Female pattern hair loss is the most common cause of hair thinning in women. Hair plays a major role with one’s appearance and self-esteem especially in women. Hair loss in women and men are not the same. Women are not petite men. There is miniaturization of the hair follicle in both men and women with thinning hair but the pattern of the miniaturization clinically looks different in the two sexes. With age this process of miniaturization gradually decreases hair thickness and the hair shaft becomes thinner. The clinical result is the appearance of thinning scalp hair. This miniaturization process is controlled by hormonal and genetic factors. The incidence of thinning in women is less but there is a greater clinical importance and emotional impact. The difference is further demonstrated by the lack of response to medications that help male pattern thinning, like Propecia, demonstrating that there are other hormonal issues at play in female pattern hair loss.
There is a uniqueness of women with fine and thinning hair versus men as they have different thinning patterns, age of onset, and progression of the hair thinning process.
What are my options?
For women with pattern hair loss, there are many things that can damage the scalp and hair. Sun damage causes thinning of the epidermis and dermis and hair care products and treatments can also cause damage to the hair shaft and scalp skin. There are specific nutritional and metabolic requirements needed for healthy scalp skin and hair follicle growth, as well.
Any scientifically-proven ingredient that can directly stimulate the hair follicle complex (follicular stem cells) will increase hair volume, thickness and hair density. There are no quick fixes or hair fertilizers to create growth, but there are things women can do to improve and maintain healthy scalp and hair growth.
Sun protection is important for normal scalp as well as scalps with pattern hair loss. The greater the predisposition for pattern hair loss, the more important is the need for preventative sun protection. It is a myth that hats make your hair fall out and become bald. To the contrary, a hat can help protect the scalp and hair from UV sun damage which slows down the thinning hair process.
The greater the significance of female pattern hair loss (finer, thinner hair with more exposed scalp), the less natural protection the person has from sun damage. Obviously, the front, top and vertex of the scalp are the most vulnerable due to their proximity to the sun’s rays. Sun damage to the scalp can result in damaged stratum corneum cells, atypical epidermal cells, thinned epidermis and damaged dermis.
There are agents which have been shown clinically and histological to improve the health of the epidermis, dermis and hair follicle. Generally, these agents have been used on non-scalp skin. They include glypoic complex, minoxidil, retinoic acid and others. On a clinical basis, there is improvement in skin texture, skin color and skin tone with use of these ingredients, and even improvement in scalp hair growth.
These ingredients also cause a flattening of the stratum corneum, increased thickness of the epidermis, increased cellularity and vascularity of the dermis, an overall thickening of the dermis, and the development of larger hair follicles which will create thicker and longer hairs. On a physiologic basis, there is increased cell growth of the epidermis, improved epidermal exfoliation, increased glycosaminoglycan production, increased collagen synthesis and stimulation of the hair follicle matrix stem cells (increasing the hair growth cycle and shortening the resting phase of the telogen cycle) increasing the length, thickness and volume of the hair.
The scalp and hair have a pH of 4.5 +/- 0.5. Maintaining the normal pH of the scalp and hair is important for normal structure and function. Shampoos which contain ingredients to promote healthy scalp and hair (Glypoic Complex Volumizing Shampoo) are designed to clean dirt, sebum, oil and dead skin cells from the scalp and to promote normal scalp skin stratum corneum exfoliation and maintain the normal acidic pH of the scalp. Conditioners which contain ingredients to promote healthy scalp and hair (Glypoic Complex Volumizing Conditioner) are designed to restore the normal acid pH of the scalp skin, reduce tangle and restore the normal moisture content of the hair shaft. The moisture retention of the hair shaft is pH dependent. Acidic pH causes the cuticle cells to flatten and seals the moisture into the hair shaft. Safe chemical treatments to the hair shaft do not have a negative impact on the scalp, hair follicle or hair growth. They work only on the hair shaft above the scalp skin and do not have a negative impact on the hair follicle, stem cells of the hair follicle or the dermal papillae.
Nutrition plays a role in healthy scalp skin and hair shaft growth. Scalp skin and hair are composed of keratin protein. with hair consisting of 97% protein. Keratin proteins are amino acids linked end-to-end and cross linked with sulfur bonds from the amino acid cystine. Cystine and glutamic acid make up 30% of the amino acid content of human hair.
Red meat and eggs contain significant cystine, but many people have decreased their intake of red meat and eggs to lower blood cholesterol levels. To avoid unhealthy dietary changes, it is more efficient to take a multivitamin and an amino acid supplement on a daily bases to improve scalp skin and hair growth. There are individuals at greater risk for genetic pattern hair loss or conditions with increased telogen loss and daily nutritional support for normal hair growth is important. These patients are at greater risk to have poor hair growth without adequate nutritional supplements.
Low level laser light therapy creates biostimulation which affects the mitochondria and in turn messenger RNA synthesis which ultimately leads to enhancement of cell proliferation. Early initiation of therapy more effective and late stage treatment may just prevent progression.
PRP is an exciting alternative, non-surgical procedure for men and women who are experiencing hair loss on the scalp or eyebrows. PRP has been a successful procedure for tissue and wound healing throughout the body and has also been proven to be a beneficial alternative for treatment of hair loss. PRP is an all-natural, bio-identical autologous procedure in which the platelet rich plasma used to stimulate hair growth comes from your own blood. PRP is effective because Platelet Rich Plasma contains specific growth factors which, when injected back into an area of hair loss, stimulates hair follicle stem cells promoting new hair growth.
Amniotic fluid and membrane contain collagen substrates, growth factors, amino acids, carbohydrates, and cytokines, which are known to aid in the migration and proliferation of cells to the site of injury, helping to construct a natural scaffold on which new tissue growth can take place
If conservative non-surgical treatment is not effective for female pattern hair loss, hair transplant surgery is the final option. Follicular unit hair transplant procedures create increased hair density with a natural pattern and appearance. The introduction of follicular unit extraction techniques eliminate the need for surgical excision of donor tissue and suturing of the donor tissue. The Artas robotic system eliminates the surgical fatigue created by manual extraction of the follicular units needed for placement in the recipient area.