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Female-pattern hair loss: therapeutic update.

Paulo Müller Ramos, Daniel Fernandes Melo, Henrique Radwanski, Rita Fernanda Cortez de Almeida, Hélio Amante Miot
Review Anais brasileiros de dermatologia 2023 29 citações
PubMed DOI CC-BY PDF
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Study Design





            

                

                    

                        
                        

                            
Tipo de Estudo

                            
Review

                        

                        
                        
                        
                        
                    

                    

                        
                        

                            
Intervenção

                            
Female-pattern hair loss: therapeutic update. topical minoxidil (first-line); various other therapies reviewed

                        

                        
                        
                        

                            
Comparador

                            
Placebo

                        

                        
                        
                        

                            
Direção do Efeito

                            

                                
                                    Mixed
                                
                            

                        

                        
                        

                            
Risco de Viés

                            
Unclear

                        

                        
                    

                

            

        

        

        
        
        

            

  
Abstract





            

                
Female androgenetic alopecia or female-pattern hair loss (FPHL) is highly prevalent and has a great impact on the quality of life. The treatment is a routine challenge in dermatological practice, as many therapeutic options have a limited level of evidence and often do not meet patients expectations. Lack of knowledge of the pathogenesis of the hair miniaturization process and the factors that regulate follicular morphogenesis restricts the prospect of innovative therapies. There is also a lack of randomized, controlled studies with longitudinal follow-up, using objective outcomes and exploring the performance of the available treatments and their combinations. Topical minoxidil, which has been used to treat female pattern hair loss since the 1990s, is the only medication that has a high level of evidence and remains the first choice. However, about 40% of patients do not show improvement with this treatment. In this article, the authors critically discuss the main clinical and surgical therapeutic alternatives for FPHL, as well as present camouflage methods that can be used in more extensive or unresponsive cases.

            

        

        

        
        

        
        
        

            

  
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Figures





            

                
                
                    
                    

                        Classification and clinical presentation of female-pattern hair loss (FPHL), also known as female androgenetic alopecia. The review updates current understanding of this prevalent condition and its impact on quality of life.
                    

                    
                    

                        
Figure 1

                        
                        
Classification and clinical presentation of female-pattern hair loss (FPHL), also known as female androgenetic alopecia. The review updates current understanding of this prevalent condition and its impact on quality of life.

                        
                        
                        photograph
                        
                    

                
                
                
                    
                    

                        Pathophysiology diagram of female-pattern hair loss, illustrating hormonal, genetic, and environmental factors contributing to progressive hair thinning. The therapeutic update contextualizes current treatment targets.
                    

                    
                    

                        
Figure 2

                        
                        
Pathophysiology diagram of female-pattern hair loss, illustrating hormonal, genetic, and environmental factors contributing to progressive hair thinning. The therapeutic update contextualizes current treatment targets.

                        
                        
                        diagram
                        
                    

                
                
                
                    
                    

                        Summary of pharmacological treatment options for female-pattern hair loss, including FDA-approved and off-label therapies. The therapeutic update reviews evidence for minoxidil, anti-androgens, and newer modalities.
                    

                    
                    

                        
Figure 3

                        
                        
Summary of pharmacological treatment options for female-pattern hair loss, including FDA-approved and off-label therapies. The therapeutic update reviews evidence for minoxidil, anti-androgens, and newer modalities.

                        
                        
                        diagram
                        
                    

                
                
                
                    
                    

                        Procedural and device-based treatment approaches for female-pattern hair loss, covering platelet-rich plasma, low-level light therapy, and hair transplantation. The update evaluates emerging evidence for these interventions.
                    

                    
                    

                        
Figure 4

                        
                        
Procedural and device-based treatment approaches for female-pattern hair loss, covering platelet-rich plasma, low-level light therapy, and hair transplantation. The update evaluates emerging evidence for these interventions.

                        
                        
                        diagram
                        
                    

                
                
                
                    
                    

                        Treatment algorithm or clinical decision framework for managing female-pattern hair loss, integrating pharmacological and procedural options based on severity and patient preferences.
                    

                    
                    

                        
Figure 5

                        
                        
Treatment algorithm or clinical decision framework for managing female-pattern hair loss, integrating pharmacological and procedural options based on severity and patient preferences.

                        
                        
                        diagram
                        
                    

                
                
            

        

        

        
        

        
        
        

            

  
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Used In Evidence Reviews





            

                
                
                    

                        A

                        
                            Minoxidil para Alopecia Androgenética
                        
                    

                    
                
                
                
                    

                        A

                        
                            Minoxidil para Perda Capilar de Padrão Feminino
                        
                    

                    
                
                
                
                    

                        A

                        
                            Finasteride para Alopecia Androgenética
                        
                    

                    
                
                
            

        

        

        
        
        

            

  
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