Female pattern hair loss

The commonly held – and incorrect – belief that hair loss in women is uncommon can lead to women suffering from the condition to wonder if there is something seriously wrong.

In turn, this can lead to them taking quite some time to pluck up the courage to seek medical advice, and even longer to seek treatment.

A confidential consultation with our experienced team can provide the reassurance and confidence needed to take a positive step to remedy the situation.

Our links with leading academic and commercial hair research units mean that we are at the forefront of new developments and genuine techniques to help alleviate hair loss problems in women.

The difficulty in dealing with hair loss in women is that a number of conditions result in the same diffuse pattern, in which the hair over the top and crown of the head becomes thinner (occasionally, the temples will recede too). There is often some investigation needed to first isolate the true cause before deciding on a treatment.

How to diagnose your hair loss

If possible, the first person you should turn to is your GP and, depending on his or her findings, you may be referred to a dermatologist (skin specialist doctor), endocrinologist (hormone specialist doctor) or gynaecologist.

If you get referred to us, or you do not wish to see your GP about this, we will arrange for you to consult with our trichologist (hair and scalp specialist) and if indicated, one of our hair transplant doctors as well. We will need to take a detailed medical, drug and family history and conduct an examination of your hair and scalp.

It is most likely that you will need some blood tests: full blood count, glucose, serum ferritin (iron stores), thyroid hormones and, where relevant, gestational hormone levels amongst others. The treatment you require, whether medical, surgical or simply cosmetic, then depends on the identified cause of the hair loss.

In many cases where there is permanent hair loss and a sufficient area of normal hair growth, hair transplantation can be contemplated once any underlying problem has been treated.

Modern hair transplant techniques have introduced a new era in the treatment of hair loss for both men and women. Since we are usually dealing with women who are only thinning or who can conceal their loss, it is uncommon for anything to show after treatment. We shall, of course, advise you if we believe this not to be so in your case.

What happens next?

One very important aspect of your treatment is its planning. To this end, during your consultation, you will be taken through the pros and cons of the options open to you, so that you are in a position to make an informed choice.

Some women are more suited to surgical treatment than others (and some are not suitable candidates at all). We shall endeavour to give you as realistic a picture as possible of the type of result you can expect from your treatment, whether it be surgical or non-surgical.

Female pattern hair loss

Three types of female
pattern hairloss

Female pattern hair loss is the most common type of hair loss in women and is an inherited condition but hormonally more complex than its male counterpart. The hair loss is triggered by androgens (male hormones), so it may occur at anytime from puberty, but is most commonly seen after the menopause.

This is brought about by increasing levels of male hormone, which often occurs when levels of female hormone decrease, such as during the menopause.

In both men and women, the male hormone testosterone is converted to dihydrotestosterone (DHT) by the enzyme 5-alpha reductase.

DHT then proceeds to influence the susceptible hairs to fall or thin out. However, in women, it is thought that hair loss does not proceed as far as it does in men because women have only half the amount of 5-alpha reductase.

In addition, women have increased amounts of the enzyme aromatase. This converts male hormones into female hormones.

Hair transplantation and medical treatments could be of benefit with this condition.

Ludwig stages of female pattern hair loss

For the most accurate assessment of the degree of your hair loss, stand in front of a mirror while holding a mirror behind and over your head, just as they do in a hairdressing salon.

Female pattern hair loss
Female pattern hair loss
Female pattern hair loss

Type I

At this stage, most women may have difficulty noticing that hair loss has occurred, as the frontal hairline remains relatively unaffected. Hair loss may occur on the top and front of the scalp, however. Such hair loss may be noticeable when the hair is parted down the centre of the scalp, as more and more scalp will become visible over time.

Type II

In this stage, women may notice each of the following: thinning, shedding, general decrease in volume and a centre part that continues to widen over time. Depending on the severity, a hair transplant procedure may be a viable option for women who exhibit a Type II classification.

Type III

This is the most extreme classification of female hair loss. In this stage, hair is so thin that it has difficulty camouflaging the scalp, rendering it clearly visible to the naked eye. This may be worsened by a number of factors, including hair shrinkage, progressive thinning and extensive loss.


Other causes of hair loss

While female pattern hair loss is the most common type of hair loss in women, there are other causes – and they can afflict other parts of the body besides the scalp.

Here are just a few.

Did you knowTraction alopecia

Traction alopecia

The popularity of hairstyles that involve putting hair under tension – the attachment of hair extensions and tight plaiting or braiding – has seen a growing number of instances of this condition, which is usually temporary, if the source the traction is removed. It can, however, pose permanent problems if the cause of trauma is not addressed. The most commonly affected area is the front of the hairline. In bad cases, hair transplant surgery is often the only remedy.

This is particularly commonly seen in women of Afro-Carribean origin and was publicised widely in the case of the model, Naomi Campbell.

The use of electric hair straighteners – particularly if over-used and pulled too hard – can bring on traction alopecia.

Did you knowChemical scarring and burns

Chemical scarring and burns

If you’re putting anything more than shampoo or conditioner on your hair, there’s every chance that you are doing some damage to it due to the chemicals involved. The amount and the regularity with which you apply harsh dyes, perm solution, highlights, relaxers and straighteners will impact on the extent of the damage.

However, it is usually a breakage, not true hair loss, and it can be ‘treated’ by reducing or stopping the application of the chemical. In the case of burns, in which the hair roots may be destroyed, follicular unit transplantation could be the solution, but is dependent on how much scar tissue is involved.

Follicle damage, burns and dry patches on the scalp can be caused through the use of chemical hair relaxers and perms. The use of a gentle shampoo followed by a conditioner containing vitamin E, which you leave in, and allowing your hair to dry naturally is often sufficient to remedy the damage.

Did you knowPhysical and emotional stress

Hair loss can be brought on and accelerated by rapidly losing weight, becoming ill, undergoing surgery, medical conditions such as a low blood count or thyroid abnormalities and emotional stress. Once diagnosed and the source of the problem is eliminated, hair will normally grow back in a few months.

Simply relaxing can be highly beneficial in reducing stress-related hair loss.
So however you choose to unwind – breathing techniques, napping, tai chi, yoga, listening to your favourite music, long walks – it’s not just your hair that will benefit.

Did you knowPlastic surgery

Plastic surgery

We are now seeing an increase in the number of women with hair loss above and in front of the ears due to the traction involved in a face-lift – a condition that can be effectively treated with follicular unit hair transplantation.

Hair loss following facial cosmetic surgery can be temporary and will grow back after time – but it may be permanent. A consultation with one of our team of experts can help identify your particular condition and advise you of the best option going forward.

Did you knowAlopecia areata

Alopecia areata

Antibodies that stop hair roots from growing hair are believed to be the cause of this condition. In its simplest form, it can be seen as one or more completely bald patches. A more severe form – alopecia totalis – causes a loss of all hair from the head, while the most extreme form – alopecia universalis – results in the loss of all body hair. In a lot of cases, the condition clears up without any form of treatment and less severe cases can be treated using medication. The condition can recur.

That, contrary to commonly held beliefs, alopecia areata doesn’t cause pain, nor can you pass it on to others as it is a disease related to your autoimmune system and is not inherited.

Did you knowMedications

Some contraceptive pills, chemotherapy drugs, some medication for thyroid-related conditions and some drugs used to thin the blood are among the more than 100 medications known to cause hair loss. In almost all cases, any hair loss is temporary and will grow back when the treatment is changed or stopped.

If you would like to know more about drugs that can cause hair loss, or to review your medication regime and the potential effects of a combination of drugs, you should consult your doctor or a pharmacist.

Did you knowPregnancy and childbirth

Many women experience hair loss for a few months after giving birth. This is due to a delay in the normal ‘shedding’ process during pregnancy. In other words, the hair gets thicker during pregnancy and then returns to its normal state afterwards – accounting for the apparent ‘hair loss’. The scalp hair balance should normally be restored 6-12 months after childbirth.

‘Thicker’ hair during pregnancy is due to increased levels of estrogen which prolongs the growing stage – reducing the amount of hair fall in the shower or on the hair brush.

Did you knowSkin conditions

Skin conditions

Hair loss – temporary or permanent – can be attributed to eczema, psoriasis, inflammatory scarring conditions and other localised skin conditions and infections. In the case of permanent loss, we have a range of restorative surgical treatments, the efficacy of which depends on the successful treatment of the underlying skin condition.

If your hair is thinning, be sure to protect your scalp against the sun – a simple hat or cap, or even rubbing sun cream into it. A severe case of sunburn to the scalp can harm hair follicles.

Did you knowChemotherapy and radiotherapy

Chemotherapy and radiotherapy

The drugs used in the chemical treatment of cancer are among the most aggressive developed, which, in a lot of cases, means that they not only attack cancerous cells but also, unfortunately, other non-cancerous cells – including follicles. The wearing of a ‘cool cap’ that inhibits the amount of chemo drugs reaching the scalp is proven to be an effective way of reducing the loss of hair caused by chemotherapy. In most cases, hair will re-grow when a course of chemotherapy is completed.

In the case of radiotherapy, hair loss only occurs in the area undergoing treatment, but hair doesn’t always grow back when the course of treatment has finished. We are happy to advise and help if this is the situation you find yourself in. The first people you should consult, however, should be your GP, specialist nurse or cancer support specialist.

If you are undergoing a form of treatment for cancer other than chemotherapy or radiotherapy, be aware that they too can sometimes cause hair loss. If this happens, be sure to consult you GP, specialist nurse or cancer support specialist.

Did you knowTrichotillomania


Trichotillomania is a compulsion disorder where a person uncontrollably pulls their hair out.

They may do so from their scalp, eyebrows or even eyelashes. It is a psychological condition where the person is simply unable to stop themselves from carrying out this action.

Usually there is an intense urge to pull your hair out and an immense relief after pulling out the hairs. Pulling out hair on the scalp or other areas can leave bald patches.

Sufferers may feel guilt, embarrassment, shame or other negative feelings.

The first line treatment should be counselling and psychological therapy. Only when assured that the urge to pull is no more, can treatments such as hair transplant surgery be considered if needed.

Dispelling female pattern hair loss myths

Female pattern hair loss can be treated through the use of vitamins and supplements alone.

While vitamins and supplements can help maintain the health of your hair, they have never been proven to be effective in the treatment of hair loss on their own.

Female pattern hair loss is rare

It may surprise you to know that women make up around 40% of all hair loss sufferers.