Wednesday, 1 January 2014

Genetic hair loss in Women

Characterised by thinning of the hair in the front and top area of the scalp, genetic hair loss is understood to be inherited from both parents. While a daughter may inherit the condition from her parent's gene pool, it is still possible for both parents to have thick hair.

Genetic hair loss in women is sometimes associated with oily skin, excessive facial hair and sensitive or 'burning' scalp.

Estrogens (female hormones) are “good” for the hair. Androgens (male hormones) are “bad” for the hair. Women and men produce both types of hormones. In women with genetic thinning, their levels of androgens are usually quite normal.

In younger women, genetic thinning can be triggered by particular oral contraceptives. Progestogens that are not considered to have an adverse effect on the hair include desorgestrol, gestodene and cyproterone acetate (androcur). Androcur is contained in the oral contraceptive Diane 35 ED (see below)

If a sex hormonal imbalance is suspected, blood tests can be run that establish whether the ovaries or adrenal glands are at fault. Once the problem can be pinpointed, corrective action can be taken. Relevant blood tests include SHBG. Total testosterone, free testosterone, DHEAS, FSH, LH and Prolactin.

Inflammation / swelling around the hair follicles are indicative of the stem cells of the hair follicles being attacked by a group of white blood cells. The oral intake of tyrosine usually reduces this inflammation quite quickly. Tyrosine reduces the production of noradrenaline from the sympathetic nerves in the skin. In turn, this reduces the white blood cells.


Such oral contraceptives as Diane 35 ED (Brenda, Estelle, Juliet) or Yasmin or Yaz. The possible side – effects of the therapy include weight gain, nausea, headaches and decreased libido.

The diuretic Aldactone also called spironolactone. Possible side-effects include hyperkalaemia, mood swings, disturbed cycles, and tenderness of the breasts. Because of the hyperkalaemia, patients on spironolactone should not take potassium supplements.

The topical application of Minoxidil 5% (Rogaine etc.)

Finasteride (Propecia or Prosar), 1 to 2.5 mg daily. There have now been several medical studies undertaken with Finasteride which show positive results for women. You or your doctor can review the studies at PubMed on the internet: Type in 'androgenetic alopecia in females and Finasteride'.

Herbally, phytoestrogens such as Dong Quai, red clover or Black Cohosh can sometimes stabilise or reverse genetic thinning. Phytoestrogens probably work by blocking androgen – receptor sites. Saw palmetto may also be of benefit.

If treatment helps, it has to be continued for life. It can take at least 6 months before improvement becomes apparent.

Kate Dawes I.A.T Trichologist

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