Women’s hair loss at the back of the head can be worrying and difficult to spot until it becomes advanced. Around half of all women will experience some degree of hair loss at some point in their lives [1].
The most common cause is female pattern hair loss, which leads to gradual thinning over time [1]. Other causes include hormonal changes, autoimmune conditions and tension from hairstyles.
In this article, you’ll discover what causes hair loss at the back of the head in women and how to stop it before it worsens. We’ll explain the most common triggers, how to identify the underlying cause, and the best treatments to restore a healthy head of hair.
Key takeaways
Several conditions can cause female hair loss at the back of the head. These include female pattern hair loss, alopecia areata, traction alopecia, telogen effluvium, and scarring alopecias.
The back of the head is made up of the parietal, occipital, and nuchal areas, as shown above. The nuchal scalp is considered part of the occipital region. Some hair loss conditions, such as female pattern hair loss, can affect specific scalp areas but not others.
Female pattern hair loss is the most common type of hair loss in women, affecting over 50% of women before the age of 80 [2]. It leads to gradual thinning over the crown and parting area as hair follicles slowly shrink (miniaturise), producing finer, shorter hairs.
Female pattern hair loss can affect the parietal scalp [3], which is part of the back of the head. However, it does not usually affect the occipital area because this part of the scalp is not affected by androgens, the key hormones involved in female pattern hair loss [3].
For this reason, the occipital scalp is used as the safe donor area when performing hair transplants for female pattern hair loss [4]. Female pattern hair loss is assessed using the Ludwig Scale, shown below.
Alopecia areata affects around 2% of all people, with men and women equally affected [5]. This autoimmune condition leads to patchy hair loss that can occur anywhere on the scalp, including the back of the head.
In some cases of alopecia areata, a band-like pattern of loss around the sides and back of the head, known as ophiasis alopecia, is seen and can be more resistant to treatment with corticosteroids [6]. However, ophiasis alopecia is much less common and affects only around 2 in 10,000 people [7].
Source: Trüeb, R. M., & Dias, M. F. R. G. (2018). Alopecia areata: A comprehensive review of pathogenesis and management. Clinical Reviews in Allergy & Immunology, 54(1), 68–87. https://doi.org/10.1007/s12016-017-8620-9
Traction alopecia can affect the back of the head if hairstyles such as tight ponytails, braids, top knots or buns create repeated tension in that area. Over time, this constant pulling can damage hair follicles and cause thinning or bald patches where tension is strongest.
Hair weaves, for example, can cause hair loss along the hairline at the front and back of the head if scalp trauma is caused when they are removed [8]. Traction alopecia is common among women of African descent, affecting about one in three who frequently wear tight or heavy hairstyles [9].
Telogen effluvium usually causes diffuse shedding across the whole scalp rather than patchy hair loss. Hair density at the back of the head can appear thinner if shedding is severe, as the hair cycle is disrupted everywhere.
Telogen effluvium can develop for many reasons. Certain medications, physical trauma, illness, or periods of high stress can all trigger more hairs than usual to enter the shedding phase of the hair growth cycle [10]. This often causes noticeable thinning 2-3 months after the trigger, but it’s usually temporary [10].
In women specifically, telogen effluvium may be caused by:
Some types of scarring alopecia can involve the back of the head. Conditions such as lichen planopilaris can damage hair follicles in any area of the scalp, leading to permanent hair loss and visible scarring, including the occipital area.
Lichen planopilaris usually affects specific parts of the scalp, most often the sides, front, and lower back of the head [12]. It tends to cause patchy hair loss rather than widespread thinning across the whole scalp [12].
Women’s hair loss at the back of the head can be challenging to diagnose. There’s no need to go it alone, because our specialist hair doctors are here to help.
Before trying any treatment, it’s important to find out what’s causing the hair loss at the back of your head. Trichologists are hair loss experts who can examine your scalp and review your history to identify the reason your hair is falling out
If needed, they may perform diagnostic trichology tests to identify the root cause. Treating the underlying problem early gives you the best chance of regrowth and prevents further loss.
Once the cause has been identified, your hair doctor may recommend clinically proven treatments to stimulate regrowth and protect existing hair. Options may include:
Your treatment plan will depend on the cause and pattern of hair loss, and your medical history. Treating hair loss at the back of the head takes patience, but you can make some immediate changes to improve your look while you’re treating the cause.
Go for hairstyles that add fullness at the back, such as loose waves or layered cuts to disguise thinning areas. You can also use volumising powders or root-lifting sprays at the crown and back of the head to create the look of thicker hair, while avoiding tight styles to protect it from tension and breakage.
You should see a trichologist or dermatologist if you notice persistent thinning, patchy bald spots, or sudden hair shedding at the back of your head. Early assessment is especially important if you also experience itching, redness, pain, or scarring, as these may be a sign of an underlying scalp condition that needs medical treatment.
Getting expert advice early can help prevent permanent damage and give you peace of mind about what’s causing the change in your hair. In many cases, the sooner you act, the better.
A trichology assessment is detailed and tailored to your individual symptoms. Here are some aspects that your hair doctor may consider when evaluating your hair loss.
Your trichologist will closely assess how dense your hair is and whether any areas are showing signs of miniaturisation. This is when hair follicles gradually shrink and produce finer, shorter hairs, and it is common in female pattern hair loss. They’ll also examine the overall health of your follicles, checking how many are actively growing new hair versus those that may be dormant or damaged.
Your scalp’s condition can reveal a lot about the cause of hair loss at the back of the head. Your trichologist will look for redness, flaking, scaling, pimples, or scarring, which may suggest inflammation or autoimmune activity.
These clues help determine whether the issue is temporary and reversible or if it involves scarring alopecia, where hair follicles can be permanently damaged. It also helps to rule out an infection, which may need prompt medical treatment.
To confirm the cause, your trichologist may recommend a few simple tests. A hair pull test helps measure how easily hairs come out, while trichoscopy (a magnified scalp imaging technique) allows them to see your hair and scalp structures in detail.
Blood tests for hair loss can check for nutrient deficiencies, thyroid problems, or hormonal imbalances that might be contributing to your symptoms. In more complex cases, they may take a small scalp biopsy (tissue sample) to look at the follicles under a microscope and give you a clear diagnosis.
Sometimes, a few simple lifestyle changes can make a world of difference for your hair health. Here are our top tips to combat hair loss at the back of your head.
If your hair loss is linked to traction alopecia, reducing tension is the most important step to stop further hair loss. Avoid tight hairstyles like ponytails, braids, or buns that pull on the back of your scalp.
Go for looser styles and give your scalp regular breaks from extensions or weaves. When detangling, use a wide-tooth comb and handle your hair gently, especially when it’s wet.
Micronutrients such as vitamins and minerals play an important role in normal hair follicle development, although researchers are still investigating exactly what that role is [13]. Aim for a balanced diet for hair growth, which should be rich in biotin, zinc, vitamin D, and protein, among other nutrients.
If you have heavy periods or follow a restrictive diet, ask your doctor about blood tests to check for deficiencies. Chronic stress can also cause hair loss [14], so building in time for relaxation, gentle exercise, or mindfulness can help support your wellbeing and hair health.
A healthy scalp creates the best environment for new hair growth. Here are a few tips to keep your scalp and hair in top condition:
The time it takes for hair to regrow depends on what caused the hair loss and how early you start treatment. In temporary conditions such as telogen effluvium, it’s common to see regrowth after around 6 months as long as the trigger has resolved [15].
The British Association of Dermatologists advises that when using minoxidil for female pattern hair loss, it usually takes 6 months to see hair growth results. Results will only be maintained as long as you continue with the treatment [16].
Unfortunately, not all hair loss at the back of the head is reversible. Scarring alopecias, such as lichen planopilaris, lead to permanent hair loss [17].
Although traction alopecia is often thought of as a temporary type of hair loss, research shows it can become permanent if the hair is pulled tightly for too long. Over time, constant tension and inflammation can damage the hair follicles, leading to scarring and lasting hair loss in the affected areas [18].
You can often restore hair lost from female pattern hair loss (and in some cases, traction alopecia) with a hair transplant when the scalp is healthy and the hair loss is stable. Here are examples from female patients who received a hair transplant at the Wimpole Clinic:
900 graft FUT (follicular unit transplantation) hair transplant for female pattern hair loss
Left: before. Right: 12 months after
2,000 graft FUT hair transplant for traction alopecia
Left: before. Right: 13 months after
When discussing female hair transplants, Wimpole Clinic surgeon Dr Peter Barron shares:
“Ladies typically prefer the FUT method for extraction because it doesn’t need as large an area of the donor area to be shaved. They’re less likely to see the linear scar as they will typically keep the hair at the back of their head longer than men.”
“Whereas men don’t mind shaving their donor area for FUE (follicular unit extraction)… their hair may be short enough that an FUT scar would be more visible compared to the smaller, scattered FUE scars which are more discreet at shorter lengths.”
Learn more here about the differences between FUE and FUT hair transplants.
As the UK’s leading hair clinic — awarded best hair transplant clinic for four years running — at the Wimpole Clinic, we’re experts in female hair loss. If you’re a woman experiencing hair loss at the back of the head, we can help.
We offer a highly specialist team, state-of-the-art facilities, and clinic locations across the UK from Glasgow to Exeter. If you’re a good candidate for a hair transplant, we work with some of the best hair transplant surgeons in the UK.
Ready to learn how we can help get your hair back on track? Book a free consultation today.
Yes. Hormonal changes after childbirth can cause telogen effluvium, where many hairs move into the shedding phase at the same time. This type of hair loss can affect the entire scalp, including the crown, though it’s often most noticeable where hair is naturally finer.
Hair loss at the back of the head can progress quietly because it’s a hard area to see without mirrors or photos. Many women only notice it once density has noticeably decreased or others point it out, but checking your scalp regularly can help catch it earlier.
There’s no strong evidence that certain sleeping positions directly cause hair loss. However, friction from rough pillowcases may cause hair breakage, and tight hairstyles worn overnight can damage your hair follicles. Using a silk pillowcase and avoiding tension while sleeping helps protect your hair and scalp.
Low ponytails or buns may cause bald spots if they’re tight and worn frequently. Constant tension from low ponytails, buns, or braids can strain the follicles and lead to traction alopecia. Wearing looser styles and varying how you wear your hair helps prevent damage and allows your scalp to recover.
Wimpole Clinic Services:
Hair Transplants, Beard Transplants & Eyebrow Transplants.
Talk to a specialist
Dr Meena Zareie (GMC number 7722917) is the first female member of Wimpole Clinic’s Hair Transplant Surgeons team.
Dr Meena started her journey in the hair transplant industry 8 years ago, where she worked closely with leading surgeons to hone her skills, having conducted more than 1,000 FUE hair transplants.
Starting as a technician and nurse while working simultaneously for the NHS, she decided to take her passion for helping patients with hair loss further.
Her qualifications include an MD doctorate from the prestigious Medical University of Warsaw, and a Master’s degree in Drug Toxicology with the institute of cancer therapeutics. She has previously completed a bachelor’s in Biomedical Science, and is qualified in minor aesthetic and dermatological procedures for the face and body. She is a member of the British Medical Association and is a registered doctor on the General Medical Council.
Her passion for perfection and attention to detail is what drew Dr Meena to the aesthetic industry. She has completed additional FUE Hair transplant training with renowned hair transplant doctors in Georgia and Iran, and has developed a fine motor skills which serve to produce outstanding results, as each procedure is carried out with ultimate care and meticulous attention to the detail. Dr Meena’s care for her patients and work shows in her results is a real credit to the hair transplant industry.
