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Feature Article

The balding woman

Belinda Welsh

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Abstract

Premature or extensive hair loss in a woman can cause considerable distress. An important part of management involves patient counselling regarding pathogenesis and treatment options, so that realistic outcomes can be achieved.

Key Points

  • Androgenetic alopecia affects the majority of women progressively as they age.
  • Approximately 50% of women will experience significant hair loss by the age of 60. This is a normal physiological occurrence, but it is usually well disguised by hair styling in women so its frequency is underestimated in the general community.
  • The pattern of hair loss in women is commonly diffuse, but it tends to be most marked over the crown with retention of the frontal hairline.
  • Endocrine function is normal in most women with androgenetic alopecia.
  • The realistic aim of currently available treatments is to prevent or delay further hair loss; however, some improvement may be seen in up to 50% of patients after six to 12 months of therapy.

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