The 2% and 5% solutions are available over the counter in a liquid, and the 5% is also available in a foam. Minoxidil works by prolonging the growth phase of hair -- providing more time for hair to grow out to its full density.

You have to be patient, as noticeable results usually take three to four months and the product must be used twice a day. It tends to work better if started early.

I put some on my forearm and got a big thick patch of hair. When I stopped, it went away.

Doctors may also test for levels of ferritin (a protein that indicates the amount of total body iron stores). New research suggests levels may be low in women with hair loss. Iron supplements may help.

Also new is the HairMax Laser Comb. It's a red light therapy hairbrush-like device that increases circulation and the biological march that makes hair. It's only approved in men (though some women are using it) and in my experience, is not as good as minoxidil. But in one study, 45% of users reported improvement after eight weeks, and 90% saw improvement after 16 weeks.

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