The Ultimate Guide to Women’s Hair Loss and Scalp Health

Have you been noticing a sudden influx of hair in the shower drain? Or maybe things have been more gradual – your ponytail has become thinner or you can see your scalp in photos now?

Looks like you may be trying to navigate the world of women’s hair loss. But with so much vague information out there, untangling it all (pun intended) can become a bit of a nightmare.

To help you sort through the matter, we’re breaking down everything you need to know about hair loss – plus, what to do about it.

Hair loss, hair thinning, hair shedding – explained.

First things first – what does it all mean? Here are the common colloquial terms when it comes to managing your mane. 

Hair shedding: This refers to the hairs you find on your comb, pillow, and the like, and is a normal part of your body’s renewal cycle. In fact, you shed about 50-150 hairs on your head every day. But don’t sweat it – those lost hairs are replaced by new ones. 

When you shed significantly more hair every day, you may be experiencing telogen effluvium (more on this below). 

Hair loss: This refers to hair that falls out and doesn’t grow back. The medical term for this condition is androgenetic alopecia (more on this below).

Hair thinning: This refers to the loss of density and volume of hair. It’s a gradual process that typically happens as part of normal aging.

Hair loss for men vs hair loss for women

Many people think of hair loss as mostly a male problem, but it actually affects many women. In fact, about one-third of women experience hair loss at some point and as many as two-thirds of postmenopausal women will experience hair thinning.

But there are key distinctions in how the two sexes experience hair loss. This is why you’ll commonly see hair loss separated into two categories, shown below.

Male pattern hair loss: When androgenetic alopecia affects men, it’s called male pattern hair loss. This typically equates to the classic “receding hairline” and thinning on the crown that can start for men as early as their 20s. Over time, though, it may affect almost the entire scalp.

Female pattern hair loss: When androgenetic alopecia affects women, it’s called female pattern hair loss. In this case, you may see your part widening or thinning on the top or crown area of the scalp (or both).  Unlike male pattern hair loss, receding hairline does not usually occur. 

What are the causes of hair loss?

You now understand the different types of hair loss and how to spot the differences, but where do all the lost locks come from? 

The difference between telogen effluvium and androgenetic alopecia

As it’s been briefly mentioned, androgenetic alopecia and telogen effluvium are both common types of hair loss, but they have important differentiators.

Telogen effluvium: This refers to temporary hair loss or temporary excess shedding – the two terms being interchangeable in this case. It’s most common to experience hair loss that affects your entire scalp pretty evenly.

What causes it? Usually, a physically or emotionally stressful event. A super common example is after giving birth; other triggers could be a surgical procedure, high fevers, COVID-19, or chronic illness.

The good news? It resolves itself within six to twelve months as your body readjusts; although, it can sometimes unmask androgenetic alopecia.

Telogen effluvium, summarized:

• Temporary hair loss
• Appears “all of a sudden”
• Hair looks thinner
• Affects hair evenly throughout the scalp
• Usually caused by stressful events (physical or emotional)
• Resolves in 6-12 months
• Does not require treatment

Androgenetic alopecia: This refers to long-term or permanent hair loss. As mentioned under “female pattern hair loss,” it usually looks like a thinning or widening part, and/or thinning at the top or crown of the scalp. It happens gradually, so much so that you may not even notice until looking back at photos.

What causes it? A mix of genetic factors and the effects of a hormone called dihydrotestosterone, or DHT. Because there’s this genetic component to it, the precise pattern of hair loss can vary.

Androgenetic alopecia, summarized:

• Permanent hair loss
• Happens gradually
• Thinning at the top or crown of the scalp;
• And/or thinning or widening part
• Usually caused by genetics
• Usually improves with treatment 

Other forms of hair loss

Alopecia areata: This is an autoimmune condition where the immune system attacks the body’s hair follicles causing hair to fall out in coin-sized circular patches.

Anagen effluvium: This is temporary hair loss that arises as a side effect of chemotherapy drugs and/or radiation therapy.

Traction alopecia: Hair loss caused by hairstyles that pull on the hair (e.g. tight braids, ponytails, or buns). 

Central Centrifugal Cicatricial Alopecia (CCCA): A scarring form of hair loss that occurs almost exclusively in African American women. This often appears as breakage of hairs at the crown, can be accompanied by scalp discomfort, and can progress to a permanent form of scarring hair loss.

More importantly, what solutions are available for hair loss?

Ready to meet the proven treatments so you can take care of your hair with confidence? 

Oral treatments

Oral Minoxidil: Although used to treat high blood pressure, providers may prescribe oral minoxidil for individual patients for other uses, such as to treat female pattern hair loss. It works by increasing blood flow to the hair follicles, and studies have shown  that it has been helpful in slowing hair loss and in some cases regrowing hair. Doses range from 1.25 mg to 5 mg daily in men and 0.25 mg to 2.5 mg daily in women. This is now referred to as “Low Dose Oral Minoxidil” for hair regrowth along the top of the head and crown.

Spironolactone: This pill is also FDA approved for high blood pressure; however, providers may prescribe this medication for individual patients for other reasons. It slows down the production of androgens or testosterone hormones, making it a treatment for hormone-related hair loss, as well.

Topical treatments

Minoxidil 5% foam and 2% solution: The topical form of minoxidil promotes hair regrowth in women, specifically for the crown of the head. It’s the generic version of Rogaine®. 

Procedures

Platelet-rich Plasma (PRP): Scalp injections in which the preparation of plasma comes from your own blood. Suitable for both men and women. 

Mesotherapy: Microinjections filled with active ingredients such as vitamins, minerals, and acids. 

Follicular Unit Extraction (FUE): A procedure involving the removal of hair follicles from one part of your scalp and moving them to the parts where thinning is most prominent on your head.

Scalp health treatments

Dandruff shampoos: Some medicated shampoos like ketoconazole (generic Nizoral®) which fight dandruff could be beneficial for those with female pattern hair loss. They combat scalp irritation caused by dandruff which in turn damages hair follicles, causing hair loss. 

Thickening shampoos: Specially formulated to keep your follicles clean and healthy, these shampoos are not clinically proven to improve hair growth, but they can help your hair look fuller and thicker. 

What about supplements?

Often touted as must-haves in the beauty industry, supplements (such as biotin) actually have scarce data to prove their efficacy when it comes to achieving long, lustrous hair or combatting hair loss. 

In some cases, though, temporary hair loss (telogen effluvium) may be due to poor diet, stress, or illness, so taking a holistic approach can indeed be helpful. Relaxing, eating well, and taking supplements if you’re found to have a nutritional deficiency may help.

What should I expect with hair loss treatments?

For oral and topical treatments, here’s a rough timeline of what you can expect.

1-3 Months: You likely won’t see any visible progress just yet. In fact, those taking minoxidil may even experience some extra shedding. This is totally normal at this early stage.

4-6 Months: You may be seeing progress at this point in the form of less shedding or even some regrowth.

6-12 months: You’ll see more visible results now, e.g. reduced shedding, halted hair loss, and some regrowth.

1 year: You should see improvements within a year. Hair loss should slow or stop, and there may be some visible hair regrowth.

In short, there’s hope! As more and more research comes to light about women’s hair loss, we’re better able to turn to tools and products to help us take care of our treasured tresses.

If you’re currently looking for treatment, we can help you find prescription and non-prescription options to help with female pattern hair loss (androgenetic alopecia). Get in contact with one of our experts today.

The following blog contains information about products that may or may not have been approved by the U.S. Food & Drug Administration as safe and effective for the condition being discussed. By providing such educational content, Thirty Madison, Inc. in no way supports or endorses the use of these products for such conditions. Such a determination must be made by a licensed clinician who may prescribe these products for such conditions because, in his, her, or their clinical judgment, use of the product is medically appropriate. The FDA approved product labeling may be found at https://dailymed.nlm.nih.gov. 

The information provided in this article is not a substitute for professional medical advice, diagnosis, or treatment. You should not rely upon the content provided in this article for specific medical advice. If you have any questions or concerns, please talk to your doctor.

Spironolactone, Rx only,  is approved by the Food and Drug Administration (FDA) to treat high blood pressure. Spironolactone may cause side effects including headache, nausea, vomiting, diarrhea, and stomach pain, or cramps. If you would like to learn more about spironolactone, please see the full prescribing information here. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit MedWatch: https://www.fda.gov/Safety/MedWatch/default.htm or call 1-800-FDA-1088.

Oral Minoxidil, Rx only, is approved by the Food and Drug Administration (FDA) to treat high blood pressure. Minoxidil may cause side effects including chest pain or palpitations, dizziness or fainting, skin rash, blisters, or itching. If you would like to learn more about minoxidil, please see the full prescribing information here. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit MedWatch: https://www.fda.gov/Safety/MedWatch/default.htm or call 1-800-FDA-1088.

Ketoconazole Shampoo, Rx only, treats tinea versicolor. Ketoconazole may cause side effects including allergic reactions like skin rash, itching, or hives, swelling of the face, lips, or tongue. If you would like to learn more about ketoconazole shampoo, please see the full prescribing information here. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit MedWatch: https://www.fda.gov/Safety/MedWatch/default.htm or call 1-800-FDA-1088.