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    Hair loss in women: causes, treatments & prevention

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      Reviewed by our clinical team

      Lady touching her hair

      Hair loss can be upsetting no matter what your age or gender – but for women, it can be particularly distressing, because of societal norms, peer and media pressure. It is simply not expected for a woman to lose her hair.  In contrast to this, hair loss in men is not thought to be unusual.

      In women, there are several different things that can cause hair loss. Some types of hair loss are related to stress or medical treatment and might only be temporary. Other types might result in permanent loss.

      The good news is that most types of hair loss are only temporary and your hair is likely to grow back once the underlying cause or stress has been dealt with. Start by visiting your GP who will be discussing with you what your hair loss might be caused by and what to expect.

      Causes of hair loss in women

      Female pattern baldness

      Female pattern hair loss is unusual in women in their 20s and 30s, but about 40% of women over the age of 50 are affected by this and about 45% of all women over 80 have some degree of female pattern hair loss. Women of with Asian heritage tend to be less affected.

      Female pattern hair loss can run in families, and it's probably related to hormones. It is less noticeable than male pattern hair loss because the hair loss usually starts from the centre parting which can be disguised more easily in longer hair. A receding hair line, like seen in men, is not common at all.

      Telogen effluvium

      Telogen effluvium is another type of hair loss. Typically, the hair falls out evenly across the scalp - there are no obvious bald patches. You may notice more hairs in your hairbrush or on your pillow than normal. This type of hair loss is common after childbirth or other events that are stressful for body or mind. Nutritional deficiencies, for example iron deficiency anaemia, lack of Vitamin B12, folic acid or zinc might also contribute to excessive hair loss.  Sometimes a thyroid problem or other hormonal imbalances can be the reason for the hair loss.  Excessive sun exposure can also contribute to telogen effluvium- so wearing a hat or headscarf might be a good idea during the summer months or when having a holiday in the sun. Because sometimes there is a treatable cause for the hair loss it's worthwhile talking to your GP about this- they might suggest running a few blood tests.

      Normally, we shed around 100 hairs a day, but telogen effluvium causes the shedding of around 300. This is because more hairs than normal have moved from the growing phase into the resting phase.

      The good news is that this type of hair loss is usually temporary. Your hair should return to normal within six to nine months once any imbalance has been rectified or the stressful event or time is over.

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      Alopecia areata

      Alopecia areata (patchy hair loss) is a condition thought to be related to the immune system. It can be triggered by emotional or physical stress, trauma, hormonal changes and sometimes even viral infections.

      Patchy alopecia areata usually starts with a round-ish patch. The hair loss is sudden and sometimes goes unnoticed.  The eyebrows or eyelashes can also be affected. The patch can get bigger before the hair starts growing back. You can have one or more patches in different stages.

      Other types of alopecia areata are alopecia totalis (loss of all hair on the scalp) or alopecia universalis (loss of all hair on the head and body).

      The milder, patchy forms of alopecia areata are normally temporary, and hair usually grows back within six months. The more extreme forms that cause widespread hair loss tend to be permanent (3).

      Traction alopecia

      Traction alopecia is hair loss caused by damage to or strain on the hair follicles, normally due to one of the following:

      • Wearing your hair pulled back in a very tight style (e.g. braids, dreadlocks, or a tight ponytail) 
      • Wearing tight headwear (e.g. a cycling helmet) that puts pressure on the scalp 
      • Wearing hair extensions that pull on the hair follicles 
      • Using chemical relaxers to straighten your hair 

      You may notice patches of thin or broken hair where the scalp and follicles have been under strain. You may also notice redness, itching, pimples, or areas of scarred or shiny skin. 

      If traction alopecia is diagnosed early enough you can take steps to avoid further damage and prevent permanent hair loss (4). 

      Chemotherapy

      Chemotherapy commonly causes hair loss.  This can be anything from gradual hair thinning to going completely bald and losing all your body hair. The hair usually starts falling out 2-4 weeks after the start of the treatment. However, a few weeks after you have completed your chemo your hair will usually start to grow back.

      Other types of hair loss

      There are some other types of hair loss that can affect women, including trichotillomania, a compulsive condition where you feel the urge to pull out your own hair and eyelashes.

      To learn more about this condition and other rarer forms of hair loss, consult this guide from Alopecia UK.

      How do I know what type of hair loss I have?

      It’s not always easy to work out what’s causing your hair loss, but as a general guide: 

      • Thinning on top of the head, particularly over the age of 65, is likely to be female pattern baldness. 
      • Widespread shedding of the hair, particularly after a stressful incident or period of illness, is likely to be telogen effluvium. 
      • Patchy hair loss is likely to be alopecia areata. 
      • Broken hair and sore skin is likely to be traction alopecia.

      The best way to work out what type of hair loss you have is to visit your GP.

      Treatments for hair loss in women

      Many types of hair loss are only temporary, which means you may be advised to simply wait for your hair to return. For permanent or persistent forms of hair loss, there are some treatment options you can try.

      Minoxidil
      One treatment option for women experiencing female pattern hair loss is minoxidil. This is usually used by women with female pattern baldness, although it’s sometimes recommended for other types of hair loss, including telogen effluvium.

      Minoxidil is a topical treatment – in other words, it should be applied directly to affected areas of the scalp. Applying minoxidil every day, as directed, can halt hair loss and in some cases encourage regrowth. It normally takes about six months of daily use for any effects to be seen (3).

      Minoxidil isn’t prescribed on the NHS, but you can buy it through LloydsPharmacy. For women, a 2% concentration is usually recommended, rather than the stronger 5% concentration used by men.

      Wigs
      Hair extensions, hair pieces, and full wigs can be an option for women struggling with hair loss – whether on a temporary or permanent basis. Depending on the nature of your hair loss, you may be eligible for a free wig on the NHS.

      Click here to find out how you can get a wig through the NHS.

      Hair transplants
      Hair transplants can be an effective solution for female pattern baldness. They involve taking hair from healthy areas of the scalp (normally the back and sides) and transplanting them to areas that are balding.

      However, hair transplants aren’t available on the NHS and can be very expensive. There may also be a need for more than one procedure if you have progressive hair loss. You can learn more about hair transplants by consulting this guide from the NHS.

      Alopecia areata treatments

      In severe cases of alopecia areata, when the hair isn't growing back as expected or it's causing distress,  some of the following treatments might be suggested:

      • Corticosteroids – as a topical ointment, injection, or tablet 
      • Dithranol ointment 
      • Immunotherapy 
      • Immunosuppressants 
      • Minoxidil

      You can learn more about treatments for alopecia areata at the Alopecia UK website.

      Can women use finasteride?

      Finasteride (branded as Propecia) is a hair loss treatment for men that comes in tablet form. It’s not suitable for women because it can harm a baby if you get pregnant. No studies have been done on older women, so it is not known what negative effects it might have in this age group.

      Emotional help for hair loss

      If you’re struggling with your hair loss, just know that you’re not alone, and there are resources available to help you cope.

      In this guide for women coping with hair loss, the NHS advises the following: 

      • Joining an Alopecia UK support group 
      • Talking about your hair loss with friends and family 
      • Getting therapy or couples counselling 
      • Using wigs, hair extensions, scarves, and make-up 
      • Being patient, as hair will often grow back!

      VideoGP by LloydsPharmacy

      References

      https://www.alopecia.org.uk/androgenetic-alopecia-pattern-hair-loss
      https://www.alopecia.org.uk/telogen-effluvium
      https://www.alopecia.org.uk/alopecia-areata
      https://www.alopecia.org.uk/traction-alopecia-hair-loss
      https://www.alopecia.org.uk/chemotherapy-induced-alopecia-anagen-effluvium
      https://www.nhs.uk/conditions/hair-loss/
      https://dermnetnz.org/topics/female-pattern-hair-loss/ 
      https://dermnetnz.org/topics/telogen-effluvium/

      Authors and editors

      • Reviewed and updated by

        Dr Tatjana Street
        GMC number: 4569536
        Date reviewed: 19th August 2021

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