Baldness is slow, painless hair loss that

follows a set pattern in some people as they

age. In many women a gradual but slight,
widespread thinning of the hair starts in adult
life. It is basically a natural process and
should not be regarded as abnormal. About
50% of women have significant hair loss by
the age of 60. However, some women expe-
rience marked loss of hair which can be
embarrassing and upsetting.
What i s t he pat t ern?
Women experience a different pattern of
hair loss from men. Diffuse thinning usually
occurs on the top of the head (ie, the crown).
The front hairline usually remains but in
some women this can recede.
Although hair loss can appear in men as
early as the 20s, it rarely appears before the
age of 50 in women. Some women notice a
short period of considerable hair loss but this
may be followed by a long, stable period of
no loss. However, some women may have
total hair loss.
What i s t he cause?
Significant hair loss may follow a family
tendency. Ageing is also a factor and hair
thinning is inevitable in most people with
advancing years.
Baldness is sometimes caused by a severe
sudden illness in which hairs stop growing
and then fall out in about three months.
However, they usually grow back after
recovery.
Crash dieting and anorexia can also cause
this problem.
Certain illnesses such as thyroid disorders
and iron-deficiency anaemia can cause dif-
fuse hair loss. Some fungal infections can
result in bald patches.
Certain treatments, especially cytotoxic drug
treatment used to slow down cell growth in
cancer can cause severe hair loss. Hair usu-
ally regrows when drugs are stopped.
Some people are affected by a specific
hair loss disorder called alopecia which
causes premature hair loss and can spread
to involve the whole scalp (alopecia totalis).
Some women notice hair thinning occurs
about three months after having a baby and
are aware of many loose hairs when combing.
This is a common occurrence and the hair
usually grows back in the following months.
Is menopause associ at ed wi t h hai r
t hi nni ng?
There is a tendency to lose hair after
menopause. Some women, particularly those
with a hereditary tendency, are more prone to
this condition.
Is t aki ng t he combi ned oral cont ra-
cept i ve pi l l a probl em?
Female hormones are protective against
hair loss. The pill should not cause either
hair thinning or regrowth.
How common i s t he probl em?
Natural hair loss is very common in women.
Each year about one person in 400 sees a
doctor about unusual hair loss or baldness.
What can be done?
Medication
Management is a rather controversial sub-
ject, especially the use of medication. Med-
icated shampoos and ointments should not be
used they do not help. Do not get caught
up with quack remedies. Vigorous brushing or
washing of the hair also does not usually help.
Some drug treatments may slow down or
prevent further hair loss. These include a top-
ical treatment called minoxidil which is mas-
saged into the scalp, and hormone-altering
tablets, namely spironolactone and cypro-
terone acetate. With these treatments most
women will notice a reduction in hair loss
and some will notice hair regrowth but normal
regrowth is exceptional. The medications are
expensive and need to be used for the rest of
ones life if a good response occurs.
You can discuss these medications with
your doctor.
Physical treatments
Other treatments include the use of wigs,
hair transplantation and camouflage.
Wigs can be worn on the whole head, on
the bald spot, or fibres can be interwoven
into the remaining hairs. Wigs made from
real human hair look better but are more
expensive than artificial wigs.
Camouflage can be used either by having
existing hair bleached by a skilled hairdresser
or by colouring the scalp the same colour as
the hair. Mascara can be lightly brushed into
the roots of the hair at receding hairlines or
along parts. You can consult hairdressing
experts about camouflage.
PATIENT INFORMATION
Female pattern baldness
AUTHOR: PROFESSOR JOHN MURTAGH
Copyright of Professor John Murtagh and Australian Doctor. This patient handout may be photocopied or printed out by a doctor free of charge for patient information purposes.
Common pat t ern
Less common
pat t ern
Bal dness of
crown
Thi nni ng over
crown
Front al hai r
l i ne may
recede