An Update on Diagnosis and Treatment of Female Pattern Hair Loss

Thamer Mubki; Omar Shamsaldeen; Kevin J McElwee; Jerry Shapiro


Expert Rev Dermatol. 2013;8(4):427-436. 

In This Article

Abstract and Introduction


Female pattern hair loss (FPHL) is the most common cause of hair loss in women. It has a greater psychosocial morbidity than that of male pattern hair loss. The clinical presentation of FPHL is distinctive with hair thinning usually confined to the crown region of the scalp. The frontal hair line is usually spared; however, it can be affected in some patients. Miniaturization of terminal scalp hair and shortening of the anagen growth phase of the hair cycle results in growth of thinner and shorter hair fibers. Diagnosis is usually made clinically. Recent advances in digital image analysis has increased the use of dermatoscopy in the diagnosis of FPHL and as a consequence, reduced the need for doing skin biopsies. Many medical and surgical treatments are currently available with various success rates. In this review article, we discuss the major recent advances in the diagnosis and management of FPHL.


Female pattern hair loss (FPHL) and female androgenetic alopecia are two terms that are very much related. They are commonly used synonymously to refer to women with progressive thinning of scalp hair that follows a pattern distribution.[1,2] However, growing evidence suggests FPHL is a different disease that should not be regarded as the direct female counterpart of male pattern hair loss (MPHL). Therefore, the term FPHL should probably be used instead of female androgenetic alopecia.[2,3] FPHL is the most common cause of hair loss in women with a prevalence ranging from 6% of women younger than 50 years of age to 38% of those aged 70 years old.[1,4,5] Various psychological maladjustments as well as a significantly reported lower self-esteem and depression, have been reported with increased frequency in women with FPHL in comparison to men with MPHL.[6]