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11.10.2018 | Institute BCN

Female alopecia: causes and treatments

Our medical adviser Clara Serés tells us the main causes of female alopecia and the possible treatments to fight it. In our next post, we will share a success story.

Our medical adviser Clara Serés tells us the main causes of female alopecia and the possible treatments to fight it. In our next post, we will share a success story.

Female alopecia

To understand female alopecia, we must take into account the physiological process of hair growth without forgetting genetic, hormonal, metabolic aspects, deficiencies of vitamins, minerals and / or trace elements, the influence of chronic and / or acute stress, as well as anemic of ferropenic type.

The replacement of the different hair follicles of each hair root throughout life and the capillary renewal system with its three stages also involves seasonal hair falls (telogen effluvium). They are harmless in general, respond to the normal evolutionary process of hair growth and are fully reversible.

The most frequent forms of alopecia in women are telogen effluvium and androgenic alopecia. The proper diagnosis of the type of alopecia presented by the patient determines the treatment and prognosis.

  • In the case of telogen effluvium, patients perceive an increase in hair loss after washing their hair, on the pillow, etc. A reversible process possibly induced by different causes such as pregnancy, stress, diet, etc.
  • In the case of androgenic alopecia, it is necessary to carry out an active treatment to stop hair loss, since if it is not done, patient will progressively loose density in the scalp.

Pharmacological treatments

The management of androgenic alopecia (also called androgenetic, for its genetic component) is mainly pharmacological.

We differentiate a topical treatment (2% or 5% Minoxidil) and a systemic treatment (antiandrogen drugs: finasteride and dutasteride).

  • Topical treatment is used in both men and women.
  • Systemic treatment, with finasteride and dutasteride (greater action), is more used in males, although there are studies that demonstrate its efficacy in postmenopausal women. They are long-term treatments but they do not have to be for life.

Antiandrogen drugs can also be used locally, by infiltrating the scalp after applying a local anesthetic. This procedure can be performed every 4-6 months as a supplement or even as an isolated treatment in some patients.

In women, the treatment is based on minoxidil and another profile of antiandrogens, such as flutamide at low doses.

It is essential to identify if there is an underlying hormonal alteration such as polycystic ovarian syndrome, and in cases like this, based on an endocrinological study, to assess the use of hormonal contraceptives.

Non-pharmacological treatments

As a non-pharmacological treatment, we have several options:

  • Biostimulation of platelet-rich plasma (PRP) with growth factors. It consists of extracting blood from the patient and isolating the portion of platelet-rich plasma with growth factors and infiltrate the areas of the scalp to be treated.
    • Stimulates follicular growth.
    • Increase the diameter of the hair.
    • Usually 3-4 sessions per year.
    • It is usually used as a complement to medical treatment with minoxidil or antiandrogens.
  • The treatments from sterile formulations of pharmaceutical production with specific substances. The Mesoceuticals® constitute an alternative and / or complement to the therapies previously described. Both pharmacological and non-pharmacological.
    • High concentrations of active ingredients inhibit, among other actions, the action of 5-alpha reductase (enzyme that allows the passage of testosterone to DiHidroTestosterone -DHT-).
    • Cocktails that unite substances with synergistic action.
    • Other formulations that include new generation peptides in greater percentage and allow an intra and intercellular messaging action that regulates and modulates the depleted processes of hair growth.

The treatment of female alopecia with mesoceuticals®

One aspect to take into account in the local application of mesoceuticals® in female patients is the location of the treatment areas.

In women, the most common zone presenting baldness is the central area of the hairline, which gets wider, starting baldness just behind the front area.

In man, however, the most commonly affected areas are the temples, and the bald patch.

Thus, the mesoceuticals® will be applied properly and in the appropriate place according to the case; following the patterns of each gender, masculine or feminine.

If we take as an example a female patient with incipient androgenic alopecia of 4 years evolution, that accuses areas with low hair density in typically characteristic areas as described above, the first thing is to make an adequate diagnosis. A dermatologist and, if possible, a trichologist, will indicate to the patient the necessary tests to confirm or identify the type of alopecia, ruling out deficiencies that could cause or aggravate the fall of the patient’s hair.

In addition to an analytical and correct anamnesis, if the specialist considers it appropriate, he/she will do more tests that allow visualizing the miniaturization of the hair by the effect of the androgen hormonal imbalance that affects the hair follicle.

If the case is considered with severity or evolution to indicate an oral pharmacological therapy, it can also be combined and completed by using mesoceuticals®. Its application will be scheduled in several sessions that can go from 5 to 10 and that, with time, can be repeated at key moments (before the seasonal periods in which the hair goes through a replacement that manifests itself with greater fall).

In certain cases in which genetic inheritance requires to do preventive therapy, this option is an excellent choice. In addition to mesoceuticals® specific for alopecia, there are others that can be combined to maintain an adequate state of the scalp and optimize aspects like blood flow or skin nutrition that are optimal to the follicles.