FEMALE ALOPECIA: AN INTEGRATED APPROACH FROM DIAGNOSIS TO THERAPEUTIC MANAGEMENT

Abstract

Female alopecia encompasses a heterogeneous group of conditions characterized by hair thinning or increased hair shedding, often associated with significant psychosocial impact. Among the most common causes, female pattern hair loss (FPHL) represents a progressive non-scarring alopecia associated with follicular miniaturization. This study aimed to review the main aspects of female alopecia, focusing on pathophysiology, clinical evaluation, differential diagnosis, and therapeutic management. A narrative literature review was conducted using the MEDLINE/PubMed database with descriptors related to female alopecia and telogen effluvium. Review articles, systematic reviews, and clinically relevant studies were prioritized. The literature indicates that FPHL is the most prevalent cause of alopecia in women and is characterized by progressive follicular miniaturization and a typical pattern of hair thinning. Systematic clinical evaluation combined with tools such as trichoscopy and laboratory investigation when indicated is essential for differential diagnosis. Therapeutic management should be individualized according to etiology, including topical minoxidil as first-line therapy for FPHL, antiandrogen therapy in selected cases, and etiological management in telogen effluvium and secondary alopecias. An integrated clinical approach that considers both medical treatment and psychosocial impact is essential for improving clinical outcomes and patient quality of life.