Some degree of hair loss is healthy and unnoticeable — people lose around 50 to 100 hairs a day on average.
But it can be more severe.
In people assigned female at birth (AFAB), noticeable hair loss is pretty common, with around one third experiencing it at some point.
However, whether it’s subtle thinning all over or a bare patch where the scalp can be seen, it can look different to the typical “baldness” you might expect.
And there are various types with various causes. For example, the thinning hair associated with female pattern baldness is different from the mass shedding of telogen effluvium.
What causes it?
From dietary deficiencies to stress, hair loss in AFAB folks can have a number of causes.
Telogen effluvium — when significantly more hairs move from the growing to the shedding stage — can occur after a traumatic or stressful experience, such as:
- extreme weight loss,
- the loss of a loved one
Triggers for other types of hair loss range from inflammatory scalp conditions, like eczema, to an underlying health concern, such as an autoimmune condition.
Even tight hairstyles, like ponytails or braids, can lead to hair loss as a result of putting pressure on roots.
Female pattern baldness — also known as androgenetic alopecia — is hair loss that affects people assigned female at birth.
It’s similar to male pattern baldness, except that the hair loss tends to occur in a different pattern.
What causes female pattern baldness?
Female pattern baldness is usually hereditary — caused by a genetically shorter hair-growing period and a longer period between the shedding and growth phases.
Genes from parents may also affect the hair, causing smaller follicles and thinner strands.
However, age and hormones may play a part, too, as it’s more common after menopause when estrogen levels reduce.
This means that the effects of male androgen hormones — which are linked to male pattern baldness —may be greater.
More androgenetic activity can also occur through an underlying endocrine condition, such as a tumor on the ovary gland.
In female pattern baldness, the hair’s growing phase slows down. It also takes longer for new hair to begin growing. Hair follicles shrink, leading the hair that does grow to be thinner and finer. This can result in hair that easily breaks.
People with this condition also tend to shed more hairs than the average person, though complete baldness is less likely.
In male pattern baldness, hair loss starts in the front of the head and recedes to the back until the person goes bald.
But female pattern baldness starts at the part line, sometimes appearing all over the head. Hair at the temples may also recede.
Doctors divide the condition into three types:
- Type I is a small amount of thinning that starts around the part.
- Type II involves widening of the part and increased thinning around it.
- Type III is thinning throughout, with a see-through area at the top of the scalp.
If you have female pattern baldness, you may be able to camouflage the hair loss at first by adopting a new hairstyle.
But it often becomes too difficult to hide the thinning hair.
Early diagnosis is encouraged, as it can enable you to start a treatment plan and potentially minimize future hair loss. Your treatment plan will likely consist of one or more medications approved to treat the condition.
Minoxidil (Rogaine) is the only drug approved by the Food and Drug Administration (FDA) to treat female pattern baldness.
It’s available in 2% or 5% formulas. If possible, opt for the 5% formula — older studies found that it’s superior.
Apply minoxidil to your scalp every day. Though it won’t fully restore the hair you’ve lost, it can grow back a significant amount of hair and give an overall thicker appearance.
It can take around 6 to 12 months to see results. And you’ll need to keep using minoxidil to maintain the effect, or it’ll stop working. If this happens, your hair may return to its previous appearance.
The following side effects are possible:
- hair growth on areas where you didn’t want it, such as your cheeks
Finasteride and dutasteride
Finasteride (Propecia) and dutasteride (Avodart) are FDA approved to treat male pattern hair loss. They’re not approved for female pattern hair loss, but some doctors do recommend them.
Studies are mixed about the effectiveness of these drugs for AFAB folks, but some research shows that they do help regrow hair in female pattern baldness.
Side effects can include:
- hot flashes
- decreased sex drive, especially during the first year of use
People also should avoid becoming pregnant, because it can increase the risk for birth defects.
Spironolactone (Aldactone) is a diuretic, which means it removes excess fluid from the body. It also blocks androgen production and therefore may help regrow hair that’s been lost as a result of female pattern baldness.
This medication can cause a number of side effects, including:
- electrolyte imbalances
- spotting between periods
- irregular menstruation
- tender breasts
You may need to have regular blood pressure and electrolyte tests while you take it. If you’re pregnant or plan to become pregnant, you shouldn’t use this medication due to the risk of birth defects.
Laser combs and helmets are also FDA approved to treat hair loss. They use light energy to stimulate hair regrowth, but more research needs to be done to determine if this is truly effective.
Platelet-rich plasma therapy may also be beneficial. This involves drawing your blood, spinning it down, then injecting your own platelets back into your scalp to stimulate hair growth. Though promising, more studies need to be done.
Similarly, there isn’t any evidence that taking iron will regrow your hair. But if low iron is contributing to your hair loss, a doctor or other healthcare professional still might prescribe an iron supplement. Other supplements, such as biotin and folic acid, are also promoted to thicken hair.
A 2015 study showed that people developed thicker hair after taking omega-3 fatty acids, omega-6 fatty acids, and antioxidants. However, it’s best to check with a healthcare professional before taking any supplements with this aim.
If you want a simple way to conceal hair loss, you might try a wig or spray hair product.
A hair transplant is a more permanent solution. During this procedure, a healthcare professional removes a thin strip of hair from one part of your scalp and implants it in an area where you’re missing hair. The graft regrows like your natural hair.
A doctor or dermatologist can give a diagnosis for thinning hair. Testing generally isn’t necessary, but they’ll examine your scalp to see the pattern of hair loss.
If they suspect another type of hair loss other than female pattern baldness, they may also perform a blood test to check your levels of thyroid hormone, androgens, iron, or other substances that can affect hair growth.
Can genetics cause female pattern baldness?
Hair loss is passed down from biological parents to their children, and many genes are involved. You can inherit these genes from either biological parent.
You’re more likely to develop female pattern baldness if your biological parents or other close genetic relatives have experienced hair loss.
What else causes female pattern baldness?
Female pattern baldness is generally caused by an underlying endocrine condition or a hormone-secreting tumor.
You could consult a healthcare professional if you have other symptoms, such as:
- irregular period
- severe acne
- increase in unwanted hair
These may be a sign that you’re experiencing a different type of hair loss.
Can people get female pattern baldness in their 20s?
People are less likely to develop female pattern baldness before midlife and are more likely to start losing hair once they get into their 40s, 50s, and beyond.
Is it reversible?
While some forms of AFAB hair loss are temporary, female pattern baldness is permanent and irreversible without treatment.
However, proper treatment can stop the hair loss and potentially help regrow some lost hair. You’ll need to stay on this treatment long-term to prevent losing your hair again.
Can female pattern baldness worsen?
Female pattern baldness will progress without treatment. However, progression is often slow, taking years to even decades to worsen.
You might notice periods of stability followed by more rapid hair loss phases. And the earlier you experience female pattern baldness, the quicker it may progress.
Can you prevent female pattern baldness?
You can’t prevent it, but you can protect your hair from breakage and loss via the following:
If you’re noticing hair loss, consider reaching out to a doctor or dermatologist. They’ll be able to figure out what kind of hair loss it is and what could potentially be causing it.
Plus, they’ll be able to recommend and prescribe the best form of treatment. The sooner you receive treatment, the faster you’ll be able to stop the loss — and possibly even regrow some of your hair.