Perimenopausal hair loss is caused by hormonal shifts that affect hair growth. It tends to affect women around the age of 49 years old. It can look like androgenetic alopecia (female pattern hair loss) but starts later in life.
Perimenopausal hair loss: history
An African American woman in her late 50s requested treatment for a five-year history of hair loss. She had worn dreadlocks and twists in the past but had no visible scarring on examination. She had a family history of hair loss. Only in the past few years, however, has she experienced any hair loss herself. The patient stated that her prior dermatologist had done a biopsy and had told her that she had traction alopecia. She was treated with injections of steroids with little change in her hair loss condition. She had also tried minoxidil in the past but had found it to irritate her scalp. Other than her high blood pressure, which she treated for years with hydrochlorothiazide, the patient was otherwise healthy.
Perimenopausal hair loss: evaluation
The patient had a normal scalp. She wore her hair in its natural texture but used artificial color. Her curly hair stretched out to about chin length. The hair was not brittle and did not pull out of the scalp with ease. She was noted to have thinning of the hair on the frontal scalp with slight widening of the midline part. Her blood tests were normal. The physical appearance of the patient’s hair loss looked like female pattern hair loss, however, this usually starts before the age of 40. As this patient reported that her alopecia had started in her early 50s, we concluded that she had perimenopausal hair loss.
Perimenopause hair thinning treatment
Treatment of perimenopausal hair loss is much the same of for androgenetic alopecia or female pattern hair loss. Minoxidil is a common choice. Supplements can be helpful to balance hormones and address any nutritional issues to better support hair growth. Red light therapy and PRP were also discussed.
Hair growth before and after: Revian Red
Given her history of irritation with topical minoxidil, and her concern about unwanted facial hair growth, a know side effect of both oral and topical minoxidil, the patient decided to try red light therapy with the Revian Red cap. At her follow up visit 6 weeks later, she reported that she noticed improvement. Her before and after hair growth photos indicated that her condition was improving.
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