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The causes of hair loss in women are much more varied than in men. When a woman presents to a physician with alopecia (hair loss) for the first time, a careful history must be obtained. In other words, the pattern must first be determined.Is the thinning all over?, or is it a widening of the part, or a typical “male” pattern of hairline recession? This information suggests to the physician where to direct his physical exam, and if laboratory studies are indicated.
The typical female pattern is the so-called Ludwig pattern, which retains the hairline, but sees the middle part become progressively wider over time; women, however, can also experience the typical Norwood pattern, so common in men. Then the progression must be determined. Did the loss begin suddenly, and was a “rapid “shedding” noted? Or has there been a slow, steady loss over time? Depending on the pattern and progression, the doctor may decide to do microscopic hair exams, together with hair pull or pluck tests, or to order various lab studies.
Common systemic conditions which can cause hair loss include anemia, excess androgens, autoimmune disorders, and many, many causes of acute stress, such as surgery , childbirth, fever, severe illness, and extreme psychological stress.
In men, the most common cause by far is male pattern baldness, or androgenetic alopecia. This is the common hair loss pattern that is dependent on genetic predisposition, androgens (male hormones), and the simple passage of time. This usually results in the common Norwood pattern of loss, consisting of hair line recession, with or without loss in the crown. It is quite uncommon to find other causes of hair loss in men. The most common treatments for men are medical treatment (Propecia, Rogaine) and surgical treatments (hair transplantation).
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