![]() The diagnosis of FPHL is made on clinical grounds. 3 Clinicians should also screen for maladaptive coping mechanisms such as compulsive fixing of one’s hair and underlying psychiatric trichotillomania. 1 In another questionnaire, 70% of surveyed women with hair loss had a negative body image and poorer self-esteem, with poorer sleep, feelings of guilt and restriction of social activities. A study showed that 52% of women were very-to-extremely upset by their hair loss, compared with 28% of men. ![]() This generates feelings of greater confusion and distress for female patients. 8 Psychological morbidityįPHL is less well understood and accepted by society than alopecia in males. The risk factors for FPHL include increasing age, family history, smoking, elevated fasting glucose levels and ultraviolet light exposure of >16 hours/week. 7–9 Screening for metabolic cardiovascular risk factors is useful in patients presenting with patterned hair loss. 7 One study found that patterned hair loss was an independent predictor of mortality from diabetes mellitus and heart disease in both females and males. The diagnosis of FPHL is associated with underlying hypertension in women aged £35 years and coronary artery disease in women aged £50 years. All causes of hyperandrogenism, such as ovarian or adrenal tumours, polycystic ovarian syndrome and adrenal hyperplasia, can induce rapid hair loss in women. 3,5,6 Female pattern hair loss and general healthĪs alopecia is highly visible, a patient may note hair loss as the first symptom of a host of underlying or contributing medical and psychiatric conditions. DHT and testosterone both bind to the same androgen receptors, but DHT does so with more affinity, leading to increased miniaturisation. The free testosterone either binds to intracellular androgen receptors in the hair bulb, causing follicular miniaturisation, or is metabolised by enzyme 5-alpha reductase into dihydrotestosterone (DHT). Androgens exert their effect on hair via circulating levels of testosterone, which is produced in females by the ovaries and adrenal glands. 1,3,5,6 The trigger for miniaturisation remains unclear but is postulated to be a combination of genetic predisposition, androgen influence and other not yet elucidated factors. This undesired process is known as hair follicle miniaturisation. 1,6įPHL is a non-scarring alopecia characterised by progressive transformation of thick, pigmented terminal hair into short, thin, non-pigmented villous hair. 5 Alopecia can also be the first symptom of underlying systemic illness within the primary care setting. In one survey, 40% of women experienced marital problems and 64% had career difficulties that they ascribed to their hair loss. 4 Alopecia is associated with significant psychological distress and reduced quality of life. 1–4 This translates to 800,000 women who suffer from moderate-to-severe FPHL. 1 The incidence steadily increases with age in all ethnicities, and the age-adjusted prevalence among adult Australian women of European descent is >32%. Approximately 49% of women will be affected by hair loss throughout their lives, with female pattern hair loss (FPHL) being the most common cause of female alopecia.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |