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Female AGA: medical and surgical treatments for female androgenetic alopecia

posted by Vance W. Elliott, MD, FISHRS on April 16, 2015


Androgenetic alopecia (AGA) is a common form of hair loss in both men and women.


There are several differences between male and female androgenetic alopecia. Men typically lose their hair in a well-defined pattern along the front and sides of their head first, followed by thinning in the vertex (crown). For women, the pattern is different. In women, the hair often thins without recession of  the hairline, beginning in the scalp area about one to two centimeters behind from the hairline.  The first 1-2cm of the hairline zone may then also thin to some degree.


Women’s hair also commonly thins the parietal scalp at the sides of the head, while men’s hair usually does not. Men’s hair thins in the front third of the scalp, and especially at the vertex earlier and more severely than it does in the middle. In women, the middle is often not spared. Their hair usually thins equally along the entire top, or just in the front region. Unlike men, women do not usually lose all of their area in the impacted areas, becoming progressively thinner, but not completely bald.


There are several treatment options available for women to help with hair loss. Medical therapies such as the topically applied Minoxidil, and in selected patients oral finasteride  (off-label use), may be prescribed. Low-level laser therapy has also been shown to help prevent further hair loss and stimulate hair re-growth. Some may choose to camouflage with scalp tinting products such as keratin microfibers.


A hair transplant is a viable surgical option for women. The results in women are just as positive as with men, as long the candidate meets the criteria for hair transplantation, and the hair restoration specialist is an expert in their field. The side effects are minimal post surgery.


Just as in men, it is recommended that female patients with AGA commit to long-term medical therapy to prevent future loss and maximize whatever re-growth is possible.

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