Hair loss conditions Mostly affects women
Female pattern hair loss: signs, causes and treatment options
Female pattern hair loss is the most common type of hair loss in women. It usually shows as gradual thinning over the top of the scalp and a parting that looks wider, while the front hairline stays where it was. There is no cure, but treatment such as minoxidil may slow it down and partially restore hair in some women.
What is female pattern hair loss?
Female pattern hair loss (FPHL), also called androgenetic alopecia, is caused by a combination of genetic and hormonal factors, according to the British Association of Dermatologists (BAD). In the affected areas, follicles gradually produce hairs that are finer, shorter and lighter in colour, a process called miniaturisation, until some stop producing hair altogether.
It runs in families and can be inherited from either parent. It most often starts in the 50s or 60s, but it can begin earlier, in the 30s or 40s. It tends to progress very slowly, over years to decades, and the BAD notes that an earlier start may mean quicker progression.
Unlike male pattern hair loss, FPHL rarely causes a receding hairline. Hair thins diffusely over the top of the head instead. Doctors often describe the pattern using the Ludwig scale, a three-point scale of thinning over the crown with the front hairline preserved. Another pattern, sometimes called the Christmas tree pattern, shows the parting widening most towards the front.
Hair loss can affect self-esteem, and the BAD encourages talking about the emotional side with your healthcare professional too.
Signs to look for
- A parting that looks wider than it used to, often most noticeable towards the front
- More scalp showing on top of the head, especially in photos or under bright light
- Hairs on top that are finer and shorter than those at the back and sides
- A ponytail that feels thinner than it did
- A front hairline that stays in place while the top thins
- Scalp skin that looks normal, without redness, scaling or soreness (some women notice mild itch)
What causes it
Genes
FPHL is hereditary and can be inherited from either or both parents. A family history of thinning is common.
Hormones
Androgens (a group of hormones all women make in small amounts) play a part. FPHL can accompany conditions with raised androgens, such as PCOS, though thinning on its own is a weak sign of raised hormone levels.
Age and the menopause
The most common age to notice it is the 50s or 60s, so it often becomes visible around the menopause.
Overlapping causes of shedding
Iron deficiency, thyroid problems and telogen effluvium (temporary shedding) can cause thinning that looks similar, and can happen at the same time as FPHL.
How it is diagnosed
A doctor usually diagnoses FPHL from your history of gradual thinning or increased shedding on top, the pattern of loss, and any family history. The scalp looks normal on examination. Occasionally a scalp biopsy is used to confirm the diagnosis.
Blood tests do not diagnose FPHL itself, but they are useful for ruling out things that cause or worsen thinning. The BAD lists iron deficiency and thyroid conditions as causes of shedding that a blood test can exclude. If you also have irregular periods, acne or excess facial or body hair, NICE CKS advises that PCOS should be considered, and hormone tests become part of the picture.
Some scarring conditions, such as frontal fibrosing alopecia, can look like FPHL in their early stages. Redness, scaling, pain or a front hairline that is moving back are reasons to see a GP or dermatologist rather than self-treat. Our page on scarring alopecia explains the warning signs.
Treatment options
Every option below has trade-offs, and choosing not to treat is a reasonable decision too. Medicines are only prescribed after a doctor has reviewed your history and confirmed they are suitable for you.
What to expect
Patience is part of any treatment. The licensed women's foam says it may take 12 to 24 weeks of daily use before growth is visible, and to stop if there is no improvement after 24 weeks. The BAD advises using minoxidil for at least 6 months before judging whether it is helping.
Some people notice more shedding at first. The licensed foam's product information says this usually begins 2 to 6 weeks after starting and settles within a couple of weeks, as old resting hairs make way for new ones. If it continues for longer than 2 weeks, speak to your prescriber. See minoxidil shedding.
Results vary from person to person. Any benefit lasts only as long as you keep using treatment; if you stop, hair gained is gradually lost. Choosing not to treat, or to use camouflage instead, is a perfectly reasonable decision.
When to see a doctor promptly
See your GP soon, rather than waiting or self-treating, if you notice any of these:
- Hair that comes out suddenly, in clumps, or in round bald patches
- Redness, scaling, pain, burning or itching on the scalp, or areas that look smooth and shiny
- A front hairline or eyebrows that are receding
- Irregular or absent periods, new acne, or excess facial or body hair alongside the thinning
- Tiredness, shortness of breath, feeling cold or unexplained weight change, which can point to anaemia or a thyroid problem
How WMG Meds can help
If your thinning looks like female pattern hair loss, you can complete a free online assessment. A GMC-registered doctor reviews your answers and decides whether a minoxidil-based treatment is clinically appropriate for you: compounded topical minoxidil or low-dose oral minoxidil, both prescribed off-label. Medicines are dispensed by a GPhC-registered UK pharmacy partner, to UK addresses only.
There are limits. Finasteride and dutasteride are not suitable for women who are or could become pregnant, and spironolactone is a GP or dermatologist decision rather than something WMG Meds prescribes. If your answers suggest a different cause, such as patches, scarring or sudden shedding, the doctor will tell you and point you to your GP, a dermatologist or a blood test instead.
Please tell us if you are pregnant, trying to conceive or breastfeeding. Minoxidil is not used during pregnancy or breastfeeding, so treatment may need to wait.
Frequently asked questions
Can women use minoxidil?
Yes. Topical minoxidil is licensed for female pattern hair loss in the UK, as a 2% solution and a 5% once-a-day foam. Compounded solutions and low-dose oral minoxidil can also be prescribed off-label after a doctor has assessed you. Minoxidil should be avoided if you are pregnant, planning a pregnancy or breastfeeding.
Can women take finasteride for hair loss?
The NHS says women should not use finasteride. Women who are or may become pregnant must not handle crushed or broken tablets, because of the risk to a developing male foetus. Finasteride also carries MHRA warnings about psychiatric side effects, including depression and suicidal thoughts, and sexual side effects that may persist after stopping (Drug Safety Updates of 29 April 2024 and 11 May 2026). See can women take finasteride and our MHRA safety updates.
How long before I know if treatment is working?
Allow at least 6 months. The licensed women's foam says growth may take 12 to 24 weeks to appear, and the BAD suggests at least 6 months before judging any benefit. Photos taken in the same light every few months are more reliable than the mirror.
Do I need a blood test before treatment?
Not always, but it is often worthwhile. Blood tests cannot diagnose female pattern hair loss, but they can rule out iron deficiency and thyroid problems, which cause similar shedding and can happen at the same time. If you have irregular periods, acne or excess facial hair, hormone tests can help your GP look for PCOS.
Will my hair stay if I stop treatment?
No. The BAD says any benefit is only maintained for as long as treatment is used. After stopping, the hair gained on treatment is gradually lost and thinning continues along its underlying course.
Is treatment for female pattern hair loss available on the NHS?
Partly. The BAD notes that the licensed 2% minoxidil is not available on the NHS, while spironolactone is usually available on NHS prescription when a doctor thinks it is appropriate. Synthetic wigs can be provided on the NHS; hair transplants and PRP are private only.
Sources
- British Association of Dermatologists: Hair loss, female pattern (androgenetic alopecia), patient leaflet (October 2024)
- Regaine for Women Once a Day Scalp Foam 5% w/w: Summary of Product Characteristics (eMC)
- British Association of Dermatologists: Spironolactone, patient leaflet
- NHS: Hair loss
- The Female Pattern Hair Loss: Review of Etiopathogenesis and Diagnosis, BioMed Research International (2014)
Facts checked against these sources on 4 October 2026. This page is general information, not a diagnosis. Read our editorial policy.