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Expert Q and A: Fighting Hair Loss in Women

An interview with Mary Gail Mercurio, MD.

How is female hair loss treated? continued...

In some cases, a hormonal abnormality, such as excess male hormones known as androgens, may be responsible for hair loss in women. One clue that hormones are involved is if the hair loss pattern resembles that of a man’s hair loss. This can be treated with prescription medications such as spironolactone or oral contraceptives.

In men, finasteride (originally marketed as Proscar) is approved for hair loss associated with androgens. In one study, 62% of women also taking oral contraceptives containing the synthetic progestin drospirenone reported improvement. So it may be effective for female hair loss in the setting of increased androgen. But studies are limited and it is harmful to the male fetus so should not be used by women thinking about becoming pregnant or who are pregnant.

Another treatment option is hair transplantation, in which tiny hair follicles taken from one area of the scalp are transplanted into the affected areas. It can be very effective and produce permanent results that are natural looking.

Should I change my hair care regimen?

No. Since there is no structural problem with the hair with female-pattern hair loss, women should continue their regular hair styling regimen. Sometimes women think they should stop washing, coloring, or perming their hair, but these things won’t impact the course of hair loss or speed up the process.

Wash with an anti-dandruff shampoo that contains ketoconazole (an antifungal) or zinc pyrthione (an antifungal and antibacterial).

Can hair loss be a sign of a more serious problem?

Yes. Hyperandrogenism, a medical condition characterized by excessive production of male hormones called androgens, can cause hair loss in affected women. The most common cause of hyperandrogenism in women is functional ovarian hyperandrogenism, also known as polycystic ovary syndrome. In addition to hair loss, other signs include obesity, acne, and irregular menstruation, and it is one of the most common causes of infertility.

Many of these women have metabolic syndrome -- a combination of five medical conditions including belly fat and high blood pressure that increase the risk of diabetes, heart attack, and stroke.

Although hair loss stemming from hyperandrogenism can be treated with minoxidil, you need to seek care for the other conditions.

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Reviewed on March 11, 2010

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