Top 10 Misconceptions of Androgenetic Alopecia in Women

Debunking many of the myths and misconceptions associated with this common type of hair loss.

10. “…but I am in my twenties.”
Thinning hair can begin between 12 to 40 years old in both males and females. About half of the population will experience or show signs of this before the age of 50.

9. “…but no women on the maternal side have androgenetic alopecia or pattern baldness.”
Androgenetic alopecia is polygenic, meaning it can be inherited from either the maternal or paternal or both sides of the family. Androgenetic alopecia in men has a highly recognizable pattern, but thinning or milder expressions in women are not as easily recognized. Female pattern baldness is commonly characterized as diffuse thinning all over, with greater thinning on the top of the scalp. It is not as common for women to lose their frontal hairline, although the extent of each person’s hair loss varies significantly. Some women may notice a thinner ponytail diameter or increased spacing between the hairs along the central part or part line. Also there can be an occurrence of normal hair density, but the hair no longer grows to its previous length, resulting in wispy ends.

8. “…but I have regular, normal periods and no acne or hirsuitism.”
When compared to women without androgenetic alopecia, women who have androgenetic alopecia have normal menstrual cycles and no increase in incidence of acne or hirsuitism.

7. “…but I was on medication that can cause hair loss.” Drugs that cause hair loss include anticoagulants, anticancer drugs, anticonvulsants, antithyroid drugs, beta blockers, tricyclic antidepressants and oral contraceptives. Discontinued usage of medication is usually followed with hair regrowth. If within one year the hair density has not been completely restored, then the drug induced hair loss may have unmasked dormant androgenetic alopecia.

6. “…I will need to have expensive tests done.” Women with androgenetic alopecia usually do not need extensive hormonal evaluations. However tests should be ordered if irregular menses, hirsuitism, infertility, severe cystic acne, galactorrhea, virilization or hirsuitism is present. An initial blood test may include total testosterone, DHEA and prolactin; screening for thyroid abnormalities and an iron panel including serum iron, total iron binding capacity and ferritin levels can be helpful too.

5. “…the pull test was negative.”
Women who have androgenetic alopecia may have a negative hair pull test (consisting of 0 – 4 hairs). Five or more hairs would indicate telogen effluvium as opposed to androgenetic alopecia. Unfortunately, telogen effluvium may be unmasked by telogen effluvium, but this discovery would accompany gradual realization of decreased scalp coverage and or hair density as opposed to increased hair shedding.