Last Updated on August 7th, 2019
Millions of women who suffer polycystic ovarian disease, a condition also known as PCOS, display acne as one of their most prominent symptoms. But for about 30 million women in the United States who have polycystic ovarian disease (PCOS) or other hormonal imbalances, an even more disturbing symptom is androgenic alopecia1, or the loss of hair in a pattern resembling male-pattern baldness. Some treatments that work for acne overlap with treatments that work for baldness in women.
In women who have PCOS, hair loss is a result of elevated levels of testosterone. The kind of hair loss triggered by PCOS is essentially male pattern baldness in a woman. Testosterone circulates through the bloodstream to the skin where an enzyme converts it into an active form of the hormone that switches off growth from hair follicles. Women’s bodies naturally make small amounts of testosterone, but in this condition testosterone levels run very high.
Why do women who have PCOS have elevated testosterone levels? There is no definitive explanation for elevated testosterone in each and every woman who has PCOS. Some women who have the condition actually have low testosterone levels. In other women who have the condition, the problem is how the body recycles testosterone. But in other women who have the condition, the problem is that insulin2, the hormone that transports glucose sugar inside cells, does not “stick” to its target cells properly.
When insulin can’t do its job, blood sugar levels increase. Most of the tissues in the body have to receive glucose with the help of insulin (except at extremely high blood sugar levels), but the ovaries are an exception to the rule. The ovaries have to house all the eggs a woman’s body will ever produce. The ovaries have to have a constant supply of glucose to fuel their activities. They can absorb sugar from the bloodstream even when insulin does not work properly.
The ovaries use the inflowing flood of glucose to make more hormones. They make both estrogen and testosterone. The extra estrogen interferes with the hormonal signals that restart the menstrual period and women may fail to ovulate and also fail to have periods. The excess testosterone causes both acne and hair loss. Interestingly, there is one treatment that works for both conditions.
For hundreds of years, folk healers have recognized that sunlight has a beneficial effect on both acne and hair loss. The old advice used to be to “dry out” the skin to treat both conditions, but it is not actually drying that causes improvements. It turns out that specific wavelengths of visible light have specific effects in the skin3.
Visible blue light (either from sun exposure or from a blue light lamp) kills the bacteria that trigger inflammation in acne. Visible red light reduces sebum production in the oil glands at the base of pores, so blemishes do not grow as large. Dermatologists have also discovered that red light also stimulates circulation of blood through the skin, and have begun using laser light therapy using a red light-emitting diode (LED) to stimulate the growth of hair on the scalp in women who have been affected by hair loss.
Could you get the same effect from using an acne treatment lamp?
Makers of acne treatment lamps cautiously guarantee they will work for treating acne, although government regulators take a very close look at these kinds of claims. No maker of a red light lamp or blue-red combination light lamp typically used for acne treatment is going to guarantee it will restore women’s hair. Dermatologists usually prefer to use a much stronger light source for a much shorter time.
But if you are a woman who has both acne and hormone-related hair loss, red light treatment may be worth a try. A red light or combination light lamp won’t cost more than $200—while a custom-designed wig can cost as much as $2000. Don’t neglect other possibilities for taking care of hair loss, such as Minoxidil, hair extensions, and wigs. But try red light and see if hair regrowth is not accelerated.
Frequently asked questions about women’s hair loss:
Q. What does female hair loss look like?
A. Hormone-related hair loss in women follows the same pattern as in men4. Hair begins to fall out as the sides of the forehead, causing a “widow’s peak,” and hair loss continues on the scalp at the top of the head. The process is usually gradual and not total. Sudden, total hair loss is usually due to toxic exposure or an autoimmune disease.
Q. Are women ever treated with hair plug transplants?
A. The old procedure of transplanting hair in “plugs”5 created a number of cosmetic disasters for men in the 1960’s and 1970’s. Some well-known news anchors in the United States can no longer appear in close-ups on television because of the scarring left by failed hair plug transplants. Nowadays, especially for women, dermatologists typically transplant single hair follicles, one at a time, to give the resulting a hair a more natural distribution.
Q. Do follicular transplants leave scars?
A. Usually the dermatologist removes a strip of skin from the back of the scalp, which still has hair. The individual follicles are then dissected out of the donor skin and individually transplanted into the bare scalp that needs correction. The strip of skin used to harvest hair follicles leaves only a fine scar that is concealed by healthy hair.
Q. Are there any drugs for women’s hair loss?
A. In the United States, the only approved drug for women’s hair loss6 is Minoxidil. It’s also available over the counter without a prescription. Minidoxil is more effective when treatment is begun as soon as hair loss is noticed, not after the scalp has been bare for a period of years.
Q. Will hair transplantation help non-hormonal hair loss in women?
A. Unfortunately, transplanted hair can also be destroyed by autoimmune disease. A hair transplant won’t work as long as the disease is active.
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