Female Follicle Loss
Women who are losing their are receiving more and more attention. For many women, hair is an important extension of their personality and esteem. An estimated 30 million women in the country experience some form of follicle depletion. Loss of hair in men, although generally very undesirable, has always been socially acceptable. For women who are going bald, it is not so acceptable, and is generally more devastating. Not so uncommonly, a woman who is bald is thought to have an illness rather than someone who is experiencing genetic baldness. Women who are bald experience feelings of embarrassment as well as a loss of confidence and self-esteem, which may lead to feelings of inadequacy and alienation.
In women, as in men, the most likely cause of this problem is androgenetic alopecia – an inherited sensitivity to the effects of androgens (male hormones) on follicles. An enzyme converts testosterone to dihydrotestosterone, which shrinks the follicle. This problem in women usually manifests itself as diffuse thinning throughout the head with preservation of the hairline. The patterns in women are not as easily recognizable as those in men, and may not occur in any recognizable pattern at all.
Female follicle loss patterns may include:
- Diffuse thinning over the entire head with more noticeable thinning toward the back
- Diffuse thinning over the entire head, more noticeable thinning toward the front, but not involving the hairline
- Diffuse thinning over the entire head, more noticeable toward the front and involving the hairline
Women with androgenetic alopecia do not usually develop true “cue ball” baldness as often seen in male patterns. It may begin at any age and may not have any obvious hereditary association. A trained and experienced physician should make diagnosis of this problem in a woman.
Non-pattern causes of follicle loss in women:
In women, more often than in men, female baldness may be due to conditions other than androgenetic alopecia. Some of the most common of these causes are:
- Traction Alopecia: Associated with persistent tight braiding or “corn-rowing” most commonly seen in African-American females. Usually seen in the frontal and temporal hairlines as chronic traction and pulling destroys the follicles over time.
- Telogen Effluvium: A common type of loss caused when a large percentage of follicles in a relatively short period of time are shifted into a “shedding” phase. The causes may be hormonal, nutritional, drug associated, or stress induced. Follicles generally regrow with removal of the offending cause.
- Trichotillomania: Generally a patchy loss of follicles caused by compulsive follicle pulling with underlying psychological or emotional cause.
- Alopecia Areata: Thought to be an auto-immune disorder. A patchy baldness that can range from diffuse thinning to extensive areas of baldness with “islands” of retained follicles. A recurrent disease with episodes of depletion and regrowth generally treated with steroids and minoxidil.
- Scarring Alopecia: Permanent loss of follicles occurs as normal tissue is replaced by scar tissue. They include:
- Lupus Erythematosus – a multisystem immune disorder
- Scleroderma – a genetic disease which causes local or generalized hardening of skin and body tissues
- Trauma or surgery - poor scarring from accidents or cosmetic surgery, commonly seen and generally very successfully treated
- Infectious Agents - Bacterial, fungal, or viral infections may leave scarred areas bald.
- Burns – from heat or chemicals. Success of treatment depends on extent of injury and scarring.
- Loose Anagen Syndrome: A genetic condition in which follicles sit losely and are easily extracted by combing or pulling. The condition, more common in fair-haired persons, may appear in childhood and improve as one ages.
- Medication induced baldness : Chemotherapeutic agents/cytotoxic agents, anticoagulants, colchicine, ceptapril, Vitamin A as well as many more may induce nonscarring baldness.
- Chemical induced follicle depletion: Caustic chemicals such as relaxers or straighteners.
