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What is female alopecia?

Hair loss is not just a male trait. Female alopecia also exists. This alopecia can appear between the ages of 20 and 30, although it is more common between the ages of 40 and 60.

What is androgenetic alopecia?

Female alopecia

Healthy, strong hair.


Androgenetic alopecia appears in women due to hormones, ageing and genes. Female physiology is unique and factors such as menstrual cycles, pregnancy, and menopause are particularly influential in this alopecia.

The symptoms of female alopecia differ greatly from that of male alopecia. The pattern is considered widespread or crown. The area that begins to weaken in this case is the central line, while the hair in the frontal area is maintained. The hair does not completely disappear, but is replaced by increasingly thinner hair, which leaves more and more of the scalp visible. In the most severe cases, however, the frontal line may disappear due to the loss of estrogenic protection caused by menopause.


Local treatment

Stages of female alopecia

Stages of female alopecia

  • Minoxidil

It is a vasodilator agent that has been used orally in the treatment of arterial hypertension and is now widely used in the treatment of various types of alopecia. It works better in young men than in women (20 years), especially in those with slight hair loss (thinning) on the crown (vertex) or a small 3-4 cm bold spot, although it also acts upon the hairline. Increased hair loss may be seen in some after the first applications. This is because the old hairs must fall out so that new ones can grow. Positive results can be seen as early as four to eight months, although the best results of minoxidil are reached after 12 to 14 months.

  • Pyrimidine N-Oxides

This is a generic class of hair tonics similar to minoxidil. Results in over 250 men include an 8% increase in hair growth after six weeks of treatment, compared to a decrease in the percentage of hair growth in the placebo group.

  • Tretinoin

This is also a hair tonic in suitable doses, particularly when combined with minoxidil. If applied together, first apply the minoxidil solution, wait for it to dry (usually 15-30 minutes) and then apply the tretinoin.

  • Natural treatments

There are many treatments with vitamins, sulphur-containing amino acids (cystine, methionine, cysteine, thiazolidine carboxylic acid), minerals (zinc), and plant extracts (horse chestnut, marigold). They are useful for supplementing your diet and promote healthier hair. Sulphur-containing amino acids favour the formation of keratin, the structure-building protein in hair. Plant extracts act by stimulating the capillary circulation and revitalising the follicle.

  • Others

Lotions containing superoxide dismutases (copper binding peptides) have recently been used to strengthen and activate hair growth.

Stages in the hair life cycle

Stages in the hair life cycle.

This is based on the fact that there are chemical messengers in the body that send the follicles a signal to initiate the anagen and telogen phases. Radicals move hair into the telogen phase (resting phase), while nitric oxide causes hair to enter into the anagen phase (growth phase).

Obviously, treatments should stimulate nitric oxide levels and reduce superoxide radical levels using superoxide dismutases and antioxidant agents.

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Oral treatment


Androgenetic alopecia is not due to a lack of vitamins. However, it has been found that certain sulphur-containing amino acids and vitamins favour capillary nutrition, keratin, and reduce oil.


DHT male hormone.

DHT male hormone.

They reduce the male hormones (DHT) that produce baldness. To understand the action mechanism used by these drugs, it must first be known that DHT is one of the male hormones called androgens that compete for a place in the follicle receptors. If the receptors are kept occupied with other hormones such as progesterone, DHT would have no chance of entering the receptors and beginning to reduce the follicle. The problem is that if DHT is blocked in other parts of the body, symptoms of feminisation occur in males. In contrast, this blockade is less problematic in women.

1. Finasteride
It prevents testosterone from becoming the male hormone responsible for hair loss. It is taken orally.

2. Zinc
It affects hormone levels when taken orally and inhibits the production of DHT when applied topically.

3. Spironolactone
Reduces DHT, a hormone that causes hair loss. It can also be applied topically so it is not absorbed and produces no internal effects.

4. Other antiandrogens
Ketoconazole is an antifungal agent with antiandrogen properties. Therefore, it also reduces the DHT that causes hair loss.

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Laser treatment for female alopecia

Hair Regrowth machine HL800 laser treatment for alopecia

Hair Regrowth machine HL800 laser treatment for alopecia

Laser treatment promotes hair growth. The laser used is Hair Regrowth machine HL800.

Surgical procedure

  • Hair transplant Small pieces of hair-bearing skin are transferred from the back of the scalp to the bald area. Several sessions are required and the results are very satisfactory.
  • Reduction The bald portion is surgically removed, thereby disappearing or decreasing the bald area. Results are better in mature men whose skin is more lax and foldable.

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Cosmetic procedure for female alopecia

  • These include imaginative hairstyles, wigs, and hair transplants. Camouflaging techniques can be used to reduce the visual effect of thinning hair.
  • Wearing short hair will make it look less patchy and it will be easier to take care of it. With longer hair, chunks of hair are produced that separate and show broad areas of the scalp.
  • A skilled hairdresser can camouflage the fine hair in certain areas. If the hair is thin on the forehead, the front line extends to the temples. To minimise this, ask your hairdresser to trim the front shorter and leave the hair at temple height longer.
  • If your hair is thinner on the crown, keep the hair at the nape of your neck short. Since long hair at the nape of the neck will be heavier, it will pull down and away from the crown and further expose the bald area.
  • If you still have reasonably thick hair on the top of your head, leave it long and cover the bald patches. If your hair if very thin, you will have problems covering the bald areas. You can try a gentle permanent to increase hair volume.
  • If you have dark hair, slightly lighten the colour to reduce the contrast between the remaining hair and the scalp, thus making the skin less noticeable. A cosmetic trick that can work on women is to apply a little skin-coloured eye shadow to the scalp over the areas with thin hair. It is harmless and can make thin hair less noticeable.
  • Finally, do not use products that favour the adherence of hair strands, which make bald areas of the scalp visible.


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Hygiene tips

Keeping your hair clean contributes to maintaining its health and beauty. The frequency of washing and shampooing suitable for each person is an important factor that will be recommended by your dermatologist.

In cases of oily hair that is accompanied by thinning, it is advisable to wash it frequently, as it reduces sebum on the surface of the scalp. Clean, oil-free hair is important, as sebum contains elevated levels of dihydrotestosterone and testosterone (male hormones) that could be reabsorbed into the skin and affect the hair follicle.

In cases of dandruff and oily hair, it is best to alternate a treatment shampoo with a frequent use shampoo if you wash the hair frequently. Lather twice using both shampoos and leave the shampoo’s foam on for two or three minutes the second time, without rubbing.

Your comb should have wide, separated teeth. Metal brushes should be avoided. If there are split ends (trichoptilosis), they can be repaired with a silicone-polymer-based repair fluid, which acts as a patch on the split ends.

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Diagnosis and treatment of hair loss and female alopecia in Valencia

Dr. Gabriel Serrano Sanmiguel

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