What are the treatment options for female pattern hair loss (Androgenetic Alopecia)?

From the Guidelines

Treatment for female pattern hair loss (Androgenetic Alopecia) typically begins with minoxidil (Rogaine), the only FDA-approved medication for this condition, applied as a 5% solution twice daily or 5% foam once daily to the scalp. The provided evidence does not directly address the treatment of female pattern hair loss, but rather focuses on alopecia areata. However, based on general medical knowledge and the example provided, minoxidil is a well-established treatment for female pattern hair loss. Some key points to consider in the treatment of female pattern hair loss include:

• Minoxidil must be continued indefinitely as hair loss will resume if stopped 1.
• For hormonal hair loss, spironolactone (50-200 mg daily) may be prescribed to block androgens, though it's not FDA-approved for this purpose and requires monitoring.
• Iron supplementation may help if deficiency is present.
• Platelet-rich plasma (PRP) injections, low-level laser therapy devices, and hair transplantation are additional options for appropriate candidates.
• Addressing underlying causes is crucial - treating thyroid disorders, managing stress, ensuring adequate nutrition, and avoiding harsh hair treatments can improve outcomes.
• Women should expect to use treatments for at least 6-12 months before seeing significant results, and a combination approach often works best.
• Consulting with a dermatologist specializing in hair disorders is recommended for proper diagnosis and personalized treatment.

From the Research

Treatment Options for Female Pattern Hair Loss

The treatment options for female pattern hair loss (Androgenetic Alopecia) include:

• Medical treatment: Oral antiandrogens and topical minoxidil can help regrow some hair, but early diagnosis and initiation of treatment is desirable as these treatments are more effective at arresting progression of hair loss than stimulating regrowth 2.
• Non-pharmacological treatment modalities: Counseling, cosmetic camouflage, and hair transplantation are important measures for some patients 2.
• Low-dose oral minoxidil: Has been used off-label to treat female pattern hair loss, with successful treatment reported in 61-100% of patients 3.
• Topical minoxidil foam: A once-daily minoxidil topical foam has been developed to treat female pattern hair loss, with increased target area hair count (TAHC) from baseline at 24 weeks 4.
• Combination therapy: The use of oral minoxidil in combination with oral spironolactone is a novel therapy with promising results 5.
• Oral minoxidil versus topical solution: A randomized controlled trial compared the effectiveness and safety of topical minoxidil versus 1 mg daily oral minoxidil, with both groups showing significant improvement in hair diameter after 6 months of treatment 6.

Key Considerations

• All treatments need to be continued to maintain the effect, as female pattern hair loss is a chronic progressive condition 2.
• An initial therapeutic response often takes 12 or even 24 months, and monitoring for treatment effect through clinical photography or standardized clinical severity scales is helpful 2.
• The most common adverse effects with oral minoxidil include hypertrichosis and postural hypotension 3.