Stage wise Hair loss Treatment in Women – Female Pattern Baldness

In Today’s article, we will look into the stages of female pattern baldness and the best treatment options for hair loss in women. In my previous article, we discussed on the causes and mechanism of female hair loss and hair thinning and the telogen effluvium.

The pattern of hair loss in women is different from that in men. We have discussed male pattern baldness and its stage wise treatment in earlier episodes. Now we will discuss stages wise treatment of female pattern baldness – that’s again androgenetic alopecia.

The male pattern hair loss is typically seen at the front of the hairline and at the crown of the head, whereas women with androgenetic hairloss more often have diffuse thinning on all areas of the scalp but thinning starts typically at the front portion of the scalp.  Remember the reduction in hair thickness and density leads to a reduction in the overall hair volume.  But complete baldness in women is very rare.

The stages of hair loss in women is measured by different scales. One simple and the conventional scale used is the Ludwig’s scale. This scale has three stages. In all three stages, the hair line is preserved unlike the male pattern baldness, where hair line recedes and then completely lost.

Stage – 1: There is minimal thinning of hair at the front portion of the scalp as you can see in the illustration. This type of hair loss can be easily covered or hidden by hair styling techniques. But this does not mean that you should not start treatment at this stage.  We will discuss treatment options later.

Stage – 2: There is moderate thinning and noticeable widening of the mid-line part.

Stage – 3: There is much more diffuse thinning, with a see-through appearance on the top of the scalp or the thinning is seen over the entire scalp.

Now lets discuss on the treatment options for hair loss in women.

Firstly you need to confirm this is androgenetic alopecia and rule out other causes of hair loss like PCOS, thyroid disease and other causes as discussed in my previous article.

The first line of treatment for female pattern baldness is:

  1. MINOXIDIL solution: This is the first and foremost medication used for the treatment of hair loss in females as well as males and easily available over the counter medication without any prescription. This is an FDA approved medication for hairloss. In women generally 2 % or 5 % minoxidil applied on the affected area of scalp once or twice daily is used. 2 % is used for the treatment of Stage 1 and 5% solution is used for stage 2 and 3 . This is important to prevent you from going into stage 2. The higher the stage, the more difficult the treatment is. And remember minoxidil is not a miracle drug. You need to consistently apply it for alteast 3 to 6 months to see some obvious improvement. If minoxidil works for you, then you need to keep using it daily to maintain those good results. If you stop abruptly, you’ll start to lose hair again. Also You must know how to properly use minoxidil solution. Use the dropper or the spray pump and apply on a dry scalp on the affected area and gently massage with your fingers in a circular movement. Do not over do it and also prevent it from going into your eyes. Then wash your hands thoroughly after use. Do not shampoo you hair for at least four to six hours after application. If this is causing irritation on you scalp, then its more likely a contact dermatitis. You might need to consult your doctor. It actually not caused by minoxidil, but the alcohol content in minoxidil solution causes this irritation.
  1. Anti Androgens: This type of treatment has to be taken by consulting your doctor. Some women who don’t respond to minoxidil are prescribed with the anti-androgen drug spironolactone for treatment of androgenic alopecia. This is usually prescribed to women with polycystic ovary syndrome (PCOS) because they tend to make excessive androgens that cause hairloss as discussed in my previous episode.


  1. Hair transplantation: This is the final option, if no treatment works.



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10 Causes of Hair loss and Hair Thinning is Women | Telogen Effluvium

We will list out the 10 common causes of hair loss in women in this video. Whether its hair thinning or baldness in women, the common reason is female pattern baldness or androgenetic alopecia.

For most women, hair is more important than anything else on their body. Its an expression of their style and personality. Women are more sensitive than men and hence Hair loss in women can be absolutely devastating for self-image and emotional well-being.
So, Hair loss is n’t just a male problem. Women also lose hair the same way men do, but the percentage of females affected by baldness or hair loss or hair thinning is lesser when compared to males.  Its only about 10 percent in the third decade of life. But still its significant because only 45% of women will maintain a full head of hair throughout their lifetime. The pattern of hair loss in females is little different than male pattern baldness.

Causes of Hair loss in Women:

Remember loosing some hair daily is absolutely normal. So do not panic if you loose 50 to 100 hair strands daily.  I have discussed in detail about all this stuff in my previous hair loss articles.

  1. Genetic / Androgenetic alopecia or the female pattern baldness. Yes this is the most common type of hair loss even in women like the male pattern baldness. So what is the mechanism of action. Its pretty much similar to male pattern alopecia – the culprit is again DHT – the di hydroxytestosterone which is produced from testosterone. Normally even females have small amount of testosterone in their blood. The problem starts when this is converted to DHT in your body and again in genetically predisposed females and depending on the sensitivity of hair follicles to DHT the damage begins – that is the miniaturization of hair follicles. This can be even more aggravating in disorders of hormonal imbalances like PCOD where there is even more testosterone available for conversion to DHT which speeds up hair loss.
  2. Thyroid Disorders: Both hyperthyroidism and hypothyroidism can cause hair loss or hair thinning. This is easy to diagnose. Watch out for the unique signs and symptoms of thyroid disease and get a simple blood test to check the levels of thyroid hormones.
  3. PCOS or PCOD: Polycystic Ovarian Syndrome or Poly cystic ovarian disease is another common cause of hair loss in women. This is very easy to diagnose with classical signs and symptoms like hirsutism – meaning abnormal facial hair growth in women. Also Acne or pimples and irregular or delayed periods. A simple pelvic ultrasound and hormone tests including serum FSH, LH, testosterone and oestrogen levels may help in diagnosing this condition and then start early treatment.
  4. Pregnancy and Child birth is another hormonal cause for hair loss or hair thinning. But most of these hormonal imbalances are generally reversible on treatment.
  5. Oral Contraceptive pills can also trigger hair loss due to hormonal imbalances.
  6. Other medications like blood thinners and medicines that treat high blood pressure, heart disease, arthritis, and depression can all lead to some amount of hair loss in women.
  7. Dieting or Crash diets: This is becoming another common reason for hair loss in women caused by nutritional deficiencies. The deficiencies can be from one or more element like Protein deficiency and also Vitamin A, D and b12 deficiency or even iron deficiency. But this type of hair loss can be easily reversed with nutritional foods that promote hair growth.
  8. Traction Alopecia: This is again very common due to traction or pulling of hair from bad hair styling like tight braiding or tight pony tails or even from bad hair styling options.
  9. Chemotherapy for Cancer treatments is another important cause, but do not worry, this is not permanent form of hair loss.
  10. Stress: This is actually an important factor often ignored. Not only emotional stress but also stress from trauma or illness or surgery and stuff like that can cause hair loss, but again its temporary and reversible. Last but not the least
  11. Alopecia areata or pathy hair loss is not uncommon in women. As discussed in my earlier artilces, its an auto immune condition where hair follicles are damaged by body’s own immune response.

What is Telogen effluvium?  Most of the causes I discussed except androgenetic alopecia and alopecia areata, the hair loss is temporary and reversible and all these factors may cause telogen effluvium. This is a form of temporary hair loss where the anagen phase of hair growth cycle slows down, meaning that fewer hairs enter the next two stages. But hair grow back within 3 to 6 months after the cause has been dealt with. You can check my animated video and article explaining the hair growth cycle here.  Also next article is on Female Pattern baldness Treatment with Stage wise treatment.

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