Female pattern alopecia: current perspectives

Abstract

Hair loss is a commonly encountered problem in clinical practice, with men presenting with a distinctive pattern involving hairline recession and vertex balding (Norwood-Hamilton classification) and women exhibiting diffuse hair thinning over the crown (increased part width) and sparing of the frontal hairline (Ludwig classification). Female pattern hair loss has a strikingly overwhelming psychological effect; thus, successful treatments are necessary. Difficulty lies in successful treatment interventions, as only two medications – minoxidil and finasteride – are approved for the treatment of androgenetic alopecia, and these medications offer mediocre results, lack of a permanent cure, and potential complications. Hair transplantation is the only current successful permanent option, and it requires surgical procedures. Several other medical options, such as antiandrogens (eg, spironolactone, oral contraceptives, cyproterone, flutamide, dutasteride), prostaglandin analogs (eg, bimatoprost, latanoprost), and ketoconazole are reported to be beneficial. Laser and light therapies have also become popular despite the lack of a profound benefit. Management of expectations is crucial, and the aim of therapy, given the current therapeutic options, is to slow or stop disease progression with contentment despite patient expectations of permanent hair regrowth. This article reviews current perspectives on therapeutic options for female pattern hair loss.

Promotion of anagen, increased hair density and reduction of hair fall in a clinical setting following identification of FGF5-inhibiting compounds via a novel 2-stage process

“…It will be interesting to directly compare demonstrated FGF5 inhibitory products such as the monoterpenoid MTP3 against the FDA-approved treatments in our preparation for larger trials in men and women. One consistently reported feature of minoxidil treatment is an initial increase in hair shedding as follicles transition to anagen phase and existing telogen hair shafts enter exogen 45. Such initial shedding can impact on patients’ compliance and continued use of hair loss products containing minoxidil.…”

Cosmetic Procedures in the Treatment of Alopecia

“…Various cosmetic procedures are being applied for different types of alopecia including mesotherapy, microneedling, platelet-rich plasma (PRP), low-level light therapy, and stem-cell therapy with variable outcomes [2,3].…”

Controversy on the role of iron and a clinical trial with intermittent iron and nutritional supplements in hair loss management

“…The duration of 6 months also provide adequate duration of treatment for minoxidil response which most studies consider to be 6 months (6), for effective clinical improvement. Complain of hair loss for 8-10 weeks in the minoxidil group can be due to initial increased shedding known to happen with minoxidil during the phasing period (6). The shedding creates a lack of confidence among patients who then insist that the hair loss is severe and unremitted for a longer duration.…”