Female pattern hair loss is caused by a combination of genetic and hormonal factors.

Over time, susceptible hair follicles gradually become smaller (miniaturise), producing finer, shorter hairs until some follicles eventually stop producing visible hair altogether.

Although female hormones play a role, most women with female pattern hair loss have normal hormone levels.

The condition often runs in families and may be inherited from either side of the family.

Female pattern hair loss may occur at any adult age but is most common:

• After menopause

• In women with a family history of hair thinning

• Following pregnancy (although temporary shedding after pregnancy is usually due to telogen effluvium)

• In women with polycystic ovary syndrome (PCOS)

• In women over 50 years of age

It affects women of all ethnic backgrounds.

Female pattern hair loss usually develops slowly and progressively.

Common signs include:

• Widening of the central part line

• Gradual thinning over the crown

• Reduced hair volume

• Smaller ponytail diameter

• Increased visibility of the scalp

• Finer, shorter hairs

Unlike male pattern hair loss, the frontal hairline is usually preserved.

Most women continue to grow hair, but the individual hairs become progressively finer over time.

Not all hair thinning is female pattern hair loss.

Other causes include:

• Telogen effluvium (temporary hair shedding)

• Iron deficiency

• Thyroid disorders

• Vitamin deficiencies

• Certain medications

• Autoimmune diseases

• Alopecia areata

• Scarring alopecia

• Hormonal disorders

For this reason, an accurate diagnosis is essential before treatment begins.

Your dermatologist will perform a detailed assessment that may include:

• Medical history

• Family history

• Medication review

• Examination of the scalp

• Trichoscopy (dermoscopy of the scalp)

Where appropriate, investigations may include:

• Blood tests

• Iron studies

• Thyroid function tests

• Hormonal investigations (selected patients)

A scalp biopsy is only occasionally required if another diagnosis is suspected.

Treatment is aimed at slowing further hair loss, preserving existing hair and encouraging thicker hair growth.

Because hair grows slowly, most treatments require at least 6–12 months before significant improvement is seen.

Treatment options may include:

• Topical minoxidil

• Low-dose oral minoxidil

• Spironolactone

• Anti-androgen medications for selected patients

• Treatment of iron deficiency or other underlying medical conditions

• Nutritional advice where appropriate

Treatment is individualised according to your age, medical history, future pregnancy plans and the severity of hair loss.

Topical minoxidil remains one of the most effective first-line treatments for female pattern hair loss.

It works by prolonging the hair growth phase and increasing the size of miniaturised hair follicles.

Initially, some women notice increased hair shedding during the first few weeks of treatment. This is temporary and usually indicates that older hairs are being replaced by new growth.

Daily use is important to maintain results.

Low-dose oral minoxidil has become an increasingly popular treatment for female pattern hair loss.

When prescribed by an experienced dermatologist, it may improve hair density and reduce shedding in many women who have not responded adequately to topical treatment or who prefer not to use topical preparations.

As with all prescription medications, your dermatologist will discuss the potential benefits, risks and possible side effects before commencing treatment.

Spironolactone is an anti-androgen medication that may be recommended for women whose hair loss is influenced by sensitivity to male hormones (androgens).

It is commonly used in women with:

• Female pattern hair loss

• Acne

• Excess facial hair (hirsutism)

• Polycystic ovary syndrome (PCOS)

Regular follow-up and monitoring may be required while taking this medication.

Female pattern hair loss is a chronic condition.

Treatment cannot usually restore every hair that has been lost, but early intervention can:

• Slow progression

• Increase hair density

• Improve hair thickness

• Reduce ongoing hair loss

The earlier treatment is started, the better the long-term outcome is likely to be.

Hair thinning can significantly affect confidence and emotional wellbeing.

Many women benefit from:

• Early diagnosis

• Medical treatment

• Camouflaging hairstyles

• Hair fibres or cosmetic concealers

• Gentle hair care

• Ongoing monitoring by their dermatologist

Our aim is to provide both effective treatment and realistic expectations about hair regrowth.

Our Specialist Dermatologists have experience diagnosing all forms of female hair loss.

We offer:

• Comprehensive assessment

• Trichoscopy (scalp dermoscopy)

• Investigation for underlying medical causes

• Blood tests where appropriate

• Prescription treatments including topical and oral therapies

• Long-term monitoring

• Individualised treatment plans

Our goal is to identify the cause of your hair loss early and develop a personalised treatment plan to maximise hair preservation and regrowth.