Female pattern hair loss is a common condition affecting women of all ages. Research has shown that for women, the consequences of hair loss can be more severe than for men. Women often experience stress and loss of sleep and may start avoiding social situations when hair loss begins. Body image and self esteem can be seriously affected. Many women will respond to hair loss by first trying to cover it up with styling, hats, wigs, or other tactics. Treatments are available, however, that have been proven to be effective for the majority of women in reducing hair loss and improving new hair growth.
Types of Hair Loss in Women
Female pattern hair loss is a common type of hair loss in women. It is medically referred to as androgenic alopecia and it is hereditary. Women can start experiencing hair loss anytime after puberty, but most will not experience it until menopause. This is likely because female pattern hair loss, while it is associated with genetics, may be triggered by hormonal changes. Unlike with male pattern hair loss, women do not get a receding hair line and bald spots. Female hair loss more often involves hair thinning and falling out around the part line. In general women may notice that their hair is not as thick at first, followed by hair loss and a widening part.
Sudden-onset female hair loss is often not associated with genetics. Sometimes, underlying health conditions or medications that are being taken can affect hair growth. Most often this is through some effect on production of androgen hormones. Medication used to treat cancer, severe illnesses, and autoimmune conditions can all have an effect on hair growth. Alopecia areata is hair loss related to the immune system attacking hair follicles. Unlike androgenic alopecia, this type of hair loss can come and go, with hair re-growing and then falling out again.
Stress and other factors can cause acute, rapid hair loss that is not related to genetics. This type of hair loss is referred to as telogen effluvium and can result from:
- Highly stressful events
- Fever and illness
- Thyroid conditions
- Taking certain medications
- Certain “crash” diets that result in poor nutrition
- Iron deficiency
Telogen effluvium does not always occur right after the precipitating event. In many cases it can be weeks or months later that the hair loss occurs.
Hair Loss Treatment for Women – Ingredients
For female pattern hair loss and alopecia areata, treatment with medications can improve quality of life for many patients. Treatment for female hair loss involves the use of either topical or orally administered medications. Topical treatment with minoxidil is often the first-line treatment for hair loss, but newer formulations are being studied that may be more effective. It is important to deal with any nutritional deficiencies, medications, and other health issues that may be causing hair loss. Hair loss treatments may be less effective if an underlying issue is not resolved. Some treatment options for female hair loss include:
Minoxidil is the first-line treatment for hair loss in both women and men. It was first marketed for hair loss as a topical preparation under the brand name Rogaine but it is now available in generic versions. Minoxidil helps extend the growing phase of hair, which counteracts the shortening of the growing phase that occurs with androgenic alopecia. It is also able to grow hair follicles and thicken hair that is still growing.
Spironolactone is an anti-androgen drug that helps reduce the effects of androgen hormones on hair loss. Hormonal changes associated with menopause can often affect hair growth. Because spironolactone competitively blocks androgen receptors, it is only recommended for use in women as it can cause gynecomastia and loss of libido in men. These capsules should never be taken if you are pregnant or trying to conceive. For pre-menopausal women, a negative pregnancy test should be confirmed before starting treatment.
What About Telogen Effluvium?
For patients experiencing telogen effluvium, treatment is often unnecessary or not helpful. New hair will often grow back if the underlying cause is treated or once the stressor is removed. In most cases, it is more beneficial to manage the stressor, nutritional deficiency, or health issue before attempting treatment with a hair loss medication.
Oral Hair Loss Treatment for Women
Topical treatments are frequently prescribed for treating hair loss in women. A topical foam or gel needs to be used consistently every day, however. It can be messy and cause dryness and irritation of the scalp. It can also require planning as water can not touch the area for several hours after application. If a woman finds it too difficult to regularly apply the product, she will not get the same results and may get discouraged by the treatment. Doctors and researchers studying hair loss in women realized that an orally administered once-daily medication would make treatment much easier for women. A recent study on a minoxidil and spironolactone combination was undertaken for this reason.
In an observational pilot study conducted by Dr. Rodney Sinclair and published in the International Journal of Dermatology, patients were given combination capsules containing minoxidil 0.25mg with spironolactone 25mg. There were 100 women in the study who took the capsules once daily for 12 months.
Hair Loss Score: At baseline, the mean hair loss severity score was 2.79 on a range from 2-5. The mean reduction in the hair loss severity score was 0.85 at 6 months and 1.3 at 12 months.
Hair Shedding Score: At baseline, the mean hair shedding score was 4.82. The mean reduction in hair shedding score was 2.3 at 6 months and 2.6 at 12 months.
During the study, side effects were mild and 2 out of the 100 women discontinued treatment because of urticaria. Hair growth in other places like the face is common. This study is promising but should be followed up with placebo-controlled trials to better understand the optimal dosages of these two ingredients and their effects on hair growth. However the results do show that combination minoxidil and spironolactone capsules can improve hair growth, reduce shedding and improve hair density.
Read coverage of this pivotal study in Allure magazine here.
Side Effects of Minoxidil and Spironolactone Treatment
Both minoxidil and spironolactone are drugs that have been proven to be safe and effective when used separately. When combined, the side effects were similar to when they are used alone. Usually the side effects are mild and include urticaria (itching) and an increase in body hair in other areas of the body like the upper lip. These side effects will cease within a few months of discontinuing the medication. Other side effects may include menstrual irregularities, fatigue, and postural hypotension.
One benefit of taking hair loss capsules instead of using a topical foam or gel is that scalp irritation is reduced. Scalp irritation from topical application of minoxidil is related to the vehicle used (like propylene glycol) and not the active ingredient. Contact dermatitis can be avoided by using an orally administered hair loss capsule.
How to Obtain Combination Hair Loss Capsules for Women
As of right now, there are no commercially available drugs that contain both minoxidil and spironolactone. However these combination hair loss capsules for women can still be made by a compounding pharmacy with a prescription from your doctor.