Female pattern baldness (androgenetic alopecia) is the most common cause of hair loss in women, but there are many other potential causes. Treatment options are limited but can be effective.
Although it’s more common in men, hair loss regularly affects women and people of other genders. You may experience any one of several types of hair loss, such as hair thinning, a widening part, or patchy hair loss.
This article will focus primarily on hair loss in cis women. The information in this article will also apply to you if you were assigned female at birth and have never had hormone replacement therapy (HRT). Trans women and trans men who have used HRT may have additional risk factors for hair loss that are not covered here.
There are several reasons women experience hair loss, including:
- genetics
- health conditions
- hormonal changes
- stress
Treatment options for hair loss typically depend on the cause. They can also vary according to the pattern and location of hair loss. While most causes of hair loss are treatable, some may not be.
Below, we’ll explore common causes of hair loss in women and the treatment options available.
Hair loss may present in different ways depending on the cause. You may notice sudden hair loss or a gradual thinning over time.
Key signs and symptoms of hair loss include:
- Overall thinning: Gradual thinning on the top of the head is the most common type of hair loss. It affects both men and women. While men tend to see a receding hairline, women generally notice that their part broadens.
- Bald spots: Bald spots may be circular or patchy areas on your scalp with thinning or no hair. Your skin may feel itchy or painful immediately before the hair falls out.
- Handfuls of hair: You may experience very sudden hair loss, particularly after emotional or physical trauma. The hair may quickly come out in clumps while you’re washing or brushing it, leading to overall thinning.
- Full loss: Medical treatments like chemotherapy can cause sudden and dramatic hair loss.
It can be helpful to keep a hair diary to track any changes you notice or symptoms you experience and to look for patterns.
Female-pattern baldness is the
While men tend to notice balding as a receding hairline and specific bald spots, women’s hair loss appears more as overall thinning or a widening of the part at the top of your head. This type of hair loss occurs slowly, over the course of several months or years.
Androgenetic alopecia can occur at any age after puberty, but it’s most common in postmenopausal women. Advancing age and a family history of the condition are two of the primary risk factors.
There are many other potential causes of hair loss in women.
Other types of alopecia
Alopecia means “hair loss.” There are many different types of alopecia, in addition to androgenetic alopecia.
- Alopecia areata is patchy hair loss that happens suddenly on the head or body. It typically begins with one or more round bald patches that may or may not overlap.
- Cicatricial alopecia is a group of conditions that causes hair loss caused by
irreversible scarring . Hair falls out, and the follicle is blocked by scar tissue. - Traumatic alopecias cause hair to fall out as a result of aggressive or damaging hair styling practices. The hair shaft may break after using hot combs, blow dryers, straighteners, or certain chemicals to dye or straighten hair. It can also happen because of chronic tension from too-tight braids or other hairstyles.
- Anagen effluvium is most often associated with chemotherapy. It’s sometimes called chemotherapy-induced alopecia. It happens because of toxic or inflammatory damage that causes the hair shaft to break.
Common causes of alopecia include:
- genetics
- hair care practices or treatments (dyes, bleaching, perms)
- autoimmune and other health conditions
- medical treatments
- other trauma to hair follicles
Telogen effluvium
Another cause of hair loss is called telogen effluvium (TE), which is typically temporary. According to the American Academy of Dermatology (AAD), TE isn’t actually defined as “hair loss,” but rather as excessive hair shedding.
Stress causes a large number of hairs in the active hair growth (anagen) phase to abruptly enter the resting (telogen) phase. When the hairs reenter the growth phase, the hairs that had been suspended in the resting phase are suddenly released. This causes shedding.
You can sometimes identify TE by looking at the strand. Telogen hairs have a bulb of keratin at the root.
TE is generally caused by stress or a shock to the body. For example, you may lose hair in the months after giving birth.
- high fever
- serious infection
- estrogen drop after giving birth
- estrogen drop after stopping hormone therapy
- chronic illness
- emotional stress
- crash diets
- lack of protein
- eating disorders
- certain medications like retinoids and beta blockers
TE is typically reversible and often resolves 6–8 months after your body readjusts or the trigger is gone.
Chronic health conditions
Some medical conditions lead to hair loss.
Health conditions that may lead to hair loss include:
- psoriasis
- vitiligo
- thyroid disease
- Hodgkin’s lymphoma
- hypopituitarism
- systemic lupus erythematosus (SLE)
- Addison’s disease
- celiac disease
- allergies
- Lichen planus (autoimmune skin rash)
- ringworm of the scalp
- scleroderma
- trichorrhexis invaginata (also called bamboo hair)
Menopause and hormone imbalances
Women may experience hair loss during menopause due to reduced production of the hormones estrogen and progesterone. Menopause usually affects women between the
Menopause can also lead to uncomfortable systemic symptoms such as night sweats, weight gain, and vaginal dryness, which may raise your overall stress levels. This can also contribute to hair thinning or loss.
Some women may even notice hair growth changes after going off hormonal birth control pills. Hormonal changes of any kind, particularly falling estrogen levels, can temporarily disrupt the hair life cycle.
Hair loss can affect anyone. But some factors may make a woman more likely to experience hair loss.
Hair loss risk factors include:
- Age: Hair loss becomes more common as you age. With age, hair starts to grow more slowly, and some follicles stop producing new hairs.
- Family history: If you have an immediate family member (such as a parent or sibling) who experienced hair loss, then you are more likely to have hair loss.
- High stress levels: Stress and anxiety can contribute significantly to hair loss.
- Medical conditions: Certain health conditions can increase your risk of hair loss.
Androgenic alopecia causes the normal hair growth cycle to shorten. As a result, hair doesn’t grow as long or thick as it normally would.
Normal
- Anagen phase: The anagen phase is the active phase when hair follicles produce new hairs or hair fibers.
- Catagen: Also known as the transitional phase, the catagen phase is when a hair follicle starts to thin to a sixth the size of its previous width.
- Telogen phase: The telogen phase is when hair follicles rest and prepare for the next hair growth cycle.
- Kenogen phase: The kenogen phase is when the hair follicles remain empty after hair loss.
With androgenic alopecia, the anagen phase becomes shorter and hair follicles usually stay in the
Hair loss caused by stress or hormonal changes, like pregnancy or menopause, may not require any treatment. Instead, the loss will likely stop on its own after the body adjusts.
And any medical conditions that lead to hair loss should be treated directly to address the condition, not just its symptoms.
That said, there are a number of possible medications and treatments for hair loss caused by female-pattern baldness and other alopecias.
Minoxidil
Minoxidil 2% is an over-the-counter (OTC) drug that comes in liquid and foam forms for topical use. It’s meant to be rubbed on the scalp twice daily. Minoxidil is also available in a 5% solution that only needs to be used once a day — this version is typically marketed to men.
Studies show minoxidil is effective for most people. People tend to show hair regrowth within
Spironolactone
Otherwise known as Aldactone, spironolactone works to treat hair loss by acting on hormones. Specifically, it binds to androgen receptors and decreases the body’s processing of testosterone.
A 2020 study tracked 79 women taking spironolactone daily (doses ranged from 25–200 mg) for a minimum of 6 months. Nearly two-thirds of participants experienced some kind of improvement after 1 year. Those who began the trial with more pronounced hair loss saw the most benefit from the medication.
Not all researchers agree that spironolactone works, and the FDA has not endorsed it as a treatment for androgenic alopecia. However, the medication has still
Corticosteroids
Women with hair loss due to alopecia areata may consider treatment with corticosteroids applied to the scalp or injected into multiple sites in the affected area. Corticosteroids help reduce inflammation. People with alopecia areata may also benefit from immunosuppressive medications like methotrexate.
Other treatments
Doctors sometimes prescribe other treatments off-label to reduce the incidence of hair loss in women.
These include:
- botulinum toxin (BOTOX) injections
- immunosuppressants, such as azathioprine or cyclosporine
- JAK inhibitors
- platelet-rich plasma injections
Surgery
In hair transplant surgery, pieces of scalp tissue with the hair attached are typically taken from one area of the scalp and moved to areas of baldness.
With new techniques, many women benefit from hair transplantation surgery. But there are risks, including infection or shock that can cause hair to fall out of the transplanted areas.
A hair transplant is usually not covered by insurance. The cost (often thousands of dollars) is prohibitive for most people.
Finasteride
Finasteride inhibits 5 alpha-reductase, blocking the conversion of testosterone to dihydrotestosterone (DHT), the androgen responsible for male pattern baldness.
Our hair falls out naturally all the time. In fact, it’s normal to lose between 50 and 100 hairs a day.
Reach out to a doctor if you notice:
- hair falling out in clumps (may be evident in your brush, on your pillowcase, or in the shower drain)
- hair that does not seem to be growing as fast as it once did
- thinning hair
- a widening part
- patchy hair loss
- other symptoms like fever, pain, or fatigue
The most common cause of hair loss in women is female-patterned baldness (androgenetic alopecia). OTC medications may help reduce hair loss and promote growth. There are many other causes of hair loss. Other types of hair loss may involve treating the underlying cause.
Speak with a doctor about any troubling hair loss, shedding, or thinning you may be experiencing. Your doctor can help determine the cause of your symptoms and put together a treatment plan.