Opinion article
Female pattern hair loss: why hair thins and what helps
Female pattern hair loss is the most common cause of hair loss in women, and results from the genetic sensitivity of hair follicles to androgens. Unlike the male pattern, it rarely causes complete baldness: the most typical presentation is progressive thinning over the crown, with a widening centre part.
Before assuming it’s genetic
It’s worth ruling out other, treatable causes of hair loss: iron deficiency, thyroid problems, vitamin D deficiency, or a postpartum or acute-stress period (telogen effluvium). A simple blood test usually clarifies these possibilities.
What can make it worse
- Menopause, due to falling oestrogen levels.
- Polycystic ovary syndrome, linked to higher androgen levels.
- A family history of hair loss, on either side of the family.
Treatment
- Topical minoxidil (2% or 5%): first-line treatment, it prolongs the follicle’s growth phase. It requires continuous use, with results appearing after three to six months.
- Anti-androgens (such as spironolactone): used off-label in some cases, especially when there are signs of excess androgens.
- Microneedling and PRP: complementary treatments, with growing evidence, though still less robust than that for minoxidil.
Contrary to what most people think, this type of hair loss has no cure, but it can be well controlled. The earlier treatment starts, the more still-active follicles there are to preserve.
This article is for information only and does not replace a medical consultation.
Sources
- Kanti V, Messenger A, Dobos G, et al. Evidence-Based (S3) Guideline for the Treatment of Androgenetic Alopecia in Women and Men. Journal of the European Academy of Dermatology and Venereology. 2018
- American Academy of Dermatology Association, Hair Loss