Male and female pattern hair loss is a non-scarring, polygenetic progressive form of alopecia that typically affects the temporal, frontal, and vertex scalp in men, and the central scalp in women.

The process can begin soon after puberty, and the resulting hair loss negatively affects quality of life and self-image.

Pattern hair loss is commonly diagnosed when a thorough history is taken; this will include a physical examination of the face, scalp, and nails and laboratory testing of samples. A hair biopsy may be useful for diagnostic certainty.

Topical minoxidil and oral finasteride are first-line treatments for male pattern hair loss, with topical minoxidil as the first-line therapy for female pattern hair loss.  The Skin Company also offers a number of other off-label pharmacologic (oral minoxidil, spironolactone, HRT ) and non-pharmacologic treatments ( LED, PRP, dermal needling). 

Telogen effluvium is a  noninflammatory cause of hair loss and is often difficult to distinguish from female pattern hair loss.  Taking a thorough history is important to identify potential triggers such as: psychological stress, child birth, weight loss, or particular medications, which precede telogen effluvium by a few months.

This type of hair loss generally occurs over the entire scalp and is occasionally more pronounced in the temporal regions of the scalp.  

Alopecia areata can usually be identified by smooth patches of hair loss, which typically may spontaneously regrow.  In rare instances, this condition can present as diffuse hair loss with widespread decreased hair density (diffuse alopecia areata) or as larger patches of hair loss on the frontal, parietal, and temporal scalp (ophiasis inversus), which are very similar in appearance to female and male pattern hair loss, respectively.  

Alopecia areata totalis (total loss of scalp hair) and alopecia areata universalis (total loss of scalp, face and body hair) are less common and are characterised by more severe hair loss. These are typically treated with systemic therapies.

Lichen planopilaris and frontal fibrosing alopecia are inflammatory scarring alopecias.

Frontal fibrosing alopecia results in a receding hairline, which occurs in a band-shaped distribution in women. Unlike female pattern hair loss, frontal fibrosing alopecia often affects the eyebrows and temporal scalp and can result in complete and permanent hair loss.

Treatments combine medical hormonal and anti-inflammatory therapies.