Alopecia in women; Baldness - female; Hair loss in women; Androgenetic alopecia in women; Hereditary balding or thinning in women
Female pattern baldness is the most common type of hair loss in women.
Each strand of hair sits in a tiny hole in the skin called a follicle. In general, baldness occurs when the hair follicle shrinks over time, resulting in shorter and finer hair. Eventually, the follicle does not grow new hair. The follicles remain alive, which suggests that it is still possible to grow new hair.
The reason for female pattern baldness is not well understood, but may be related to:
Hair thinning is different from that of male pattern baldness. In female pattern baldness:
Itching or skin sores on the scalp are generally not seen.
Female pattern baldness is usually diagnosed based on:
The health care provider will examine you for other signs of too much male hormone (androgen), such as:
A skin biopsy of the scalp or blood tests may be used to diagnose skin disorders that cause hair loss.
Looking at the hair with a dermoscope or under a microscope may be done to check for problems with the structure of the hair shaft itself.
Untreated, hair loss in female pattern baldness is permanent. In most cases, hair loss is mild to moderate. You do not need treatment if you are comfortable with your appearance.
The only medicine approved by the United States Food and Drug Administration (FDA) to treat female pattern baldness is minoxidil:
If minoxidil does not work, your provider may recommend other medicines, such as spironolactone, cimetidine, birth control pills, ketoconazole, among others. Your provider can tell you more about these if needed.
This procedure can be effective in females:
During hair transplant, tiny plugs of hair are removed from areas where hair is thicker, and placed (transplanted) in areas that are balding. Minor scarring may occur where hair is removed. There is a slight risk for skin infection. You will likely need many transplants, which can be expensive. However, the results are often excellent and permanent.
Hair weaving, hairpieces, or a change in hairstyle can help hide hair loss and improve your appearance. This is most often the least expensive and safest way to deal with female pattern baldness.
Female pattern baldness is usually not a sign of an underlying medical disorder.
Hair loss may affect self-esteem and cause anxiety.
Hair loss is usually permanent.
Contact your provider if you have hair loss and it continues, especially if you also have itching, skin irritation, or other symptoms. There might be a treatable medical cause for the hair loss.
There is no known prevention for female pattern baldness.
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Sinclair R, Koh WL. Androgenetic alopecia. In: Lebwohl MG, Heymann WR, Coulson IH, Murrell DF, eds. Treatment of Skin Disease: Comprehensive Therapeutic Strategies. 6th ed. Philadelphia, PA: Elsevier; 2022:chap 12.
Sperling LC, Sinclair RD, El Shabrawi-Caelen L. Alopecias. In: Bolognia JL, Schaffer JV, Cerroni L, eds. Dermatology. 4th ed. Philadelphia, PA: Elsevier; 2018:chap 69.
Zug KA. Hair and nail diseases. In: Habif TP, Dinulos JGH, Chapman MS, Zug KA, eds. Skin Disease: Diagnosis and Treatment. 4th ed. Philadelphia, PA: Elsevier; 2018:chap 20.BACK TO TOP
Review Date: 2/18/2022
Reviewed By: Ramin Fathi, MD, FAAD, Director, Phoenix Surgical Dermatology Group, Phoenix, AZ. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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