Female Pattern Hair Loss in Women: Causes, Diagnosis & Best Treatment Options

Female pattern hair loss is different from men, and a little more complex to treat.

Female hair loss is an overall reduction in density over the central scalp. It seems like the part is widening, in contrast to temples hollowing out at first in men. The subtle hair loss begins this way but does eventually thin out everywhere.

Because females are in different hormonal changes (more complex than men) treating female pattern hair loss is an art. For example, a female who is experiencing female pattern loss may have a child and get Telogen effluvium superimposed on the androgenic alopecia. Breast feeding may render her anemic and cause further hair loss due to low iron supplies. Menopause, perimenopause and various stages of childbearing create hormonal changes that affect the hair. Women are also more likely to suffer from an autoimmune condition so thyroid disease or scarring alopecia due to autoimmune conditions can also affect a who is suffering from alopecia. Finally, women tend to do various hair styles, some can cause hair loss due to traction for example, which can create more alopecia.

Therefore, women treating women as dermatologists, we need a complete picture of all these various factors to be able to determine the best course or courses of treatment. Additionally, family history, medication changes, any medications or weight loss as well as a scalp exam is necessary to diagnose the correct hair loss.

The treatment for female hair loss can include medications in addition to supplements to procedures to really control the hair loss. Sometimes it may involve lifestyle and hair style changes as well. For example, if laboratory exam indicates iron deficiency in addition to thyroid dysfunction, both need to be corrected.

Women may benefit from bio-identical hormones when they enter perimenopause, in addition to hair stimulants such as PRP injections or Minoxidil (available both in oral and topical formulations). We may use hormonal blockers such as Aldactone for women to help with androgen excess or sensitivity as well.

In short, there is not a one simple solution for hair loss and the combination of the patient’s history, exam, lab findings and lifestyle will dictate the correct treatment.

Frequently Asked Questions About Female Pattern Hair Loss

What does female pattern hair loss look like?

Female pattern hair loss typically causes a gradual decrease in hair density over the top and central portion of the scalp. One of the earliest signs women notice is that their part appears wider or more scalp becomes visible when styling their hair.

Unlike male pattern baldness, which commonly begins with a receding hairline or thinning at the temples, women often maintain their frontal hairline while experiencing more diffuse thinning across the scalp.

What is the most common cause of hair loss in women?

There is no single cause of hair loss in women. Female pattern hair loss, also called androgenetic alopecia, is common, but women can have more than one type of hair loss at the same time.

Hormonal changes, genetics, pregnancy, postpartum shedding, perimenopause, menopause, thyroid disease, iron deficiency, significant weight loss, certain medications, autoimmune disease, stress, nutritional deficiencies, and hairstyles that create chronic tension on the hair can all contribute.

This is why identifying the cause of hair loss is important before choosing a treatment.

How can I tell if I have female pattern hair loss or another type of hair loss?

A widening part and gradual thinning over the top of the scalp can suggest female pattern hair loss, but appearance alone doesn’t always tell the entire story.

A dermatologist may evaluate your pattern of thinning, scalp and hair follicles, family history, medications, recent illnesses, pregnancies, weight changes, menstrual or hormonal changes, diet, and hairstyles. Depending on the findings, blood tests may also be appropriate.

The goal is not simply to diagnose “hair loss.” It is to determine why the hair is thinning and whether several factors are occurring simultaneously.

Can a woman have female pattern hair loss and telogen effluvium at the same time?

Yes. This is an important distinction because women can have underlying female pattern hair loss and then develop telogen effluvium on top of it.

Pregnancy and childbirth, illness, surgery, severe stress, rapid weight loss, nutritional deficiencies, and certain medications can trigger telogen effluvium. This can make previously subtle female pattern hair loss suddenly appear much more noticeable.

Treatment therefore needs to address both the underlying pattern hair loss and the trigger for excessive shedding when possible.

Can low iron cause hair loss in women?

Iron deficiency can contribute to hair shedding in some women, particularly when iron stores are significantly depleted or anemia is present. Heavy menstrual bleeding, pregnancy, postpartum changes, dietary restrictions, and other medical conditions can contribute to iron deficiency.

Iron supplements should not automatically be taken for every case of hair loss. A physician can determine whether testing is appropriate and whether supplementation is actually needed.

Can thyroid problems cause hair loss?

Yes. Both an underactive and overactive thyroid can be associated with changes in hair growth and diffuse hair loss.

Thyroid disease can also coexist with female pattern hair loss, which is another reason a complete medical evaluation may be important rather than assuming that every woman with thinning hair has the same condition.

Does perimenopause or menopause cause hair loss?

Hormonal changes during perimenopause and menopause can affect the hair-growth cycle and may contribute to thinning in susceptible women. Changes in the balance of estrogen and androgens can also make female pattern hair loss more apparent.

However, new hair loss during menopause should not automatically be attributed to hormones. Other potential causes, including thyroid abnormalities, iron deficiency, medications, nutritional changes, and inflammatory or scarring forms of alopecia, may need to be considered.

What is the best treatment for female pattern hair loss?

There isn’t one treatment that is best for every woman. Treatment depends on the diagnosis, age, medical history, hormonal status, laboratory findings, medications, pregnancy considerations, and severity of hair loss.

Depending on the individual patient, a dermatologist may consider treatments such as topical or oral minoxidil, spironolactone, correction of nutritional deficiencies, treatment of underlying medical conditions, platelet-rich plasma (PRP) injections, and other medical or procedural therapies.

Combination treatment is often considered because different therapies can target different contributors to hair loss.

Does minoxidil work for female pattern hair loss?

Minoxidil is one of the most established treatments for female pattern hair loss. It helps support the hair-growth cycle and can increase hair density in appropriate patients.

Topical minoxidil is widely used in women. Dermatologists may also prescribe low-dose oral minoxidil off-label for selected patients after considering medical history, medications, blood pressure, potential side effects, and pregnancy status.

Hair treatment takes time. Improvement generally requires consistent treatment over months rather than weeks, and ongoing treatment is usually necessary to maintain the benefit.

Is oral minoxidil better than topical minoxidil for women?

Not necessarily. Both can be useful, and the better choice depends on the individual patient.

Some women prefer oral minoxidil because applying a topical treatment every day can be inconvenient or irritating. However, oral minoxidil is an off-label treatment for hair loss and has systemic side effects that need to be considered.

A dermatologist can help determine whether topical minoxidil, oral minoxidil, or another treatment is more appropriate.

Does spironolactone help female pattern hair loss?

Spironolactone, also known by the brand name Aldactone, is an anti-androgen medication that dermatologists sometimes prescribe off-label for female pattern hair loss, particularly when androgen activity or sensitivity may be contributing.

It isn’t appropriate for every woman. Medical history, other medications, blood pressure, kidney function, potassium levels when indicated, and pregnancy potential are among the considerations that may affect whether spironolactone is appropriate.

Does PRP work for female hair loss?

Platelet-rich plasma, or PRP, is a procedure in which a concentrated portion of a patient’s own blood containing platelets and growth factors is injected into the scalp. Research suggests PRP can improve hair density and thickness in some patients with androgenetic alopecia.

PRP is generally considered a treatment for stimulating existing follicles rather than creating completely new hair follicles. Patient selection, treatment protocol, and the underlying cause of hair loss are important.

What blood tests should women with hair loss have?

There isn’t one universal blood-test panel that every woman with hair loss needs. Testing should be guided by medical history, symptoms, physical examination, diet, menstrual history, medications, and the type of hair loss suspected.

Depending on the circumstances, a dermatologist may evaluate for iron deficiency or anemia, thyroid abnormalities, nutritional deficiencies, or hormonal abnormalities.

Blood tests are only one part of the evaluation. A careful examination of the scalp and hair is equally important.

Can weight loss cause hair loss in women?

Yes. Rapid or significant weight loss can trigger telogen effluvium, a form of excessive shedding that often becomes noticeable several months after the triggering event.

Hair loss may be particularly likely when weight loss is accompanied by inadequate calorie or protein intake, nutritional deficiencies, illness, or other physiological stress.

Because female pattern hair loss can coexist with telogen effluvium, sudden shedding after weight loss may sometimes uncover an underlying tendency toward pattern thinning.

Can hairstyles cause permanent hair loss?

Yes. Repeated tension from tight ponytails, braids, extensions, weaves, or other tightly pulled hairstyles can cause traction alopecia.

Early traction-related hair loss may improve when the tension is removed. Long-standing traction, however, can damage follicles and potentially result in permanent hair loss.

When should a woman see a dermatologist for hair loss?

Consider seeing a dermatologist when hair loss is persistent, rapidly worsening, associated with significant shedding, causing a widening part or visible scalp, or accompanied by scalp symptoms such as itching, burning, pain, redness, scaling, or scarring.

Earlier evaluation is particularly important when hair loss appears suddenly or when the scalp itself looks abnormal because certain inflammatory and scarring forms of alopecia can permanently damage hair follicles.

Can female hair loss be reversed?

It depends on the cause.

Some forms of hair loss caused by temporary shedding or correctable medical problems can improve substantially once the underlying trigger is addressed. Female pattern hair loss is generally a chronic condition that can often be managed, with treatment aimed at slowing progression and improving or maintaining hair density.

Scarring alopecias are different because permanent follicular damage can occur. This is one reason obtaining the correct diagnosis early can matter.

Why is female hair loss more complicated to treat than male pattern baldness?

Hair loss in women frequently involves overlapping factors. A woman may have genetic female pattern hair loss while simultaneously experiencing hormonal changes, postpartum shedding, iron deficiency, thyroid disease, medication-related shedding, nutritional changes, or traction from hairstyles.

For this reason, successful treatment begins with identifying which type or types of hair loss are actually occurring. The treatment plan can then address the underlying causes while supporting hair growth.