Female pattern hair loss (androgenetic alopecia in women): Treatment and prognosis
- Amy McMichael, MD
Amy McMichael, MD
- Professor of Dermatology
- Wake Forest University Baptist Medical Center
Female pattern hair loss (FPHL, female pattern alopecia, androgenetic alopecia in women) is a common form of nonscarring hair loss that most frequently occurs in adult women and primarily involves the frontal scalp and vertex of the scalp. Untreated, FPHL results in a slow, progressive decline in the density of scalp hair.
Multiple therapies have been used for the management of FPHL. Topical minoxidil is considered the first-line treatment. Data are limited on the efficacy of other agents, such as spironolactone, cyproterone acetate, finasteride, and flutamide. Hair transplantation surgery is an option for women who have inadequate responses to medical therapy.
The treatment and prognosis of FPHL will be reviewed here. The pathogenesis, clinical manifestations, and diagnosis of FPHL and the diagnosis and management of androgenetic alopecia in men (male pattern hair loss) are discussed separately. (See "Female pattern hair loss (androgenetic alopecia in women): Pathogenesis, clinical features, and diagnosis" and "Androgenetic alopecia in men: Pathogenesis, clinical features, and diagnosis" and "Treatment of androgenetic alopecia in men".)
In the absence of treatment, female pattern hair loss (FPHL) leads to progressive hair loss in affected areas, though not to complete baldness. Women may find the loss of hair distressing, and many women who present for the evaluation of FPHL desire treatment. (See "Female pattern hair loss (androgenetic alopecia in women): Pathogenesis, clinical features, and diagnosis", section on 'Psychosocial dysfunction'.)
As in the treatment of many other forms of hair loss, it is essential to thoroughly inform the patient of the following:
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