Hair loss in women, particularly post-menopausal, is an increasingly common concern in aesthetic and medical practice. Often under-discussed and undertreated, female pattern hair loss (FPHL) can have a profound psychological impact, affecting self-esteem, confidence, and emotional wellbeing. While male hair loss is socially accepted to some degree, women experiencing thinning or patchy loss may suffer in silence, feeling ashamed or stigmatised. 

Understanding Female Pattern Hair Loss 

Female pattern hair loss (FPHL), also known as androgenetic alopecia in women, is a progressive, non-scarring alopecia resulting from the miniaturisation of hair follicles and a reduction in the anagen (growth) phase of the hair cycle.³ It manifests primarily as diffuse thinning over the crown and mid-frontal scalp, with relative preservation of the frontal hairline – a presentation that differs from the more patterned recession seen in men.⁴ 

Unlike acute hair shedding conditions such as telogen effluvium, FPHL typically develops gradually and persists over time, often going undiagnosed or misattributed to general ageing or stress. In women, the condition has a distinctly heterogeneous clinical course influenced by hormonal, genetic, and environmental factors.3,5 

On a histological level, affected follicles undergo miniaturisation, producing finer, shorter, and less pigmented hairs. The hair growth cycle is altered, with fewer follicles in the anagen phase and more in the telogen (resting) or catagen (regression) phases, resulting in visible volume loss.5,7 

Although the physical signs of FPHL may initially seem subtle, the emotional toll is often profound. Women experiencing hair thinning may report significant distress, loss of self-image, and even depression, particularly when the hair loss interferes with daily styling or social interaction.2,8 

FPHL is most commonly graded using the Ludwig or Sinclair scales, which categorise the extent of hair loss based on density and spread across the scalp.⁹ While FPHL is a chronic condition without a definitive cure, early intervention using evidence-based and regenerative approaches can stabilise progression, improve density, and enhance scalp health – providing both aesthetic and psychological benefit to affected patients. 

Current treatment options for FPHL  

Multiple therapeutic approaches exist, with varying degrees of efficacy: 

• Topical minoxidil: Widely used but limited by adherence, scalp irritation and plateauing of results.⁷ 

• Oral anti-androgens (e.g. spironolactone): Effective in selected patients but may cause systemic side effects.⁸ 

• Nutritional supplements: Useful where deficiencies are present but less effective alone.⁹ 

• PRP (platelet-rich plasma): Popular regenerative option but requires blood draw and has high variability in outcomes.¹⁰ 

• Hair transplant surgery: Less commonly suitable in diffuse female hair loss. 

Regenerative therapies, including polynucleotides, have emerged as a promising adjunct or alternative to conventional treatments due to their ability to improve the health and functionality of the scalp and hair follicles without hormonal or systemic disruption.¹¹ This was the approach used in the case study discussed, where polynucleotide injections were selected to address menopausal hair thinning through regenerative, non-hormonal means. 

Case study 

A 60-year-old female presented with gradual hair thinning following menopause. She described a loss of confidence and emotional distress, though she was also pragmatic and had realistic expectations. Her GP was already managing her hormone levels, and we explored various options including PRP and topical treatments. Given her preference for a minimally invasive, non-hormonal approach with a regenerative focus, we agreed on a protocol using injectable polynucleotides. 

Polynucleotides, particularly those derived via PN-HPT® (Highly Purified Technology), are bioactive DNA fragments extracted from trout gonads that support tissue regeneration, fibroblast proliferation, angiogenesis and scalp homeostasis.¹² These mechanisms make them particularly suited to patients seeking improved scalp quality and follicular support without systemic side effects. 

We selected Plinest® Hair, a formulation designed specifically to address hair thinning through improved dermal papilla function, microcirculation and oxidative stress modulation.¹³ Clinical studies have demonstrated its potential to enhance hair density, thickness, and hydration in women with mild to moderate FPHL.¹⁴ 

Protocol design 

• Treatment frequency: Every four weeks (selected due to patient availability) 

• Product selection: Plinest® Hair (1ml) for the first three sessions, followed by Plinest (1ml) for the remaining five sessions 

• Technique: Intradermal injections in a grid-like pattern across the affected scalp, including the frontal hairline 

• Preparation: The patient was asked to wash her hair the morning of the appointment; scalp cleansed with Clinisept pre-treatment 

• Aftercare: Patient advised to avoid hair washing or product use for 24 hours post-procedure, while following standard hygiene and sun protection guidance 

Risks and side effects 

Polynucleotide-based treatments are generally very well tolerated. Potential side effects include: 

• Mild erythema or swelling at injection sites 

• Occasional pinpoint bruising 

• Rare allergic reactions (always screen beforehand) 

No serious adverse events have been reported in the current literature.15 

Patient outcome 

Data indicates that clinical improvements with Plinest® Hair are typically observed between four and eight weeks following the second or third session.16 This was the case for this patient, who started noticing  new growth – including the unexpected return of pigmented hairs, having been grey since her early 30s, from the fifth session. She experienced no side effects and described feeling “thrilled” and uplifted by the visible changes. 

Outcomes include: 

• Improved scalp hydration and elasticity 

• Increased follicular activity and visible regrowth 

• Reduction in hair shedding 

• Enhanced hair thickness and quality 

While more comparative data is needed, current studies demonstrate that polynucleotides offer a safe and well-tolerated treatment that may match or exceed PRP in certain patient profiles.17 

The patient now plans to continue with maintenance treatments every four to six weeks. She values the subtle, natural progression of results and the fact that her hair improvement has not required hormonal or surgical intervention. 

A safe and subtle solution  

For many women, postmenopausal hair loss is more than a cosmetic issue – it can significantly impact quality of life. In this case, Plinest® Hair offered a safe, well-tolerated, regenerative option that helped restore not only hair density, but also the patient’s confidence. 

Polynucleotide therapy represents a growing frontier in aesthetic medicine, offering biologically active, minimally invasive solutions for challenging conditions like FPHL.