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Female pattern hair loss

In shortFemale pattern hair loss is gradual thinning on the top of the head, usually seen first as a wider parting. The hairline mostly stays. It is common, more so after the menopause, and runs in families. Minoxidil is the main treatment, after a blood test has ruled out low iron and thyroid problems.

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What it looks like

The parting widens. The ponytail gets thinner. Under bright light you see more scalp across the top, while the front hairline holds. It happens over years, not weeks. Doctors grade it on the Ludwig scale, from a slightly wider parting to clear thinning over the crown. It rarely leads to baldness.

A wooden comb being drawn through long brown hair

Why it happens

Follicles on the top of the head slowly shrink, so each hair grows finer. Genes play a part, and so do hormones: it often shows or speeds up around the menopause. In younger women it can go with polycystic ovaries, especially with irregular periods, acne or extra facial hair.

Tests first

A GP will usually check a full blood count, iron stores (ferritin) and thyroid function, and hormone levels if your periods or skin point that way. Low iron and thyroid problems cause thinning of their own and make pattern loss look worse. What the GP does.

Treatment

Minoxidil on the scalp is the mainstay (€50 to €85 for three months). Give it four to six months. A dermatologist may add a tablet that blocks male hormones. PRP (€225 to €400 a session) is offered by clinics, with mixed evidence. Toppers and fibres cover well while treatment works. Full detail: treatment for women.

What treatment can and can't do

Treatment aims to hold the hair you have and thicken what is thinning. It works slowly: less shedding by three months, visible change by six to twelve. It doesn't return hair to how it was at 20, and it stops working when you stop using it.

  • Month 1 to 2: some extra shedding on minoxidil is common and settles.
  • Month 3 to 6: shedding slows; the parting stops widening.
  • Month 6 to 12: finer hairs thicken. Compare photos taken in the same light.
  • After a year: if nothing has changed, ask your GP about a dermatology referral.

Pattern loss or shedding?

If hair is coming out in handfuls and it started in the last few months, that's more likely telogen effluvium, which usually recovers. The two can overlap.

Questions people ask

Will I go bald?

Very unlikely. Female pattern hair loss thins the top of the head but rarely leaves bare scalp.

Does it grow back?

Not by itself. Minoxidil can slow it and thicken some hair for as long as you use it.

Should I take iron?

Only if a blood test shows your iron stores are low. Too much iron is harmful.

Is female pattern hair loss the same as male pattern baldness?

It is the same family of condition, but it behaves differently: women thin across the top and keep their hairline, and bare scalp is rare.

More guides

Male pattern baldnessAlopecia areataSudden sheddingAfter pregnancyMenopauseCauses of hair lossReceding hairlineScalp problemsTreatment for menTreatment for womenWhich treatment works?FinasterideMinoxidilPRP for hair lossHair transplantLaser therapyScalp micropigmentationNatural treatmentsWigs and the grantOur price guideYour GP and blood testsWho treats hair loss?Choosing a clinicReading reviewsTurkey or Ireland?

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