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Q: I have been losing a lot of hair for the last 6 years, and at the beginning was diagnosed hyperandrogenism based on hormone analyses, presumably due to PCOS. I also have some acne and recently also some unwanted hair on the face. Now the hair loss is indeed notorious. However, it does NOT follow the expected FEMALE PATTERN, but it is mainly on the temples (where it is severe, both in density and thickness/length), and at the sides, i.e. between temples and ears, where I notice a significant hair density decline (although with no thinning as in temples). Can this pattern be attributed to androgenic or other hormone-related alopecia, or do you think it could be an independent problem?

A: Androgenic alopecia, which is hair loss due to the effect of testosterone, typically involves mainly the crown and vertex with lesser effects on the sides and front hair line. However there is considerable individual variation and some women do get considerable loss at the temples. The difference in pattern does not seem to imply any difference in hormonal cause.
Treatment is to lower or block testosterone, as discussed in the website article on alopecia.

Hope this is helpful.


Geoffrey Redmond, MD

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