Female pattern hair loss

Dear Dr. Roach: After a diagnosis of low thyroid levels, my formerly long, thick hair has thinned out. I’d say 50 to 60 percent over the years since menopause (I am 78). It is especially thin from the front to the middle of my head. All I have found to help my hair look presentable and fuller is a product to increase hair volume, which just clings to the hair, giving it fullness and shine. It’s been a lifesaver as far as appearance goes.

There are so many ads for pills and scalp treatments (some very expensive), but is there really anything that works to stimulate the follicles to regrow more hair? I’ve tried using biotin for long periods, but did not notice any difference in my hair or nail strength. I’d truly appreciate your opinion. — Anon.

Answer: Female pattern hair loss is the most likely cause of your problem. Thirty-eight percent of British women over 70 have this condition, though it is less common in women of Asian and African descent. The crown of the head to the forehead is the area most frequently involved, and the overall appearance is of thinning hair without scarring.

A dermatologist is best suited to make the diagnosis for certain. If confirmed, the most effective treatment is minoxidil: I usually recommend the 2 percent solution twice daily to begin with. It takes at least four months to see benefit, although there can be some increased hair loss in the first two to eight weeks of treatment as the follicles become stimulated. Some women think this means the product isn’t working, but they need to continue using the product for it to work. The results vary dramatically from woman to woman, with some having no benefit at all, others having progression slowed or stopped, and some having dramatic hair regrowth.