The gradual hair thinning is not usually accompanied by increased numbers of hairs coming out during combing, brushing, or shampooing. Without looking carefully, even the trained physician or office staff member may not realize the woman is truly losing her hair. Women develop time-consuming and often elaborate hairstyles as an adaptive behavior to mask their hair loss. Yet, even if the hair loss is not instantly obvious, it is important that a woman's concerns and fears be acknowledged and addressed. Understandably, treating patients with hair loss is psychologically challenging for the physician.
All hair follicles remain present in a patient with androgenetic alopecia.
However, many of these hairs have become miniaturized. Patients with androgenetic alopecia as opposed to other forms of alopecia do experience a normal hair-growth cycle. As follicles become miniaturized, new hair growth becomes thinner and shorter. That is, normal sized terminal hair may grow to a length of 2 to 3 feet in a single two to three-year growth cycle. On the other hand, miniaturized hair may grow only a few inches during a much shorter growth cycle.