Hair becomes finer and sparser, particularly at the top and crown. The overall density of hair may decrease over time.
Medical Dermatology
Hair Loss in Women
Dr. Liew Hui Min
Hair loss in women is a common condition that can affect scalp coverage and overall hair density. Androgenic alopecia, also known as female pattern hair loss, is one of the most frequent causes. While some daily hair shedding is normal, progressive thinning or a widening part may indicate ongoing hair loss. Early intervention can help manage the condition and improve scalp health.
Symptoms Of Hair Loss
Hair loss in women often develops gradually and may not be immediately noticeable. Recognising the symptoms can help determine when to seek medical advice. Common symptoms include:
Gradual Thinning Across the Scalp
Widening Part
The central parting of the hair becomes progressively wider, making the scalp more visible in certain areas. This is a key sign of female-pattern hair loss.
Increased Hair Shedding
More strands fall out during washing, brushing, or styling, exceeding the normal daily shedding of 50-100 hairs. Loose hairs may be noticeable on pillows or clothing.
Reduced Hair Volume
Hair may feel less full, making it more difficult to style. A previously thick ponytail may become noticeably thinner.
Hairline Preservation with Temple Thinning
Unlike male pattern baldness, the frontal hairline usually remains intact, though some women may experience thinning near the temples.
Causes And Risk Factors
Hair thinning in women can result from a combination of genetic, hormonal, and environmental factors. Identifying the contributing factors can help guide appropriate treatment options.
Genetic Factors
A family history of female pattern hair loss increases the likelihood of developing androgenic alopecia. Inherited traits determine follicle sensitivity to hormones.
Hormonal Imbalance
Androgenic alopecia is linked to increased sensitivity to dihydrotestosterone (DHT), which causes hair follicles to shrink over time. Hormonal fluctuations, such as those during menopause or polycystic ovary syndrome (PCOS), may contribute.
Age-Related Changes
Hair naturally becomes thinner with age. Many women notice hair loss progressing after their 30s, with a more significant reduction in density after menopause.
Underlying Health Conditions
Conditions such as thyroid disorders, iron deficiency, and chronic illnesses may contribute to hair thinning. A medical evaluation can help rule out other causes.
Nutritional Deficiencies
Low levels of iron, biotin, zinc, or protein can weaken hair follicles and increase shedding. A well-balanced diet supports hair growth and overall scalp health.
Chronic Stress
Prolonged stress can disrupt the hair growth cycle, leading to increased shedding and slower regrowth. Managing stress may help improve hair retention.
Diagnostic Methods
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Clinical Examination
The scalp and hair distribution are assessed to identify areas of thinning and rule out other scalp conditions. A classification scale may be used to monitor progression.
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Trichoscopy (Scalp Dermoscopy)
A magnified view of the hair follicles helps detect miniaturisation, inflammation, and early signs of hair loss that may not be visible to the naked eye.
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Pull Test
A gentle pull on a section of hair helps assess how much hair is shed. Excessive hair loss may indicate an active hair-shedding phase.
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Blood Tests
A blood test may be performed to check for hormonal imbalances, iron deficiency, or thyroid dysfunction. These factors can contribute to excessive hair loss.
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Scalp Biopsy (If Necessary)
A small sample of scalp tissue may be taken for further examination to confirm the diagnosis if other causes of hair loss are suspected.
Treatment will depend on the severity of your condition and your general health.
Treatment Options
Several treatment approaches are available to slow hair loss, stimulate regrowth, and improve hair density. A combination of therapies may be used based on individual needs and hair loss severity.
Topical Minoxidil: A clinically proven topical solution that increases blood circulation to the scalp and prolongs the hair growth phase. Regular use is required to maintain results.
Botanical-Based Topical Treatments: Certain plant-derived treatments may help improve scalp health and support hair strength. These may be used alongside medical treatments.
Oral Supplements: Nutritional deficiencies can contribute to hair loss. Supplements containing iron, biotin, and other essential vitamins may help strengthen hair follicles.
Oral Medications: Prescription treatments that regulate hormone levels or reduce follicle sensitivity to DHT may be recommended based on individual factors. Suitability depends on age, hormonal status, and medical history.
Low-Level Laser Therapy (LLLT): A non-invasive treatment that uses red light wavelengths to stimulate hair follicles and promote hair growth. This therapy may help maintain scalp health over time.
Prevention And Management
While genetic hair loss cannot always be prevented, early intervention can help slow its progression. Maintaining a nutrient-rich diet with sufficient protein, iron, and essential vitamins supports healthy hair growth. Gentle hair care, avoiding excessive heat styling and harsh chemical treatments, can help prevent additional hair weakening. Stress management techniques and maintaining scalp health through consistent treatments may also contribute to better long-term hair retention. Regular follow-ups with a dermatologist allow for monitoring and adjusting treatment as needed.
Dr Liew Hui Min
Dr. Liew Hui Min is an accredited consultant dermatologist from the Ministry of Health and the General Medical Council UK.
Her clinical interest includes:
- Paediatric Dermatology,
- Women’s Dermatology,
- General Adult Dermatology.
Having trained in major London Hospitals, Dr Liew returned to Singapore in 2014 as a Consultant at KK Women’s and Children’s Hospital (KKH) where she specialised in paediatric, women, obstetric and vulva dermatology. Currently, Dr Liew practices at HM Liew Skin & Laser Clinic located at Gleneagles Hospital.
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Frequently Asked Questions
Can female-pattern hair loss be reversed?
Hair thinning can be slowed or partially reversed with treatment, but full regrowth may not always be possible. The extent of improvement depends on the stage of hair loss and the treatment used.
How long does it take to see results from treatment?
Most treatments require at least three to six months of consistent use before visible improvement. Long-term maintenance is often necessary to sustain results.
Does frequent hair washing cause hair loss?
Washing hair does not cause hair loss. However, shedding may be more noticeable when shampooing because loose hairs are dislodged. Hair that falls out during washing is typically already in the shedding phase.
