Title : The management of FPHL- How it different from male AGA
Abstract:
Female Pattern Hair Loss (FPHL) is a prevalent non-scarring alopecia that exhibits distinct clinical, pathophysiological, and therapeutic characteristics compared to male Androgenetic Alopecia (AGA). Unlike AGA, which follows a well-defined pattern of hairline recession and vertex thinning, FPHL typically presents as diffuse thinning over the central scalp while sparing the frontal hairline. It is difficult in early stages to diagnose FPHL as there is no obvious thinning. The multifactorial etiology of FPHL includes hormonal, genetic, and environmental
factors, with a lesser role of androgens than in AGA. Therapeutically, the management of FPHL differs significantly from AGA due to these biological variations. Minoxidil remains the cornerstone treatment for both conditions; however, its efficacy is influenced by factors such as the differential expression of SLC22A9 transporters, which are reportedly higher in men, affecting drug response. Moreover, systemic antiandrogens like spironolactone and oral contraceptives are often employed in FPHL to counteract androgenic activity, a strategy less commonly applied in men. Finasteride dose for women is higher than men. Pregnancy and lactation add complexity to FPHL management, as certain treatments, including oral medications, must be avoided. Additionally, FPHL treatment demands a psychosocial approach due to the significant emotional impact of hair loss in women, necessitating supportive counseling alongside medical interventions. Understanding these distinctions is essential for optimizing outcomes in FPHL management. Future research focusing on gender-specific pathophysiology and therapeutic targets, including biomimetic peptides and exosome-based therapies, holds promise for advancing personalized care in hair disorders.
