Table of Contents Author Guidelines Submit a Manuscript
BioMed Research International
Volume 2014, Article ID 767628, 8 pages
http://dx.doi.org/10.1155/2014/767628
Review Article

The Female Pattern Hair Loss: Review of Etiopathogenesis and Diagnosis

Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, Route de Lennik 808, Anderlecht, 1070 Brussels, Belgium

Received 11 November 2013; Accepted 14 January 2014; Published 9 April 2014

Academic Editor: Claudine Piérard-Franchimont

Copyright © 2014 Anja Vujovic and Véronique Del Marmol. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Linked References

  1. A. G. Messenger and R. Sinclair, “Follicular miniaturization in female pattern hair loss: clinicopathological correlations,” British Journal of Dermatology, vol. 155, no. 5, pp. 926–930, 2006. View at Publisher · View at Google Scholar · View at Scopus
  2. V. H. Price, “Androgenetic alopecia in women,” Journal of Investigative Dermatology Symposium Proceedings, vol. 8, no. 1, pp. 24–27, 2003. View at Publisher · View at Google Scholar · View at Scopus
  3. N. Atanaskova Mesinkovska and W. F. Bergfeld, “Hair: what is new in diagnosis and management? Female pattern hair loss update: diagnosis and treatment,” Dermatologic Clinics, vol. 31, no. 1, pp. 119–127, 2013. View at Google Scholar
  4. O. T. Norwood, “Incidence of female androgenetic alopecia (female pattern alopecia),” Dermatologic Surgery, vol. 27, no. 1, pp. 53–54, 2001. View at Publisher · View at Google Scholar · View at Scopus
  5. M. P. Birch, J. F. Messenger, and A. G. Messenger, “Hair density, hair diameter and the prevalence of female pattern hair loss,” British Journal of Dermatology, vol. 144, no. 2, pp. 297–304, 2001. View at Publisher · View at Google Scholar · View at Scopus
  6. T. L. Wang, C. Zhou, Y. W. Shen et al., “Prevalence of androgenetic alopecia in China: a community-based study in six cities,” British Journal of Dermatology, vol. 162, no. 4, pp. 843–847, 2010. View at Publisher · View at Google Scholar · View at Scopus
  7. J.-H. Paik, J.-B. Yoon, W.-Y. Sim, B.-S. Kim, and N.-I. Kim, “The prevalence and types of androgenetic alopecia in Korean men and women,” British Journal of Dermatology, vol. 145, no. 1, pp. 95–99, 2001. View at Publisher · View at Google Scholar · View at Scopus
  8. L. Yip, N. Rufaut, and R. Sinclair, “Role of genetics and sex steroid hormones in male androgenetic alopecia and female pattern hair loss: an update of what we now know,” Australasian Journal of Dermatology, vol. 52, no. 2, pp. 81–88, 2011. View at Publisher · View at Google Scholar · View at Scopus
  9. J. B. Hamilton, “The relationship between common baldness and male sex hormones,” Transactions of the New York Academy of Sciences, vol. 8, p. 101, 1946. View at Google Scholar
  10. D. A. Whiting, “Possible mechanisms of miniaturization during androgenetic alopecia or pattern hair loss,” Journal of the American Academy of Dermatology, vol. 45, supplement 3, pp. S81–S86, 2001. View at Publisher · View at Google Scholar · View at Scopus
  11. P. Vexiau, C. Chaspoux, P. Boudou et al., “Role of androgens in female-pattern androgenetic alopecia, either alone or associated with other symptoms of hyperandrogenism,” Archives of Dermatological Research, vol. 292, no. 12, pp. 598–604, 2000. View at Publisher · View at Google Scholar · View at Scopus
  12. E. A. Olsen, “Female pattern hair loss,” Journal of the American Academy of Dermatology, vol. 45, supplement 3, pp. S70–S80, 2001. View at Publisher · View at Google Scholar · View at Scopus
  13. E. A. Olsen, Disorders of Hair Growth: Diagnosis and Treatment, vol. 12, McGraw-Hill, New York, NY, USA, 1994.
  14. D. A. Whiting, “Diagnostic and predictive value of horizontal sections of scalp biopsy specimens in male pattern androgenetic alopecia,” Journal of the American Academy of Dermatology, vol. 28, no. 5, pp. 755–763, 1993. View at Google Scholar · View at Scopus
  15. M. E. Sawaya and V. H. Price, “Different levels of 5α-reductase type I and II, aromatase, and androgen receptor in hair follicles of women and men with androgenetic alopecia,” Journal of Investigative Dermatology, vol. 109, no. 3, pp. 296–300, 1997. View at Google Scholar · View at Scopus
  16. J. A. Miller, C. R. Darley, and K. Karkavitsas, “Low sex-hormone binding globulin levels in young women with diffuse hair loss,” British Journal of Dermatology, vol. 106, no. 3, pp. 331–336, 1982. View at Google Scholar · View at Scopus
  17. D. R. Nyholt, N. A. Gillespie, A. C. Heath, and N. G. Martin, “Genetic basis of male pattern baldness,” Journal of Investigative Dermatology, vol. 121, no. 6, pp. 1561–1564, 2003. View at Publisher · View at Google Scholar · View at Scopus
  18. W. Küster and R. Happle, “The inheritance of common baldness: two B or not two B?” Journal of the American Academy of Dermatology, vol. 11, no. 5, part 1, pp. 921–926, 1984. View at Google Scholar · View at Scopus
  19. F. F. Brockschmidt, A. M. Hillmer, S. Eigelshoven et al., “Fine mapping of the human AR/EDA2R locus in androgenetic alopecia,” British Journal of Dermatology, vol. 162, no. 4, pp. 899–903, 2010. View at Publisher · View at Google Scholar · View at Scopus
  20. A. M. Hillmer, S. Hanneken, S. Ritzmann et al., “Genetic variation in the human androgen receptor gene is the major determinant of common early-onset androgenetic alopecia,” American Journal of Human Genetics, vol. 77, no. 1, pp. 140–148, 2005. View at Publisher · View at Google Scholar · View at Scopus
  21. S. Redler, F. F. Brockschmidt, R. Tazi-Ahnini et al., “Investigation of the male pattern baldness major genetic susceptibility loci AR/EDA2R and 20p11 in female pattern hair loss,” British Journal of Dermatology, vol. 166, no. 6, pp. 1314–1318, 2012. View at Publisher · View at Google Scholar
  22. L. Yip, S. Zaloumis, D. Irwin et al., “Gene-wide association study between the aromatase gene (CYP19A1) and female pattern hair loss,” The British Journal of Dermatology, vol. 161, no. 2, pp. 289–294, 2009. View at Google Scholar · View at Scopus
  23. U. Blume-Peytavi, A. Blumeyer, A. Tosti et al., “S1 guideline for diagnostic evaluation in androgenetic alopecia in men, women and adolescents,” British Journal of Dermatology, vol. 164, no. 1, pp. 5–15, 2011. View at Publisher · View at Google Scholar · View at Scopus
  24. E. Ludwig, “Classification of the types of androgenetic alopecia (common baldness) occurring in the female sex,” British Journal of Dermatology, vol. 97, no. 3, pp. 247–254, 1977. View at Google Scholar · View at Scopus
  25. R. Sinclair, D. Jolley, R. Mallari, and J. Magee, “The reliability of horizontally sectioned scalp biopsies in the diagnosis of chronic diffuse telogen hair loss in women,” Journal of the American Academy of Dermatology, vol. 51, no. 2, pp. 189–199, 2004. View at Google Scholar · View at Scopus
  26. E. A. Olsen, “Current and novel methods for assessing efficacy of hair growth promoters in pattern hair loss,” Journal of the American Academy of Dermatology, vol. 48, no. 2, pp. 253–262, 2003. View at Publisher · View at Google Scholar · View at Scopus
  27. J. B. Hamilton, “Patterned loss of hair in man; types and incidence,” Annals of the New York Academy of Sciences, vol. 53, no. 3, pp. 708–728, 1951. View at Google Scholar · View at Scopus
  28. B. Werner and F. Mulinari-Brenner, “Clinical and histological challenge in the differential diagnosis of diffuse alopecia: female androgenetic alopecia, telogen effluvium and alopecia areata—part II,” Anais Brasileiros de Dermatologia, vol. 87, no. 6, pp. 884–890, 2012. View at Google Scholar
  29. C. Ziller, “Pattern formation in neural crest derivatives,” in Hair Research for the Next Millenium, R. V. Dvan Neste, Ed., pp. 19–23, Elsevier, Amsterdam, The Netherlands, 1996. View at Google Scholar
  30. T. F. Cash, “The psychosocial consequences of androgenetic alopecia: a review of the research literature,” British Journal of Dermatology, vol. 141, no. 3, pp. 398–405, 1999. View at Publisher · View at Google Scholar · View at Scopus
  31. J. Van der Donk, J. A. M. Hunfeld, J. Passchier, K. J. Knegt-Junk, and C. Nieboer, “Quality of life and maladjustment associated with hair loss in women with alopecia androgenetica,” Social Science and Medicine, vol. 38, no. 1, pp. 159–163, 1994. View at Publisher · View at Google Scholar · View at Scopus
  32. E. E. Reid, A. C. Haley, J. H. Borovicka et al., “Clinical severity does not reliably predict quality of life in women with alopecia areata, telogen effluvium, or androgenic alopecia,” Journal of the American Academy of Dermatology, vol. 66, no. 3, pp. e97–e102, 2012. View at Publisher · View at Google Scholar · View at Scopus
  33. V. H. Price, “Androgenetic alopecia in adolescents,” Cutis, vol. 71, no. 2, pp. 115–121, 2003. View at Google Scholar · View at Scopus
  34. S. Arias-Santiago, M. T. Gutiérrez-Salmerón, L. Castellote-Caballero, A. Buendía-Eisman, and R. Naranjo-Sintes, “Androgenetic alopecia and cardiovascular risk factors in men and women: a comparative study,” Journal of the American Academy of Dermatology, vol. 63, no. 3, pp. 420–429, 2010. View at Publisher · View at Google Scholar · View at Scopus
  35. S. Arias-Santiago, M. T. Gutiérrez-Salmerón, A. Buendía-Eisman, M. S. Girón-Prieto, and R. Naranjo-Sintes, “Hypertension and aldosterone levels in women with early-onset androgenetic alopecia,” British Journal of Dermatology, vol. 162, no. 4, pp. 786–789, 2010. View at Publisher · View at Google Scholar · View at Scopus
  36. A. Amoretti, H. Laydner, and W. Bergfeld, “Androgenetic alopecia and risk of prostate cancer: a systematic review and meta-analysis,” Journal of the American Academy of Dermatology, vol. 68, no. 6, pp. 937–943, 2013. View at Google Scholar
  37. L. H. Su and T. H. Chen, “Association of androgenetic alopecia with smoking and its prevalence among Asian men: a community-based survey,” Archives of Dermatology, vol. 143, no. 11, pp. 1401–1406, 2007. View at Publisher · View at Google Scholar · View at Scopus
  38. R. M. Trüeb, “Is androgenetic alopecia a photoaggravated dermatosis?” Dermatology, vol. 207, no. 4, pp. 343–348, 2003. View at Publisher · View at Google Scholar · View at Scopus
  39. U. Blume-Peytavi, S. Atkin, J. Shapiro et al., “European consensus on the evaluation of women presenting with excessive hair growth,” European Journal of Dermatology, vol. 19, no. 6, pp. 597–602, 2009. View at Publisher · View at Google Scholar · View at Scopus
  40. H. Mason, A. Colao, U. Blume-Peytavi et al., “Polycystic ovary syndrome (PCOS) trilogy: a translational and clinical review,” Clinical Endocrinology, vol. 69, no. 6, pp. 831–844, 2008. View at Publisher · View at Google Scholar · View at Scopus
  41. C. Piérard-Franchimont, V. Goffin, F. Henry, I. Uhoda, C. Braham, and G. E. Piérard, “Nudging hair shedding by antidandruff shampoos. A comparison of 1% ketoconazole, 1% piroctone olamine and 1% zinc pyrithione formulations,” International Journal of Cosmetic Science, vol. 24, no. 5, pp. 249–256, 2002. View at Publisher · View at Google Scholar · View at Scopus
  42. S. Kossard, “Postmenopausal frontal fibrosing alopecia: scarring alopecia in a pattern distribution,” Archives of Dermatology, vol. 130, no. 6, pp. 770–774, 1994. View at Publisher · View at Google Scholar · View at Scopus
  43. A. F. Pedrosa, P. Morais, C. Lisboa, and F. Azevedo, “The importance of trichoscopy in clinical practice,” Dermatology Research and Practice, vol. 2013, Article ID 986970, 3 pages, 2013. View at Publisher · View at Google Scholar
  44. O. de Lacharrière, C. Deloche, C. Misciali et al., “Hair diameter diversity: a clinical sign reflecting the follicle miniaturization,” Archives of Dermatology, vol. 137, no. 5, pp. 641–646, 2001. View at Google Scholar · View at Scopus
  45. A. Tosti, M. Iorizzo, and B. M. Piraccini, “Androgenetic alopecia in children: report of 20 cases,” British Journal of Dermatology, vol. 152, no. 3, pp. 556–559, 2005. View at Publisher · View at Google Scholar · View at Scopus
  46. A. Rakowska, M. Slowinska, E. Kowalska-Oledzka, M. Olszewska, and L. Rudnicka, “Dermoscopy in female androgenic alopecia: method standardization and diagnostic criteria,” International Journal of Trichology, vol. 1, no. 2, pp. 123–130, 2009. View at Publisher · View at Google Scholar
  47. M. Guarrera, M. T. Semino, and A. Rebora, “Quantitating hair loss in women: a critical approach,” Dermatology, vol. 194, no. 1, pp. 12–16, 1997. View at Google Scholar · View at Scopus
  48. K. Hillmann and U. Blume-Peytavi, “Diagnosis of hair disorders,” Seminars in Cutaneous Medicine and Surgery, vol. 28, no. 1, pp. 33–38, 2009. View at Publisher · View at Google Scholar · View at Scopus
  49. J. Shapiro, M. Wiseman, and H. Lui, “Practical management of hair loss,” Canadian Family Physician, vol. 46, pp. 1469–1477, 2000. View at Google Scholar · View at Scopus
  50. R. Sinclair, D. Jolley, R. Mallari et al., “Morphological approach to hair disorders,” Journal of Investigative Dermatology Symposium Proceeding, vol. 8, no. 1, pp. 56–64, 2003. View at Google Scholar
  51. D. M. Elston, M. L. McCollough, and V. L. Angeloni, “Vertical and transverse sections of alopecia biopsy specimens: combining the two to maximize diagnostic yield,” Journal of the American Academy of Dermatology, vol. 32, no. 3, pp. 454–457, 1995. View at Google Scholar · View at Scopus
  52. E. A. Olsen and U. Blume-Peytavi, Hair Growth and Disorders, vol. 26, Springer, Berlin, Germany, 2008.
  53. V. Pecoraro, I. Astore, J. Barman, and C. Ignacio Araujo, “The normal trichogram in the child before the age of puberty,” The Journal of investigative dermatology, vol. 42, pp. 427–430, 1964. View at Google Scholar · View at Scopus
  54. N. A. Galliker and R. M. Trueb, “Value of trichoscopy versus trichogram for diagnosis of female androgenetic alopecia,” International Journal of Trichology, vol. 4, no. 1, pp. 19–22, 2012. View at Google Scholar
  55. D. Van Neste and R. M. Trueb, “Critical study of hair growth analysis with computer-assisted methods,” Journal of the European Academy of Dermatology and Venereology, vol. 20, no. 5, pp. 578–583, 2006. View at Google Scholar
  56. B. Riedel-Baima and A. Riedel, “Use of the trichoscan to assess female pattern hair loss,” Dermatologic Surgery, vol. 35, no. 4, pp. 651–655, 2009. View at Publisher · View at Google Scholar · View at Scopus
  57. J. Gassmueller, E. Rowold, T. Frase, and B. Hughes-Formella, “Validation of TrichoScan® technology as a fully-automated tool for evaluation of hair growth parameters,” European Journal of Dermatology, vol. 19, no. 3, pp. 224–231, 2009. View at Google Scholar · View at Scopus
  58. J. Kantor, L. J. Kessler, D. G. Brooks, and G. Cotsarelis, “Decreased serum ferritin is associated with alopecia in women,” Journal of Investigative Dermatology, vol. 121, no. 5, pp. 985–988, 2003. View at Publisher · View at Google Scholar · View at Scopus
  59. D. H. Rushton and I. D. Ramsay, “The importance of adequate serum ferritin levels during oral cyproterone acetate and ethinyl oestradiol treatment of diffuse androgen-dependent alopecia in women,” Clinical Endocrinology, vol. 36, no. 4, pp. 421–427, 1992. View at Google Scholar · View at Scopus
  60. L. B. Trost, W. F. Bergfeld, and E. Calogeras, “The diagnosis and treatment of iron deficiency and its potential relationship to hair loss,” Journal of the American Academy of Dermatology, vol. 54, no. 5, pp. 824–844, 2006. View at Publisher · View at Google Scholar · View at Scopus
  61. A. Bregy and R. M. Trüeb, “No association between serum ferritin levels >10 μg/l and hair loss activity in women,” Dermatology, vol. 217, no. 1, pp. 1–6, 2008. View at Publisher · View at Google Scholar · View at Scopus
  62. E. A. Olsen, A. G. Messenger, J. Shapiro et al., “Evaluation and treatment of male and female pattern hair loss,” Journal of the American Academy of Dermatology, vol. 52, no. 2, pp. 301–311, 2005. View at Google Scholar
  63. L. A. Sánchez, M. Pérez, I. Centeno, M. David, D. Kahi, and E. Gutierrez, “Determining the time androgens and sex hormone-binding globulin take to return to baseline after discontinuation of oral contraceptives in women with polycystic ovary syndrome: a prospective study,” Fertility and Sterility, vol. 87, no. 3, pp. 712–714, 2007. View at Publisher · View at Google Scholar · View at Scopus