Treatment options for female hair loss
systematic review questions
What treatments are safe and effective for female hair loss (FPHL)?
The most common type of hair loss in women is FPHL, or androgenetic alopecia.Unlike men, women do not go bald, but the hair on the top and front of the head is significantly thinner.Hair loss in women can occur at any time from puberty to later.Among them, postmenopausal women have a higher rate of hair loss.
The disease can be diagnosed by careful consultation with family history.Because of the many etiologies to consider, both clinical examination and laboratory tests are necessary.FPHL has a significant impact on self-awareness, and the blow to a woman's self-confidence can also impair her quality of life, producing feelings of poor image, shame, discomfort, emotional stress, and low self-esteem.
We searched for available evidence up to 7 July 2015.Forty-seven studies, including 5290 women, met the inclusion criteria for the Cochrane review.The average age of the subjects in the trial ranged from 27 to 57 years old.More than half of the studies were assessed as having an unknown risk of bias, 16 were at high risk, and only five studies were at low risk of bias.Twenty-six of the 47 studies were funded, mostly by pharmaceutical companies.
A Cochrane systematic review found minoxidil to be more effective than placebo.In six studies, twice as many women in the minoxidil group experienced at least moderate hair regrowth as in the placebo group.The researchers confirmed this by evaluating seven studies.In eight studies, there was a significant increase in the number of hairs per cm² in the minoxidil group compared to the placebo group.Quality of life was assessed in only one study, and it was not clear whether there was a significant improvement in the data.The number of adverse events was similar in both groups.Side effects are generally mild and include itching, skin irritation, dermatitis, and additional hair growth on areas other than the scalp.
Four studies compared minoxidil (2%) to minoxidil (5%), but none showed that higher concentrations were more effective than lower concentrations.The number of adverse events in the two groups was similar.Minoxidil should not be used by pregnant or breastfeeding women.
Three studies compared finasteride to placebo.Finasteride is only approved for the treatment of male pattern baldness and benign prostatic hyperplasia.In one of three studies assessing the opinions of participants and investigators, finasteride was not shown to be more effective than placebo.Hair count improved only in one small study with only 12 subjects, but not in the other two studies (219 subjects).Side-effect events were noted in only one study and were similar in both groups.None of these studies assessed quality of life.
Laser comb therapy was no more effective than sham therapy, according to two studies involving 141 subjects.However, both studies reported significant increases in hair growth.Quality of life was not reported, nor were adverse events reported in the intervention group, making these data less useful.
Individual studies have investigated and compared many other interventions, and we cannot draw firm conclusions about the effectiveness or safety of these interventions.
While it is generally believed that hair loss occurs relatively quickly after treatment is discontinued, none of the relevant studies have reported data on the sustainability of treatment effects, nor on the possible impact of hair regrowth, which was reported by women This is reflected in the reduction in time spent doing hair or using wigs.
quality of evidence
The quality of the evidence we rated was mostly moderate or low.The low quality of evidence was mainly due to the risk of bias in the study (eg, not being double-blind) or the small sample size, which made the results less precise.