An estimated 20% of women are affected by androgenetic alopecia and this number seems to be on the rise in recent years. While the condition is medically benign, its psychological impact is significant, causing stress and low self-esteem in the patient.

Femme souffrant d'une alopécie androgénétique

What is androgenetic alopecia?

As in men, androgenetic alopecia is one of the main causes of hair loss in women (it doesn’t affect body or facial hair, as can be the case with an alopecia).
Hair loss is localized and never leads to total baldness. Hair located on the frontal line, temples and occiput will last for the entire life of the patient.
However, unlike male pattern baldness, hair loss in women is more diffuse and progresses at a slower pace, which may cause significant stress.
Furthermore, androgenetic alopecia differs from two other hair loss conditions:
  • telogen effluvium, which causes diffuse alopecia and often disappears without treatment;
  • and alopecia, which causes sudden hair loss in patches (in alopecia universalis cases, all the hair on the body suddenly start falling out).

What causes androgenetic alopecia in women?

There are two overlapping causes:
  • The hair roots’ sensitivity to male hormones;
  • and the hair’s genetic predisposition to suffer from this stimulation.

Women’s adrenal glands and ovaries secrete male hormones. This androgen secretion is completely normal and is produced in much smaller quantities than in men (up to 20 times less).

Nevertheless, in case of androgenetic predisposition, this small quantity of androgens can be enough to trigger the hair loss process. The hair growth cycle will accelerate and the patient’s new hair capital will quickly run out. The hair becomes thinner until it disappears completely.
At the same time, androgens cause an increased secretion of sebum. Sebum stagnates on the scalp and progressively thickens, making it harder for the hair roots to be properly irrigated and replaced.
Androgenetic alopecia often develops during a key phase of a woman’s life, namely :
  • Puberty;
  • maternity;
  • pre-menopause;
  • or menopause.
Some life events, such as intense stress or eating disorders leading to nutritional deficiencies, can accelerate hair loss.

How to identify androgenetic alopecia in women?

The condition evolves differently in women and men. There are three clinical stages according to Ludwig’s scale:
  • Stage 1: hair thinning is moderate and affects the top of the head. The frontal border is not affected.
  • Stage 2: Alopecia is more pronounced and short, grey or white hair may appear on the diseased hair. The frontal line is located one centimeter behind the forehead.
  • Stage 3: Generalized baldness on the vertex. A thin band of hair remains on the forehead and the back of the neck.
Hair examination (finger trichoscopy) is recommended to confirm the androgenetic origin of the hair loss, to decide on the most suitable treatment and to see if grafts should be prescribed.
Classification de Ludwig pour l'alopécie androgénétique féminine

How to address androgenetic alopecia?

As with men, there are many medical and surgical solutions available to normalize hair loss and/or conceal the consequences.

Drug Treatments

A 2% Minoxidil treatment is often prescribed for women in the first phase of the Ludwig’s scale. It normalizes the hair cycle and even slows it down and, in some cases, stops hair loss. An anti-androgen hormone treatment can sometimes be recommended by the gynecologist if there are no contraindications.
Médicaments
Un chirurgien en train de corriger une alopécie cicatricielle

Hair grafts

Hair grafting involves extracting healthy hair follicles from the occipital area and inserting them into the bald area of the scalp. The results of a graft is definitive.
Un chirurgien en train de corriger une alopécie cicatricielle

Injection treatments

There are different injection treatments (mesograft, PRP treatment, mesotherapy, microneedling) that can stimulate hair activity and slow down hair loss.
Patiente en train de faire une mésothérapie capillaire
Salle de luminothérapie capillaire

Hair stimulation

Light therapy involves the use of LED laser, which can increase the hair follicle activity and stimulate hair growth in some cases.
Salle de luminothérapie capillaire

Trichopigmentation

Dermopigmentation refers to the semi-permanent tattooing of the scalp. It temporarily conceals bald areas.
Femme faisant une trichopigmentation
Nutrition pour les cheveux

Nutrition

Eating disorders are one of the causes that can worsen the effects of androgenetic alopecia. These disorders can cause vitamin or nutrient deficiencies, thus interfering with the proper development of the hair.
Nutrition pour les cheveux

Cosmetic solutions

Cosmetic solutions (hair systems, hair powder) are increasingly effective in masking baldness in an undetectable way.
Prothèse capillaire