Female Pattern Baldness (Androgenetic Alopecia): Symptoms, Causes & Treatments

Key Takeaways

• What is female pattern baldness? This is a type of hair loss that occurs in a familiar pattern in women, usually at the top and front of the scalp.
  
• Who does it affect? It affects women most often starting after menopause, most likely due to the hormonal changes that take place.
  
• What are the symptoms? Common symptoms are a widening hair parting and diffuse thinning (loss of volume)
  
• What happens? Affected hair follicles shrink and produce thinner and shorter hairs, leading to gradual thinning across the hair parting and crown.
  
• What should a patient do? If suspected, see a GP or dermatologist to confirm the diagnosis. Early treatment, usually with topical minoxidil, may slow progression and improve hair density.

Female pattern hair loss (FPHL) is the most common hair loss condition affecting women, where hair loss is seen in the hair parting and crown. It affects over half of women in their lifetime. The first symptoms may develop in the teenage years and lead to progressive hair loss.

It involves a progressive decrease in thickness and length (miniaturisation) of hair follicles and eventually hair loss s, especially in the hair parting

Unlike in pattern hair loss in men, the hair loss pattern in women is typically not as uniform and intense. As a result, you most likely won’t have any complete bald patches.²

What is Female Pattern Hair Loss?

Female pattern hair loss is a type of hair loss affecting women, where hair is lost mainly in the parting and crown. It commonly affects women going through menopause.

Sometimes, younger women can suffer from female pattern hair loss, especially those who suffer from polyendocrine metabolic ovarian syndrome (PMOS), formerly known as polycystic ovary syndrome (PCOS).  

The condition happens gradually and is considered a nonscarring type of hair loss, which means the hair follicles usually aren’t destroyed and therefore may potentially redevelop with the correct therapy.

Those who have suffered from the condition and have stabilised it can also be candidates for a hair transplant. While no other physical symptoms are usually present, women impacted may experience significant emotional distress associated with the hair loss.³

What causes female pattern hair loss?

The reason why women suffer from female pattern hair loss is still being researched. There is no clear cause found, but we believe there is likely a genetic susceptibility to the condition. 

The condition was thought to be linked with a type of testosterone called DHT; however, recently the role of the hormone DHT is less clear than in male pattern hair loss (where it is the main driver of hair loss). Only around 1 in 3 women with the condition are found to have increased androgen or DHT levels.

This is further complicated by the fact that many studies have also found an increased number of genes in common with male pattern hair loss, suggesting that hair loss in female pattern baldness may have some similar causes as it does in men who suffer from male pattern baldness.^4,5

Female pattern hair loss may also be associated with polyendocrine metabolic ovarian syndrome (PMOS), formerly known as polycystic ovary syndrome (PCOS). In these conditions, the level of DHT or androgens is generally high, and this higher level is thought to contribute to female pattern hair loss.

What does female pattern hair loss look like?

You may notice thinning of hair on the crown of the head, which spares the front hairline. It is commonly graded according to the Ludwig scale, where you will see that in severe forms of the condition, the hair parting is totally lost. 

The hair loss may form in what is known as a ‘Christmas tree’ pattern. This is called so because the hair loss creates a triangular patch widest at the front before coming to a point closer to the back of the crown.

In rarer cases, it may present with a receding hairline similar to male pattern baldness.

Diagnosis

Diagnosis is made by your doctor after they ask you some questions about the hair loss onset and how it has developed since. They may take a physical look at the scalp to check the condition and appearance. 

A biopsy and blood tests may possibly be needed to rule out other diagnoses that can mimic female pattern baldness.⁶

“My patients will require a suite of blood tests to ensure that we are treating a diagnosis of female pattern baldness. These can include a FBC, Folate, Ferritin, Thyroid Function, PCOS screen, Vitamin D, and B12.

Together with a biopsy to rule out any other rarer conditions, this can give a clear understanding of whether my female patient is suffering from female patterned balding and whether they would benefit from medical treatment to stabilise the hair loss.”

Dr Roshan Vara, Medical Director and Surgeon at The Treatment Rooms London

How to Treat Female Pattern Hair Loss

The main medical treatment is Minoxidil 2% solution, applied directly to the affected area of the scalp. This works by encouraging hair follicles to enter an active phase of growth and increases the time hairs are in this productive state. It also increases hair count and weight/ volume.⁷

Be aware that an increase in hair shedding (falling out) may happen in the first three months on minoxidil. This doesn’t mean your condition is getting worse; rather, it is the loss of hair from follicles that are already resting.⁸ 

It may take up to 6 months to notice any impact, so it is important to be patient as results take time. If you are living in the UK, be aware that the treatment is not available on the NHS and can be expensive.⁶

If you are considering solutions, artificial concealment options can include wigs and hair pieces, and a hair transplant may also be a viable option.⁹

Can I Get a Hair Transplant With Female Pattern Hair Loss?

If you have tried medical treatments and have not had any success, or the recovery is stabilised and you wish to go a step further, a surgical hair transplant may be an option for you. 

Your surgeon will assess whether this is a good choice for you. You will have to meet certain criteria. For example, your hair loss will need to remain in a steady, stable state for a certain period of time. 

The transplant will involve the relocation of hairs from other parts (mainly the back) of the head to the site of hair loss.

Follicular unit transplantation (FUT) is a common approach. This is where natural bundles of hair units are relocated in groups of 1 to 4 hairs under a microscope and placed into the areas of hair loss to give a natural appearance. This allows for a minimum shave procedure, which most female patients prefer.

Follicular unit extraction(FUE) is a more modern approach where individual hair follicles are removed from the back of the scalp. They are then placed into ready-made holes in the area of hair loss. This technique might require more hair to be shaved to perform, and as a result, women may prefer the FUT technique.

Ideal candidates for this type of treatment are women with lots of remaining hair near the back of the head (donor site) and extensive thinning and hair loss on the front part of the scalp.³

It can be more difficult to perform if there is not enough hair in donor areas. 

At The Treatment Rooms London, we can talk you through the procedure, including what is likely to provide you with the best results.

“My female patients can often present at the early stages of their female pattern baldness. This can mean they need to be referred to their GP or Dermatologist to rule out other causes of their hair loss and stabilise their hair before planning a hair transplant.

It is important to stabilise the condition before planning surgery, as we don’t want to operate for the patient to only lose more hair over time. We try and signpost our patients where necessary to ensure they don’t plan surgery when it isn’t in their best interests.”

Dr Roshan Vara, Medical Director and Surgeon at The Treatment Rooms London

If it’s Not Female Pattern Hair Loss, What Else Could it Be? 

Some conditions such as telogen effluvium (stress shedding) may be mistaken for this type of hair loss. Make sure to consult with a healthcare professional to get an accurate diagnosis. 

Conclusion

Female pattern hair loss is a common condition. While not physically harmful to your health, you may find it can affect your self-esteem and confidence. 

While there are medications which you may see benefit from, getting an accurate diagnosis is the first important step to take. 

If the hair loss has remained in a stable pattern, and you have tried medications but are not satisfied with the outcome, you may wish to consider hair transplantation. This can prove a valuable option to enhance your hair’s appearance.

With the right treatment, you may improve the look of your hair and live life with newfound confidence.

References:

1. Olsen EA. Female pattern hair loss. J Am Acad Dermatol. 2001 Sep;45(3 Suppl):S70–80. doi: 10.1067/mjd.2001.117426.
2. Birch MP, Messenger JF, Messenger AG. Hair density, hair diameter and the prevalence of female pattern hair loss. Br J Dermatol. 2001;144(2):297–304. doi: 10.1046/j.1365-2133.2001.04018.x.
3. Fabbrocini G, Cantelli M, Masarà A, Annunziata MC, Marasca C, Cacciapuoti S. Female pattern hair loss: a clinical, pathophysiologic, and therapeutic review. Int J Womens Dermatol. 2018;4(4):203–211. doi: 10.1016/j.ijwd.2018.05.001.
4. Heilmann-Heimbach S, Herold C, Hochfeld LM, Hillmer AM, Nyholt DR, Hecker J, et al. Meta-analysis identifies novel risk loci and yields systematic insights into the biology of male-pattern baldness. Nat Commun. 2017 Mar 8;8:14694. doi: 10.1038/ncomms14694.
5. Pickrell JK, Berisa T, Liu JZ, Ségurel L, Tung JY, Hinds DA. Detection and interpretation of shared genetic influences on 42 human traits. Nat Genet. 2016 Jul;48(7):709–17. doi: 10.1038/ng.3570.
6. British Association of Dermatologists. Hair loss—female pattern (androgenetic alopecia) [Internet]. London: British Association of Dermatologists; 2024 Oct [cited 2026 Jul 25]. Available from: https://www.bad.org.uk/pils/hair-loss-female-pattern-androgenetic-alopecia
7. Blumeyer A, Tosti A, Messenger A, Reygagne P, del Marmol V, Spuls PI, et al. Evidence-based (S3) guideline for the treatment of androgenetic alopecia in women and in men. J Dtsch Dermatol Ges. 2011;9 Suppl 6:S1–S57. doi: 10.1111/j.1610-0379.2011.07802.x.
8. Herskovitz I, Tosti A. Female pattern hair loss. Int J Endocrinol Metab. 2013;11(4):e9860. doi: 10.5812/ijem.9860.
9. National Institute for Health and Care Excellence. Female pattern hair loss (female androgenetic alopecia) [Internet]. London: NICE; 2026 [cited 2026 Jul 25]. Available from: https://cks.nice.org.uk/topics/female-pattern-hair-loss-female-androgenetic-alopecia/