Hair Today, Gone Tomorrow? Here’s Your Guide to Female Pattern Baldness

A study showed that female hair pattern baldness accounted for 15.3% of the diffuse hair loss in women in India. Though perceived as an aesthetic concern, female hair pattern baldness is an indicator of underlying health issues and must be addressed early. Its impact on younger females heavily affects mental health and self-confidence, leading to the need for a compassionate treatment approach. Female pattern hair loss is a prevalent type of hair loss in women that becomes more common as they age.

Nowadays, female pattern hair loss is increasingly affecting younger women, largely due to stress, lifestyle factors, and environmental influences. High stress can disrupt the natural hair growth cycle, leading to increased shedding and thinning. Lifestyle choices like poor diet, lack of sleep, and exposure to pollution may also contribute to early hair loss.

Female pattern hair loss is a non-scarring, gradual thinning of hair in the front, central, and sides of the scalp. The front hairline is often spared, and terminal hair loss is also averted. Unlike male pattern baldness, which typically leads to bald spots or a receding hairline, female pattern hair loss generally involves diffuse thinning across the scalp, with the widening of the central parting and a reduction in hair volume. It is an interplay of genetics, metabolic, and environmental factors and demands lifestyle modifications and medical help.

There are numerous causes for female pattern baldness that need to be identified to address the issue.

Genetics: Family history often plays a role, especially if it starts before age 40. Genetic factors vary in severity and onset. While certain genes linked to baldness are well-studied in men, the same connections aren’t fully established in women.

Hormonal factors: The role of ‘androgens’ or male hormones isn’t fully understood. Studies show that DHT, a form of testosterone, may impact hair growth, but its exact effect is unclear. Other hormones like thyroxin (from the thyroid gland), prolactin (pregnancy hormone), and insulin resistance (as seen in diabetes) may also contribute to reasons for female baldness.

Inflammation of the hair follicles: This ‘microinflammation’ is linked to factors like UV radiation, pollutants, and skin bacteria. Unlike severe inflammation in scarring alopecia, microinflammation is mild but may impact hair health.

External factors: Stress, smoking, and lifestyle habits (like lack of sun protection, sedentary lifestyle, poor gut health, and sleep insufficiency) can trigger the progression of hair loss.

Female pattern baldness is a gradual process that occurs in stages.

Ludwig’s classification based on hair thinning on the top of the scalp is as follows:
Type I: Hair thinning along the central parting on the top of the scalp that can be concealed with hair styling

Type II: Hair thinning on the top of the scalp along the parting, with the scalp visible. The central parting is noticeably wider than before.

Type III: The scalp becomes clearly visible along the widespread scattered hair loss. The woman may be completely bald in places; however, hair growth may be normal on the sides and back of the head.

Advanced hair loss as per the Olsen scale: Thinning hair forms a Christmas tree shape, widening at the centre and affecting the hairline.

The Hamilton-Norwood scale describes severe hair loss, including hairline recession along the sides of the scalp.

There is no ‘ONE’ way to prevent the onset of female pattern baldness. Absence of metabolic diseases like diabetes or hormonal disorders like PCOS may prevent the trigger of the condition. Lifestyle changes and doctor’s prescribed therapy are the best ways to keep your mane healthy and ensure the growth of new hair. 

Dr Snehankita Chawdhry, MBBS, Doctor of Medicine, MD, DVL, Dermatology, says, “You consult a dermatologist when hair loss exceeds 100 hair strands every day and

lasts more than three months.”

Her quick tips for haircare are:

• Wash hair with lukewarm water
• Dilute shampoo in water before applying it to the scalp
• Limit the use of hair dye; do a patch test if prone to allergies
• Quit smoking
• Don’t comb wet hair
• Avoid perfumed products for hair
• Avoid tight hairstyles
• Don’t abuse heat styling techniques
• The diet should include seasonal fruits and vegetables, protein sources such as chicken, fish, pulses, at least one egg a day, 10-12 almonds, 6-7 walnut halves, seeds (sesame, flax, pumpkin, chia)
• Adequate water intake (3-4 litres in summers, 1.5-2 litres in winters)

Nutritious food and a good, disciplined lifestyle may not prevent female pattern baldness but can help in hair growth and management of underlying issues. 

• Protein-rich foods: Proteins are the building blocks of the body. Thus, eating enough extra protein may boost skin and scalp health. This may include both vegetarian and non-vegetarian sources, like pulses, grains, milk derivatives, meat, eggs, etc. 
• Micronutrients: Vitamins and minerals, such as vitamins A, B, C, D, E, zinc, and iron, promote healthy hair, skin, and muscular tissue. However, it is advisable to take supplements as prescribed. 

Stress management: A good night’s sleep, regular exercise, breathing techniques, socialising, and nurturing hobbies are the best ways to ensure that the body is well-rested and can regenerate scalp health.

Navigating female pattern baldness as a teenager or a young adult can be bumpy. It is a journey of highs and lows. With the right information and early intervention from a certified hair specialist, the condition can be well managed. 

Yes, female pattern baldness can be genetic. While certain genes linked to baldness are well-studied in men, the same links are not fully established in women.

Other causes of female pattern baldness include hormonal imbalance, inflammation of hair follicles, and environmental factors like stress, metabolic diseases, and lack of sleep.

Yes, female pattern baldness can start as early as in the 20s if it is impacted by genetics and hormones.

Yes, female pattern baldness and its causative factors, if left untreated, can move on to advanced stages and worsen.

Yes, female pattern baldness can be reversed with doctor’s therapy, good food, lifestyle modifications, and better sleep.

Female pattern baldness affects about 40% of women by the age of 50

Female hair pattern baldness affects the body emotionally by restricting one’s confidence to appear socially and can be traced to underlying health issues like hormonal imbalance, diabetes, etc.