Non-AGA Causes of Hair Loss
While androgenetic alopecia (AGA) is the most common cause of hair loss in both men and women, the latter can also be due to a number of other conditions.
Female Pattern Hair Loss — Causes, Symptoms & Treatments
Androgenetic alopecia (AGA) occurs in many women and is also known as female pattern hair loss (FPHL). Female pattern baldness can begin at any age, from adolescence through middle age. AGA patterns in women are significantly different from male pattern baldness. The typical appearance of female hair pattern baldness is diffuse thinning areas over the top of the scalp.
Read on to learn more about AGA, including alopecia causes in females and the best female pattern baldness treatment options.
What is Female Pattern Baldness?
Female pattern baldness occurs in countless women and individuals assigned female at birth. Androgenic alopecia is the most common type of hair loss and occurs when the growth, or anagen phase, is shortened and hair follicles shrink. Over time, the hair shaft becomes thinner and shorter.
Hair is a symbol of femininity from the earliest age. It is also strongly associated with a woman’s attractiveness and sexuality. Individuals affected by female pattern baldness may experience psychological distress and impaired social functioning.
The Ludwig Classification illustrates FPHL in increasing degrees of severity.
- Grade I involves gradual thinning that can be easily concealed
- Grade II presents reduced hair volume and a visibly wider centre hair part.
- Grade III features widespread thinning, giving the top of the scalp a translucent appearance.
The Difference Between Female & Male Pattern Baldness
Signs and patterns of hair loss are different between males and females. People who experience female pattern baldness may notice diffuse thinning at the crown and towards the front of the head in a “Christmas tree” pattern. This means the hairline is less likely to be impacted.
In contrast, male pattern baldness commonly occurs in the central areas of the scalp, including the mid-frontal zone, the temples and the crown (vertex). It frequently progresses in a bald patch at the centre of the scalp.
What are the Causes of Female Pattern Baldness?
Female pattern hair loss develops due to a mix of genetics and hormonal changes or disorders, particularly those affecting androgens (male sex hormones, such as testosterone). Understanding this connection is crucial for proper diagnosis and treatment planning.
The interplay between inherited traits and hormone activity can gradually weaken hair follicles in women. When this happens, each new hair growth cycle produces strands that are increasingly fine and fragile. The hair becomes thinner in width, grows to shorter lengths, and often loses its natural pigmentation. Without medical intervention, over time, these compromised follicles may become dormant and cease hair production entirely.
A reliable diagnosis from a qualified physician or trichologist is critical before deciding on the best hair loss treatment. A specialist will perform a scalp examination to determine the extent of the hair loss.
Here are the most common causes of female pattern hair loss.
Hereditary Baldness in Females
Males with androgenetic alopecia usually have close male relatives with the condition, whereas a family history of genetic alopecia in females may be less apparent. Excessive overall hair loss and a slight gap in the centre of the hairline are usually the first signs of early female pattern hair loss. If the patient’s female baldness is hereditary, it will impact the treatment process.
Hormonal Changes
Hair thinning and baldness in women call for early diagnosis, as it may be a symptom of an underlying condition that is often the result of hormonal imbalances.
Some hormonal issues that could trigger female pattern androgenetic alopecia in women include:
Endometriosis and Polycystic Ovary Syndrome
The most common endocrinologic comorbidity that is associated with female pattern baldness is polycystic ovarian syndrome (PCOS). This condition may contribute to elevated androgen levels, which can cause accelerated hair loss alongside other symptoms. The first signs of PCOS are hair thinning and loss in the centre hair part.
Metabolic Syndrome
A study published in 2024 found that there is a significant link between female pattern hair loss and metabolic syndrome. Metabolic syndrome is characterised by obesity, insulin resistance, hypertension, hyperprolactinemia, and raised aldosterone levels. These factors, in particular hypertension, insulin resistance and higher aldosterone levels, have been associated with increased hair loss. Treatment may range from lifestyle changes to medical treatment, depending on the underlying cause.
What are the Signs of Female Pattern Baldness?
Some of the most common symptoms of female pattern balding include:
Thinning Hair
The first noticeable sign of female scalp hair loss is typically thinning hair caused by increased hair shedding. You may also notice slowed new hair growth.
Although it may be easy to miss initially, noticeable bald scalp patches may appear as time passes.
Bald Spots
As female pattern baldness develops, thinning spots may become more noticeable. Female pattern baldness can progress quickly in some people. Common areas for bald spots in females include the crown, centre hair part and over the top of the head.
Hair grows in tufts on the scalp; balding may occur when all the hairs in a tuft have fallen out. A receding hairline and frontal baldness in females are uncommon and could indicate frontal fibrosing alopecia.
At What Age Does Hair Loss Start for Women?
Early hair loss in females can start from the teenage years, although it’s rare. Hair loss in women under 40 is not very common. Female pattern hair loss at the crown is more common after 40. This may then worsen as almost 40% of women over 50 have some form of AGA.
Hair loss in a middle-aged woman may be caused by genetics, hormones, skin diseases, medications or preexisting medical conditions. For many women, FPHL is part of the ageing process and menopause.
What Can Prevent Female Pattern Baldness?
Currently, there is no proven way to completely prevent female pattern baldness. Hair loss medications such as low-dose oral minoxidil may effectively prevent future hair loss and stimulate hair regrowth. Early intervention can be useful in proactively managing and slowing hair loss in women.
In addition, it is important to avoid trauma to the scalp by reducing the use of tight hairstyles and harsh hair chemicals like bleaches.
Treatment Options for Female Pattern Baldness
While there is no known cure, there are many female baldness treatments available. Female hair loss options include topical and oral medications and hair transplantation.
The best treatment for female pattern hair loss is different for each patient. That’s why you must get the advice of a medical professional before starting a hair restoration plan.
Here are some of the options for treating FPHL.
Topical & Oral Minoxidil
Originally developed to treat high blood pressure, Minoxidil is one of the best medical treatments to help regrow lost hair for females and males.
Hair restoration specialists favour the off-label use of low-dose oral minoxidil. The medication extends the growth phase in the hair cycle and widens blood vessels to the follicular units. This stimulates new growth for female pattern baldness patients and prevents future hair loss.
Topical minoxidil solution is an approved treatment for FPHL and helps restore female hair. It is one of the most effective female hair loss treatments, contributing directly to healthy, thicker hair.
Minoxidil for women, like many other hair loss medications, may be effective in helping you regrow hair. However, if you stop the treatment, you’ll start to lose hair again.
Finasteride
Finasteride is a common treatment for male pattern baldness. This treatment has a noticeable effect on improving hair density and is available as a topical and oral medication which can be taken daily.
While using finasteride for women is not approved, some studies have examined its effectiveness for balding women. The treatment is generally only prescribed to postmenopausal women as it can disrupt the development of a male foetus during pregnancy.
Spironolactone
Spironolactone is an effective treatment for hair loss in women, particularly those with androgenetic alopecia. It works by reducing the production of androgens, which are hormones that can contribute to hair thinning in women. While effective, spironolactone is not a first-line treatment and requires careful monitoring due to potential side effects such as electrolyte imbalances, low blood pressure, and dizziness.
Ketoconazole Shampoo for Female Hair Loss
Ketoconazole shampoo is used to thicken hair and reduce further hair loss. It’s an excellent treatment plan for patients with less aggressive female pattern baldness and can be used in combination with minoxidil.
Melatonin Cream to Stimulate Hair Growth
Melatonin cream is another option for treating female pattern baldness. Some studies have shown that melatonin cream can treat hair loss, stimulate new thick hair, and help repair the hair follicle.
Microneedling to Stimulate Hair Follicles
Microneedling is a minimally invasive procedure that pricks the skin with tiny, sterilised needles to stimulate blood flow and promote hair regrowth for women in the early stages of female pattern baldness.
Low-Level Light Therapy
Low-light laser therapy can help promote hair growth using the wavelength of specialised red-coloured lights. This method has been shown to have some effectiveness for women struggling with alopecia areata and telogen effluvium.
Hair Transplants for Female Androgenetic Alopecia
Hair transplantation is indicated for patients with female pattern baldness over 25 years of age – when the hair loss has been stabilised. An FUE hair transplant for female pattern baldness is safe, minimally invasive and creates no visible linear scarring.
For female patients who wear their hair long, shaving lines of hair off the back of the head is a brilliant way to have a discreet hair transplantation for advanced hair loss. The results of a hair transplant, when performed by a medical expert, are healthy hair follicles that are natural-looking and aesthetically pleasing.
Dr Bonaros: Female Pattern Alopecia Specialist in Glasgow
Dr. Bonaros is a member of the International Society of Hair Restoration Surgery (ISHRS), the world’s leading medical authority on hair restoration.
If you are concerned about hair shedding and live in Glasgow, Edinburgh, Scotland, or the UK, we’d love to talk to you. We are here to help you regain your healthy hair and confidence.
Dr Bonaros is committed to providing the best possible guidance and care for patients suffering from male or female pattern baldness or other hair loss conditions.
Book your consultation today via Zoom or at the Dr. Bonaros clinic to
discuss personalised treatment opportunities for female pattern hair loss.
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