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Women and Hair Loss: The Causes, Treatments, and Prevention
Hair loss and hair thinning are often seen as being in the male domain, but a significant number of women also experience the loss of hair. In the UK alone, it’s estimated that around 8 million women suffer from one of several types of alopecia.
If you’re losing hair in the shower, or seeing more hair than usual on your hairbrush or pillow, it’s time to learn more about the causes of female hair loss. While most hair loss isn’t a cause for concern, it can signal an underlying health condition or the onset of progressive hair loss. Either way, it’s important to understand and tackle the problem sooner rather than later.
In this article, we’ll examine all the major female hair loss causes, from hormones and aging to postpartum hair loss. We’ll also explore the risk factors, hair loss treatments, and preventative measures for women’s hair loss.
Table of Contents
- How much hair should I lose a day?
- What types of hair loss do women experience?
- Who is at risk for female hair loss?
- What are the causes of female hair loss?
- Hair loss due to nutritional deficiencies
- Does menopause cause hair loss?
- Can female hair loss be prevented?
- How is female hair loss diagnosed?
- What is the treatment for female hair loss?
- What can I do if I’m losing hair?
How much hair should I lose a day?
Most women lose 50 to 100 hairs every day through standard practices like washing and brushing their hair [1]. Here’s what 100 hairs look like in people with short hair (left) vs long hair (right):
Having hair fall out is a normal part of the hair growth cycle and happens when hair follicles shift through the different growth phases:
Individuals with healthy hair growth will have up to 90% of their hair in the growth phase at any time. The rest is in the resting (catagen) or shedding (telogen) phase. It’s these hairs that come away from the scalp each day. Once the shedding phase has ended, healthy follicles progress into the hair regrowth phase.
If you have hair loss, your hair doesn’t continue into the growth phase. This lack of growth can be temporary or permanent, depending on the type of hair loss. Women with hair loss typically lose more than 100 hairs each day.
What types of hair loss do women experience?
Women can be affected by lots of different types of hair loss, including:
- Female pattern hair loss
- Traction alopecia
- Telogen effluvium
- Alopecia areata
- Frontal fibrosing alopecia
- Medication-related hair loss
- Hair loss caused by vitamin deficiencies
Unlike male hair loss, which usually stems from male pattern baldness, the causes of hair loss in individuals who were assigned female at birth are more varied. This is particularly true in younger women.
Let’s look at each female hair loss condition in more detail.
Female pattern baldness
Female pattern hair loss (FPHL) is caused by a combination of hormones, genes, and ageing. As a result, it’s far more likely to affect postmenopausal women. One study found that just 6% of premenopausal women had symptoms of female pattern baldness, compared with 38% in those over 70 [2].
Unlike the balding patterns that occur in male pattern hair loss, female pattern hair loss usually presents itself with thinning hair. The main symptoms of female pattern hair loss are a widening parting and diffuse thinning across the scalp:
Traction alopecia
Traction alopecia is a type of noticeable hair loss caused by hair styling practices that pull on the hair shaft. It tends to cause hair loss around the temples. Continuing to wear overly tight hairstyles can lead to permanent hair loss.
Telogen effluvium
Telogen effluvium is a common type of hair loss triggered by physical or emotional stress. It encompasses lots of hair loss conditions, including postpartum hair shedding, anxiety-related hair loss, and even hair loss caused by anorexia nervosa.
Like female pattern hair loss, telogen effluvium tends to cause diffuse hair loss (thinning hair) across the scalp:
Alopecia areata
Alopecia areata is an autoimmune condition characterised by distinctive bald spots across the scalp. This type of patchy hair loss happens when your white blood cells attack the hair follicles, causing the hair to shed.
Alopecia areata is the mildest form of this condition. It can progress to alopecia totalis (total scalp hair loss) and alopecia universalis (total body hair loss).
Frontal fibrosing alopecia
Frontal fibrosing alopecia (FFA) is a type of scarring alopecia. Scarring alopecias are almost always permanent, so it’s important to seek treatment if you have symptoms of FFA.
FFA usually occurs in postmenopausal women [3]. The main symptoms are a receding hairline in women and eyebrow hair loss:
Hair loss due to medication
While most hair loss occurs due to a premature shift to the hair shedding phase, it is possible to lose hair that’s still in the growth phase. This type of excessive shedding is known as anagen effluvium, and it’s mainly caused by chemotherapy medication [4].
Chemotherapy-related hair loss is common among cancer patients who are undergoing chemotherapy treatment, but it’s temporary in almost all cases. When treatment is stopped, new hair grows back.
Other medications, including anabolic steroids and vitamin A supplements, can also cause female hair loss.
Who is at risk for female hair loss?
There are certain factors that can put you at greater risk of women’s hair loss. These include:
- Age — conditions like female pattern hair loss (also known as androgenetic alopecia) and frontal fibrosing alopecia are more common over the age of 50 [8].
- Ethnicity — Black women are at greater risk of traction alopecia and some types of scarring alopecia [9].
- Family history — genetics can play a role in the development of female pattern hair loss and alopecia areata [10-11].
- Childbirth — following a period of hair growth during pregnancy, giving birth often triggers substantial hair loss as your hormones level out.
- Other hormone imbalances — in particular, menopause and thyroid conditions can cause hair loss due to hormone changes.
- Illness — those with other autoimmune disorders (and certain other long-term conditions) are more likely to experience alopecia areata [11].
What are the causes of female hair loss?
There are lots of female hair loss causes, which often combine to trigger sustained or temporary hair loss.
Here, we’ll explore all the key causes of each type of female hair loss.
Causes of female pattern baldness
While female pattern hair loss doesn’t present the same way as male pattern baldness, the causes are similar; namely, a combination of genes, hormones, and age:
- Hair follicles are genetically predisposed to hormone sensitivity, so you’re more likely to experience this type of hereditary hair loss if a family member has it.
- The dihydrotestosterone (DHT) hormone binds to receptors in the hair follicle, causing it to shrink. As hair follicles shrink, they stop producing hair.
- As you get older, you produce less oestrogen. This hormone imbalance sometimes leads to the development of male characteristics, including pattern hair loss.
Studies suggest nutritional deficiencies may also play a part in the development of female pattern baldness [5].
Causes of traction alopecia
Traction alopecia is normally caused by excessively tight hairstyles which pull at and damage the follicles, leading to temporary hair loss.
Hairstyles that are known to cause traction alopecia include:
- Weaves and hair extensions — glueing, sewing, or otherwise attaching synthetic hair can damage the follicles. Naomi Campbell has said wearing hair extensions caused her to lose hair.
- Braids and dreadlocks — tight hairstyles like braids and dreadlocks can also create excessive tension that damages the follicles.
- Beads in braids — beads add extra weight to the hair, which can become too heavy if worn too often.
- High ponytails — Ariana Grande is famously said to have experienced traction alopecia thanks to her trademark ponytail.
- Buns — ballet dancers have been known to experience traction alopecia as a result of wearing tight buns repeatedly [12].
- Turbans and hijabs — certain religious headwear can add pressure to the follicles if the hair is wrapped too tightly [9].
Causes of telogen effluvium
Telogen effluvium is primarily caused by stress or trauma. This can be physical trauma to the scalp, or a psychosomatic symptom of anxiety, depression, illness, or surgery.
There are several causes of telogen effluvium, including [13]:
- Hair loss after Covid-19
- Recent childbirth
- Mental health conditions
- Surgery or physical trauma including haemorrhage
- Fever, illness, and chronic infection
- Extreme weight loss
- Nutritional deficiencies
- A recent hair transplant which triggers hair transplant shedding
- Excessive sun exposure
- Medications including oral contraceptives (birth control pills), androgens, and retinoids
Some women with telogen effluvium experience trichodynia, also known as burning scalp syndrome [9].
Causes of alopecia areata
Alopecia areata is an autoimmune condition. That means it’s caused by your immune system attacking healthy cells and tissues in the body: in this case, it damages the hair follicles. This causes bald patches to develop in random places on the scalp.
The exact cause of alopecia areata is unknown. Evidence suggests it may be linked to:
- The collapse of immune privilege in the hair follicles [14]
- Genetic factors
- Environmental triggers
- Infection
- Nutritional deficiency
Causes of frontal fibrosing alopecia
The exact cause of frontal fibrosing alopecia is currently unknown. It’s thought that genetic, hormonal, autoimmune, inflammatory, and environmental factors can all contribute to FFA [3].
Researchers have linked certain specific risk factors to the development of FFA [3, 15]:
- Smoking
- Hormone levels
- Leave-on facial products
- Autoimmunity
- Excessive suncream use
The exact cause or trigger may differ from person to person.
Causes of anagen effluvium
Chemotherapy drugs are the most common cause of anagen effluvium, though there may be other triggers, too. This includes [4]:
- Pemphigus — a rare long-term condition caused by immune system problems.
- Alopecia areata — inflammation stemming from alopecia areata may lead to anagen hair shedding.
- Secondary syphilis — hair loss is a rare symptom of this sexually transmitted infection.
Hair loss due to nutritional deficiencies
A clinical deficiency of certain vitamins, minerals, and other micronutrients can lead to hair loss in women. However, deficiencies are rare in Western women, and shouldn’t be confused with micronutrient inadequacies. Inadequacies may contribute to hair loss, but are rarely a major cause themselves.
Nutritional deficiencies can contribute to several types of hair loss, including female pattern baldness, alopecia areata, and telogen effluvium [5-7].
Does menopause cause hair loss?
Menopause itself isn’t a direct cause of hair loss. However, some women start to experience menopause-related hair loss due to hormone level changes.
After menopause, your body produces less oestrogen. This sudden drop in oestrogen levels enhances the impact of testosterone and DHT [16]. This can cause a hormone imbalance in your body that leads to conditions like female pattern hair loss and frontal fibrosing alopecia.
Can female hair loss be prevented?
While some types of female hair loss are preventable, many are more difficult to anticipate and avoid. This table shows which hair loss types you can and can’t prevent:
Preventable hair loss | Unpreventable hair loss |
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That said, there are several ways to maintain your hair and keep it healthy for as long as possible. This includes:
- Eating a balanced diet that’s rich in hair health foods. This healthy diet should include nutrients like protein, zinc, and iron.
- Reducing heat styling to avoid damage that leads to hair loss and breakage.
- Avoiding hair extensions and hairstyles that pull on the hair follicles.
- Quitting smoking.
- Managing your mental health to reduce the risk of telogen effluvium.
- Using appropriate products for your hair type.
These tips won’t prevent future hair loss if you’re vulnerable to certain hair loss conditions, but they can make sure the hair you have is as healthy as possible.
How is female hair loss diagnosed?
Female alopecia is usually diagnosed with hair loss blood tests. Many female hair loss conditions have similar symptoms, so it’s not always easy to tell what’s causing your hair loss based on hair pull tests and visual patterns. Blood tests can help determine the true cause of hair loss.
If you have female pattern hair loss, a trichologist may measure the extent of this using the Ludwig Scale.
What is the treatment for female hair loss?
There are several medical treatments available to treat hair loss in women. But finding the right one depends on getting an accurate diagnosis.
In addition, some types of hair loss are temporary, and will grow back on their own without intervention. Telogen effluvium, for example, is almost always temporary, especially when the underlying cause has been addressed. Alopecia areata also has high rates of spontaneous remission.
This table shows which treatments can be effective for each condition:
Female hair loss condition | Possible treatments |
Female pattern hair loss | Spironolactone |
Traction alopecia | Minoxidil Treating the underlying cause |
Telogen effluvium | Treating the underlying cause |
Alopecia areata | Corticosteroids Minoxidil Anthralin Contact immunotherapy Immunosuppressant drugs Antihistamines |
Frontal fibrosing alopecia | Minoxidil combined with Finasteride* Corticosteroids Anti-inflammatory medications Immunosuppressant drugs |
Anagen effluvium | Spontaneous regrowth when chemotherapy is stopped Treating the underlying cause |
*Finasteride can interfere with pregnancy and foetal development, so it’s not recommended for use in premenopausal or perimenopausal women.
- Although hair loss is typically something that’s associated with men, there are many women who also struggle with losing hair. In fact,...
What can I do if I’m losing hair?
If your hair falls out unexpectedly, there are several things you can do:
- Find a hairstyle you’re comfortable with. There are lots of female hairstyles for receding hairlines and other types of hair loss, so head to the salon or restyle your hair at home.
- See your GP. Your doctor can perform general blood tests to rule out medical conditions like thyroid problems, diabetes, and some autoimmune conditions.
Book a free consultation at a hair loss clinic. At the Wimpole Clinic, we’ll perform specific hair-related tests (including additional blood tests) to determine the cause of your hair loss. We can then create a tailored hair loss treatment plan based on your diagnosis and symptoms to help reduce further hair loss and help stimulated hair growth.
Sources:
- Do you have hair loss or hair shedding? | AAD
- Hair density, hair diameter and the prevalence of female pattern hair loss | NLM
- Frontal Fibrosing Alopecia: A Review
- Anagen Effluvium | NLM
- Does tissue iron status have a role in female alopecia? | NLM
- Vitamin D and the Immune System | NLM
- Iron Status in Diffuse Telogen Hair Loss among Women
- Female pattern hair loss: Current treatment concepts | NLM
- Traction alopecia: the root of the problem | NLM
- Female pattern hair loss | AJGP
- What causes alopecia areata? | NLM
- Traction Alopecia in a Ballerina: Clinicopathologic Features
- Telogen Effluvium: A Review of the Literature
- Lymphocytes, neuropeptides, and genes involved in alopecia areata | NLM
- Frontal Fibrosing Alopecia: An Update on Pathogenesis, Diagnosis, and Treatment | NLM
- Changes of androgens levels in menopausal women | NLM
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