Hair Loss in Women

Female pattern hair loss differs from what we see in men because the frontal hairline generally stays intact. However the density behind the hairline is the major issue for most women. They complain of a see-through look, and have a harder time styling the hair. They may also notice a widening of their part. Hair thinning in women is usually limited to the frontal 1/3 – 2/3 of the scalp. However many women also notice thinning on the sides of scalp, just above the ears and they can even notice thinning in the back of the scalp.

What makes the diagnosis of female pattern hair thinning so difficult is that it can present very gradually. Hairs enter the resting phase sooner, and each new replacement hair is finer and thinner than the previous hair. Most women do not usually notice any real increase in shedding because the process is so gradual. Your dermatologist will be able to look at the scalp using a handheld magnifier to see whether miniaturized hairs are present. If so, they can help clinch the diagnosis of female pattern hair loss.


The most common cause of female pattern hair loss is genetics. Women with thinning hair may have a father who balded at an early age, or have a sibling with hair loss.  Likewise, their grandparent may have been affected by hair loss. There is no specific pattern of inheritance; one may inherit thinning from any related ancestor. And often times, you need not have a known family history in order to have the condition.

Unfortunately, even teenagers can develop hair thinning, especially if they have a strong family history or a relative who lost his or her hair at an early age. The younger age of onset should especially prompt a visit to the dermatologist or endocrinologist to make sure there is no underlying medical cause for hair loss.

The degree of hair loss in women is graded by physicians according to the Ludwig Scale: I, II, and III. Women at the very early stage of thinning are considered Ludwig I, while more noticeable thinning is considered Ludwig II. Women who are Ludwig III may require a wig or hairpiece to fully cover their thinning scalp.

If you are trying to understand whether your hair loss is due to genetics, hormones, or some underlying lab value, it may be helpful to consider how long you have been noticing your hair thinning. If it has been very gradual but going on for 1-2 years or more it is more likely to be female pattern hair loss. If your hair loss has been going on for 6 months or less, you may consider seeing your doctor first. Regardless, the sooner you get started addressing your thinning hair, the better your odds of holding onto your hair for as long as possible, and potentially even regrowing it as well!