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People often think of hair loss as a “man’s problem”, and there is a widely held view that women rarely experience hair loss. The converse is true- while male pattern hair loss is more common, women experiencing hair loss tend to experience a greater impact to their self-confidence, leading to struggles with insecurity and depression. This article aims to provide an overview of female pattern hair loss and treatment options for female pattern hair loss.
Female pattern hair loss, also known as androgenetic alopecia, is the most common form of hair loss in women, affecting about 40% of women by age 50. It usually appears as diffuse thinning of hair along the parting. In men, hair loss often manifests as a receding hairline and baldness on the crown, while women typically experience thinning hair across the scalp, particularly at the crown, without a receding hairline. Female pattern hair loss tends to happen a little later, affecting perimenopausal women in their 40s and 50s, as compared to male pattern hair loss, which usually starts in the 30s. In childbearing women, there is often an overlap between female pattern hair loss and postpartum hair loss.
Female pattern hair loss is a gradual process, progressively getting more severe over months to years. Sudden and severe bursts of hair shedding may suggest another diagnosis, such as telogen effluvium or postpartum hair loss, which may co-exist with female pattern hair loss.
The hair follicle is a complex structure that contains a tube-like structure surrounding the hair root and strand, with two main layers: the inner root sheath and the outer root sheath. The hair bulb, located at the base, contains the dermal papilla and hair matrix cells, which are responsible for hair growth. The hair follicle functions to provide hair, which provides skin protection and thermoregulation. Healthy, voluminous hair in a female is considered attractive and beautiful.
Catagen (transition phase): 1-2 weeks
Telogen (resting phase): 2-3 months
During the anagen (growth) phase, the hair follicle is long and deep and produces thick, well-pigmented hair shafts. At any time, about 90% of all scalp hairs are in the anagen phase. Following anagen comes the catagen phase, when the dermal papilla disconnects from and stops supplying nutrients to the hair shaft. Finally comes the telogen phase (resting phase), where the hair shaft is shed from the hair follicle. With time, the next anagen phase begins, and new hair starts to form in the hair follicle.
Multiple genes influence an individual's susceptibility to female pattern hair loss and can be inherited from either side of the family. If family members have experienced hair loss, there's a higher likelihood of developing the condition.
Fluctuations in estrogen and androgens (such as during menopause, PCOS, congenital adrenal hyperplasia or after childbirth) can trigger hair loss and progression of female pattern hair loss. The contribution of hormones to female hair loss is less significant than that of male pattern hair loss.
Female pattern hair loss is correlated with ageing, affecting approximately 40% of women by age 50 and 60% of women by age 70. It is uncommon amongst females aged 20-30.
Emotional stress, crash diets or illnesses can shock the body, triggering hair loss.
Thyroid disorders, anaemia and autoimmune conditions cause hair loss that overlaps with pre-existing female pattern hair loss.
Female pattern baldness is the most common hair loss condition amongst females, affecting approximately one-third of women. In older postmenopausal women, the prevalence of female pattern hair loss can rise to as much as 60-70%. Simply put, two-thirds of women will experience hair loss at some point in their lives.
The Ludwig Scale is used by healthcare professionals to assess the severity of female pattern hair loss and guide treatment strategies. It helps to determine the level of hair loss and identify the areas most affected. The scale also aids in monitoring treatment progress and evaluating the effectiveness of treatments
Grade I: Mild thinning, primarily noticeable on the crown or top of the head. The hairline remains intact, but the hair density is reduced.
Grade II: More significant thinning, widening of parting line and possible thinning at the temples. There is overall decrease in hair volume
Grade III: Significant hair loss, resulting in a noticeable gap on the crown and a receding hairline. The scalp is now visible, with only sparse patches of hairMale pattern hair loss is graded using the Norwood scale.
Female pattern hair loss is a clinical diagnosis, made based on the medical history, clinical examination and laboratory testing. Patients with female pattern hair loss typically experience progressive hair thinning over the past few years. Usually, a strong family history of hair loss is present.. Physical examination of the scalp shows diffuse areas of hair loss affecting the parting, hairline and crown area. Medical conditions causing hair loss, such as thyroid dysfunction, iron deficiency anaemia, nutritional deficiency or medications, need to be excluded. Trichoscopy (video scalp analysis) typically shows diffuse thinning of hair and miniaturisation of hair follicles, without scarring or inflammation.
During the consultation process, your doctor should perform:
Female pattern hair loss (androgenetic alopecia) is diagnosed when other causes of hair loss have been excluded
Female pattern hair loss is a medical condition and should be treated in a medical clinic by doctors, instead of relying on unproven hair loss shampoos or home remedies.
Minoxidil increases the blood flow to hair follicles, promoting hair growth. Minoxidil is used topically (2-5% minoxidil, 1 application at night) or taken orally. Regular application of minoxidil for 2-3 months is required to see hair growth, with hair loss resuming once minoxidil is stopped.
Spironolactone is a medication used for the treatment of hypertension and heart failure, and is also prescribed to treat women with signs of hirsutism (acne, facial hair, hair loss) due to increased levels of androgens (male hormones). In women with hair loss, Spironolactone was effective in improving hair density and reducing hair loss in women with no significant adverse effects reported
Hair growth supplements contain naturally sourced ingredients that counter the effects of hormones and promote hair growth. Miriqa Hair Extra Strength supplement contains Tocotrienol, Tripeptide Collagen, Saw Palmetto Berries, Keratin Forte, Biotin, KSM-66 Winter Cherry and Curcumin Bio-max. Nourkrin Hair Growth+ inCLINIC is a drug-free, safe, side-effect-free formulation, based on natural ingredients (fish cartilage) that has been certified to be safe in pregnancy and breastfeeding.
Calecim Advanced Hair System (AHS) is a stem cell regrowth serum that contains growth factors and cytokines- such as Vascular Endothelial Growth Factor (VEGF), Fibroblast Growth Factor (FGF), Platelet Derived Growth Factor (PDGF), Transforming Growth Factor (TGF), Insulinlike Growth Factor (IGF) and Hepatocyte Growth Factor (HGF).
The Stem Cell Hair Regrowth Treatment (Calecim Hair) at Bay Aesthetics Clinic is a proprietary treatment protocol incorporating the Calecim Advanced Hair System with micro needling and Low Level Laser Therapy (LLLT). Results are typically seen in 2-3 months, with patients reporting improved hair density and reduced hair loss. Treatments are weekly, with 6 sessions recommended for early hair loss and 12 sessions for moderate to advanced hair loss.With no downtime or pain, the Stem Cell Hair Regrowth Treatment (Calecim Hair) is a popular treatment choice for women looking to treat female pattern hair loss and postpartum hair loss.
Platelet-rich plasma (PRP) therapy is a hair loss treatment that involves injecting concentrated activated platelets from the patient’s own blood into the scalp to stimulate hair growth. This therapy is often used for androgenetic alopecia (male and female pattern baldness).
Blood Collection: A small amount of blood is drawn from your arm.
Plasma Separation: The blood is spun in a centrifuge to separate the plasma, which contains a high concentration of platelets. This is known as Platelet Rich Plasma (PRP)
Injection: The PRP is then injected into the scalp, typically in areas where hair thinning is most noticeable.
PRP contains growth factors that can stimulate hair follicles and encourage hair growth, improving hair density and thickness while slowing down hair loss.
Low-level laser therapy (LLLT) is a non-invasive treatment for hair loss that uses low-intensity laser light to stimulate hair growth. LLLT uses red light (around 650-670nm wavelength) to stimulate cells within the hair follicle, promoting cell metabolism and potentially shifting inactive follicles into the growth phase. The laser light can also improve blood circulation to the scalp, delivering more oxygen and nutrients to the hair follicles, which is crucial for healthy hair growth. Lastly, LLLT has an anti-inflammatory effect on the scalp.
A hair transplant is a surgical procedure that involves transplanting healthy hair from one part of the scalp to an area with hair loss. As part of the procedure, hair follicles are carefully extracted from the donor site and then transplanted to the recipient site. The final results after hair transplant surgery are typically visible within 6-12 months. While men form the majority of patients seeking hair transplantation, females are growing in number.
If you are suffering from female pattern hair loss, it pays off to take action early, as it is easier to treat the early stages of hair loss. At Bay Aesthetics Clinic, Medical Directors Dr Bernard Tan and Dr Hoe Ying Min are both experienced doctors with over 20 years of combined experience and thousands of patients. They treat patients with hair loss on a daily basis, recommending customised treatment plans with scientifically proven home-based and in-clinic treatments. To see their portfolio of before-and-after cases, please contact the clinic.Book a consultation with us today.
It may not necessarily be cured, but it can be managed effectively, especially if it’s caught early. With the right treatment, many women are able to reduce hair shedding and improve the density of their hair.
Yes. The drop in estrogen levels during menopause can accelerate hair thinning.
Generally, yes. Most treatments, like topical minoxidil and oral anti-androgens, are safe with professional supervision. At Bay Aesthetics Clinic, we’ll design and, where necessary, adjust your treatment plan to minimise any risks of further hair loss and to support your long-term hair health.
1) Spironolactone for treatment of female pattern hair loss. Burns, Laura J. et al.Journal of the American Academy of Dermatology, Volume 83, Issue 1, 276 - 278
