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New York Dermatologist Dr. Schweiger on the role that genetics play in female pattern baldness to the readers of

For women, genetic hair thinning, also called androgenetic alopecia, androgenic alopecia, or female pattern baldness, is the most common form of age-related hair loss. In their recent paper "Update on Pathogenesis, Genetics and Medical Treatments of Patterned Hair Loss," published in the November 2010 issue of Journal of Drugs in Dermatology, coauthors Dr. Eric Schweiger and Dr. Robert Bernstein reviewed the major advances in the genetics of women's hair loss over the past decade, as well as our understanding of how it is caused. Other research has shown that women may have less 5-alpha-reductase than men but higher levels of the enzyme aromatase, especially at their frontal hairline. Aromatase is responsible for the formation of the female hormones estrone and estradiol, which are thought to decrease DHT formation. This may help to explain why the presentation of hair loss in women is so different than in men, particularly with respect to the preservation of the frontal hairline. It may also explain why women have a poor response to the drug finasteride (band name Propecia), a medication widely used to treat hair loss in men that works by blocking the formation of DHT. Androgens do affect the hair growth cycle in women, but the exact mechanism is still unclear. At this point, according to Dr. Schweiger, female pattern hair loss is multifactorial and a genetically determined trait with both hormonal and nonhormonal causes. The HairDX genetic screening test, prior to the onset of symptoms, is used to predict whether a woman will experience pattern hair loss. The test is sold to doctors in a kit, is administered by a simple cheek swab and tests for the gene variant, or CAG repeat. The test provides women with a CAG Repeat Score. A smaller number in the CAG test score is associated with a higher risk for significant hair loss (Ludwig grade II or III hair loss), while a larger test score is associated with a lower risk for hair loss. “I think the test has probably identified a predictor of female pattern hair loss, but not the only predictor,” says Dr. Schweiger. “There is science behind the test and some published research studies; however, the longitudinal, larger studies have not been done, because this testing procedure is just too new.” Any genetic testing should be performed under a doctor’s supervision so that it can be put in the context of a careful history, a physical examination and a densitometry hair evaluation advises Dr. Schweiger. To read more about female pattern baldness at featuring Dr. Schweiger, click here.

Schweiger Dermatology

110 East 55th Street
New York, NY 10022

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