Female Pattern Hair Loss 

For many decades, doctors believed that androgenic alopecia was the primary cause of balding in both men and women. Today however we know that, for women, this is not true. We do not use the term ‘androgenic alopecia’ in women anymore; instead we call it ‘female pattern hair loss’, a much broader term that encompasses many possible causes. The scientific explanation for female pattern hair loss is still incompletely understood and there is evidence that hormone receptors and blockers as well as many other types of enzymes may be at work in women.

One clue that there is a definite difference between male and female balding is the pattern in which the hair loss occurs. Female pattern balding goes on around the whole top of the head and is ‘diffuse’. The hairline stays in place with varying degrees of diffuse loss over the top of the scalp. This loss can range from being barely noticeable to an almost bald appearance. These illustrations illustrate the Ludwig Scale of female pattern hair loss:

The Ludwig Classification describes three stages of genetically-based, female pattern hair loss: Type I (mild), Type II (moderate), and Type III (extensive). In all three Ludwig stages, there is hair loss on the front and top of the scalp with relative preservation of the frontal hairline. The back and sides of the scalp may or may not be affected.

Type I. Early thinning that can be easily camouflaged with proper grooming.

Type II. Significant widening of the midline parting and noticeably decreased volume.

Type III. A thin, see-through look on the top of the scalp. This is often associated with generalised thinning.


Following investigation and diagnosis, we will recommend a course of treatment, normally combining advice and trichological medication – although, in the most severe cases, a course of hair replacement surgery may also be appropriate. Many women can be helped by hair transplant surgery and as with men, hair is taken from the donor area at the back of the head and transferred into the areas of hair loss.

In female pattern balding, hair transplant surgery will place enough hair back into the thinning area to create a normal appearance of fullness – and a volume of hair that can be styled easily. This helps restore confidence in appearance and greater ease in both social and family settings.

Medical Hair Problems In Women

Although hair transplant surgery can be used successfully to treat many cases of female hair loss, not all women are good candidates for surgery. There can be underlying medical conditions that can cause the hair loss such as thyroid problems, polycystic ovary syndrome, anaemia, chronic illness or hormonal changes.

Certain types of autoimmune disorders may give rise to a slightly different and often less dramatic hair loss problem known as alopecia areata. This is an inflammatory condition that can cause hair to come out in clumps or patches.

Temporary hair shedding that often follows childbirth, crash dieting, surgery, or a traumatic emotional event is known as telogen effluvium, a condition which creates a change in the natural hair growth system.

There are also ‘scarring alopecias’. Transplanting into these areas will not be successful.

If there is an underlying physical or medical problem this has to be corrected first, which may preclude the need for hair transplant surgery. It may be advisable to undertake blood tests or even a scalp biopsy as part of the diagnostic process.

A medical treatment often prescribed for female hair loss is Minoxidil 4% lotion. And there are various cosmetic ‘cover-up’ products that are extremely useful in disguising hair loss. Many women are able to use these products to make the hair appear thicker and they often help towards styling the hair to create density. They come in a variety of colours to suit all hair types and can become an effective part of the daily routine to disguise hair loss or thinning.