Step 1: History
The most important step in the approach to hair loss should always be a doctor’s understanding of an accurate history of the client. That history consists of the family history of hair loss, other medical problems of the past and the drug use of past and present
Without a family history of hair loss in women, it is less likely that a woman suffers from the typical female model hair loss. There are several medications that are known to have an effect on hair loss in men and women. Hair loss as a side effect of a drug can be one of the causes of hair loss.
Step 2: Research (macro and microscopic evaluation)
A doctor should take a good look at the patient’s scalp. A different pattern must be sought. In a woman with a receding front line or significant thinner hair at the front but with normal hair on the top and back of the head, the cause may be the same as baldness in men, such as increased testosterone and DHT levels.
Microscopic examination of the scalp and of the hair (miniaturization study) should always be an important component of any hair loss evaluation. It is known that the diameter of the hair can become thinner before falling out. This cannot be explained by the natural growth phases that the hair is going through. The next stage of the study of hair loss in women is the mapping of head hair miniaturization with a microscope. Miniaturization studies should also be used to predict the future pattern of hair loss.
Step 3: Laboratory work.
Many women need a laboratory to exclude other medical conditions that can cause hair loss. Doing laboratory work is most needed in women with an a-typical hair loss without a family history of hair loss.
Laboratory work for hair loss in women may involve a number of simple tests, such as a CBC test and possibly more specific tests such as iron deficiency, hormonal control, evaluations for total and free testosterone, DHEA sulfate, prolactin, T3, T4, TSH and prolactin. More tests for rheumatological problems may also be needed.
Step 4: correct diagnosis.
How to deal with hair loss has directly to do with the correct diagnosis of the cause of hair loss. If we have made a correct diagnosis, the treatment of that medical condition can often also solve the hair loss problem. In cases where we can’t find any other medical cause for hair loss in women, that hair loss is best treated as a female pattern hair loss, the typical pattern for hereditary hair loss.
Step 5: specific treatment.
There are a few treatments that are suitable for women with a “female pattern hairloss”.
Minoxidil 2%. Can be purchased in pharmacies without a prescription. There is also Minoxidil 5% but a prescription is needed for that. Minoxidil 5% can cause increased hair growth in the face as a side effect in women. Minoxidil has been approved by the health authorities. (https://www.haarproblemen.nl/?s=Minoxidil)
Low Level laser (LLL) is under the brand name “HairMax Lasercomb” a treatment that has been recognized by the FDA in the USA. (https://www.haarproblemen.nl/?s=LLL)
Platelet Rich Plasma (PRP) Isolating and re-injecting the growth factors via blood collection
Hair transplant. For women also possible. However, the pattern of expectation in women needs to be taken into account. That’s usually higher than men. Bald men can be very content with a little more hair. In women, there is usually still thin hair that can only be thickened with a hair transplant. However, the hair can never become as thick as it used to be.