Female Pattern Hair Loss

Female Pattern Hair Loss

What is Female Pattern Hair Loss (FPHL)?

Female pattern hair loss is the most common type of hair loss seen in women. In males, this equivalent is male pattens hair loss, or androgenic alopecia. The severity of the hair loss in FPHL can vary individually.

What causes Female Pattern Hair Loss (FPHL)?

Female pattern hair loss is due to a combination of hormonal and genetic reasons. Clinically, the hairs that are produced by the hair follicles become finer, shorter, and lighter over time, eventually, the hair follicles shrink and stop producing hair.

Hormones such as androgen (a type of masculine hormone) can be elevated in some patients with female pattern hair loss. They can be associated with an endocrine condition known as polycystic ovarian syndrome (PCOS). You are advised to discuss with your doctor on FPHL and to consider screen for PCOS.

What are the symptoms and presentations of Female Pattern Hair Loss (FPHL)?

  • Hair thinning or hair loss as early as 30s or 40s
  • No itchiness, pain or rash over the scalp
  • Generalized thinning of the hair, in particularly more prominent over the crown of the scalp
  • ‘Widening’ of center parting over the crown
  • In early stages of FPHL, one may opt to side way parting to reduce the appearance of hair loss
  • Hairs over the affected areas are thinner, shorter, and eventually they become absent
Lady suffering from female pattern hair loss

How is Female Pattern Hair Loss (FPHL) diagnosed?

Female Pattern Hair Loss is diagnosed through a good history of progressive thinning of hair, increase shredding of hair over the crown of the head and a family history of similar condition.

Clinically, your doctor will examine the scalp and hair to ascertain the pattern of the hair loss. Sometimes, your doctor may offer you blood tests to screen for underlying medical conditions or micromineral deficiency.

Do speak to your doctor on possible reversible causes of hair loss during checkup for FPHL.

How can I treat Female Pattern Hair Loss (FPHL)?

There are both topical and oral treatment for female pattern hair loss.

Topical treatment

  • Includes use of minoxidil hair spray — this is a spray solution that is applied to the affected scalp using a dropper or pump spray device
  • Minoxidil hair spray should be used for at least 6 months before assessing its efficacy on a patient
  • Depending on possible underlying concurrent medical condition, your doctor may advise for targeted treatment of the medical condition as a holistic approach of hair loss.

Oral treatment

  • Includes Minoxidil, FinasterideIn more severe recalcitrant cases of FPHL, your doctor may discuss with you options such as light therapy or even hair transplant. You are encouraged to discuss the treatment options of female pattern hair loss during your consultation with your doctor.

What is the difference between Female Pattern Hair Loss (FPHL) and Alopecia Areata?


Alopecia Areata


More prominent initially over the vertex, then slowly becoming more diffuse and generalised over the scalp

Patchy bald patches over the scalp


Affects the scalp only

Mainly the scalp, can affect other body parts with hair distribution such as the brows, beard region

Duration of symptoms

Progression of symptoms takes years to decades

Symptoms occur more acutely over weeks to months


Genetic and hormonal underlying cause

Can be associated with medical condition such as PCOS, or thyroid disease

Autoimmune in nature, leading to inflammation of scalp folliciles and hair loss

Can be associated with thyroid disease

Speak to your doctor to understand both conditions and treatment options for both conditions.


FPHL can be inherited. If you have family members, parents or siblings with female pattern hair loss, you may have a higher chance of developing similar condition.

Although there is no cure for female pattern hair loss, the progression of the hair loss condition takes years to decades. With appropriate treatment and early treatment, the hair loss progression can be slowed down, and there are potential to regrow some of the lost hair. Speak to your doctor on various treatment options available for female pattern hair loss.

You are advised to follow up with your doctor. Occasionally, your doctor may require to follow up on individual response towards the treatment. It is also good practice to revisit the clinical diagnosis and presentation to rule out other possible underlying medical conditions during follow up visit. Your doctor may advise for blood tests to evaluate further your condition.

Patients with female pattern hair loss generally do not usually have underlying medical conditions. However endocrine medical conditions such as thyroid disease, polycystic ovarian syndrome can be associated with hair loss in female. If the diagnosis is unclear, your doctor may offer blood tests or ultrasound scans to evaluate further.

As micromineral deficiency can be associated with increase hair fall and hair shredding, you are advised for a balance regular nutritious diet which is rich in iron, vitamin B12, folic acid, vitamin D, zinc. However, as female pattern hair loss is a resultant of genetic and hormonal factors, you are encouraged to get reviewed by your physician to confirm the diagnosis and subsequent treatment plan.

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