Australian Prescriber Podcast E196 - Male and female pattern hair loss
Sep 1, 2025
In this discussion, Dr. Laxmi Iyengar, a research fellow and GP specializing in hair disorders, and Dr. Jane Li, a consultant dermatologist, delve into male and female pattern hair loss. They explore the differences in presentation between genders and the hormonal factors involved. The duo highlights the significance of trichoscopy for diagnosis and the importance of tailored treatment approaches. They discuss the efficacy of topical minoxidil and spironolactone, alongside the role of combination therapy. Insights on when to refer patients for specialized care are also shared.
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Key Differentials For Non-Scarring Hair Loss
- Important differentials for non-scarring AGA include telogen effluvium, alopecia areata, tinea capitis (in children), and trichotillomania.
- Consider history of abrupt shedding, well-defined patches, or psychiatric hair pulling when diagnosing.
Set Realistic Treatment Expectations
- Counsel patients that AGA is chronic: treatments stabilize or improve but rarely cure, and benefits often take ≥6 months.
- Explain that stopping therapy leads to gradual loss of gains over 6–12 months, but remaining better off than untreated.
Combination Therapy Is Often Better
- Combination therapy tends to outperform monotherapy because treatments target different mechanisms: stimulate growth and prevent loss.
- A multi-pronged approach maximizes response.