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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Onion Juice for Hair loss treatment? It might sound surprising, but onion juice is considered a cheap home remedy for hair loss. In todays episode, am gonna reveal you the real facts on onion juice as a remedy for hairloss. The most important question whether it works for male pattern baldness, that’s androgenetic alopecia which is the most common cause of baldness and hair loss – over 90 percent of the cases.

Before I reveal you about the efficacy of onion juice for baldness and on which type of hair loss it really works and how? Lets quickly learn some different types of alopecia. Alopecia is a medical term for hair loss. Do not skip this topic, as this is important to understand the role of onion juice for hair fall treatment.

  1. Androgenic Alopecia – or hair loss caused by genetics, or family history. This is the most common type of hair loss pattern in men and also called male pattern baldness in males and again the most common cause of hair loss in women and is called female pattern baldness. We will discuss these types and stages of male pattern baldness in detail in some other episode.
  2. Alopecia Areata – This is a patchy hair loss and is an autoimmune disorder which causes the bodys own immune system to attack the healthy hair follicles. The exact cause of this remains unknown, but it is thought to be triggered by stress and traumatic events.
  3. Alopecia Totalis and Alopecia Universalis are rare types: Totalis means the patchy type of hair loss will make the scalp totally bald. Where as the Universalis means loss of all hair from the entire body including eyebrows, eyelashes and all body hair.
  4. Traction Alopecia: This type of hair loss occurs due to traction or excessive tension by pulling of the hair like when vigorously combing hair, applying some hair styling procedures and even tight braiding and tight ponytails.  This type of hair loss is usually reversible when you stop these bad habits that cause hair loss. Please watch my important episode on the 10 common habits that can cause hair loss in men and women from an end screen link after this video.

Now coming straight to the point! Now you know the types of hair loss, we will now know the real facts and myths on onion juice for baldness treatment.

Firstly Some Facts on Onions:

  1. Onions and even garlic contain sulfur, which is good for hair because the hair protein keratin need sulfur for its production. It is also said that the sulfur from onions may also help promote collagen production. Collagen in turn helps the production of healthy skin cells and hair growth.
    Here is the catch! You need dietary sulfur intake which is then carried through blood circulation into the hair bulb which then helps in promoting hair growth. So topical application of onion juice has absolutely no scientific basis.
  2. Other theories say that it has anti microbial and anti oxidant properties that help in hair growth.
  3. Some also say it increases blood circulation and promotes hair growth, but nothing is scientifically proved.
  4. And moreover, only one research study was conducted in 2002 on this onion juice and treatment of alopecia areata, mind you it was used only for patchy hair loss and not for the commonest androgenetic alopecia. In alopecia areata it was shown to give some successful results. Although the study said it showed positive results, it was tested in a small number of  only 38 participants.  I have linked two research articles on this topic and both say – the exact mechanism of action of onion juice for hair loss treatment is not known. So that says it all!

And No other scientific study has shown the effectiveness of onion juice for male pattern baldness or hair loss.  If you have patchy hair loss or even traction alopecia, it might work, whether due to a placebo effect or by other means, not sure!

References:   2002 study.

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Hello Friends and Patients! Today we will look into a proven Do It Yourself (DIY) hair loss treatment combination that really works to regrow hair in both men and women.  We will learn everything about the inexpensive Derma Rollers plus a miracle secret combo treatment that really works wonders to cure baldness. We will also learn How to correctly use derma rollers, What else you can get rid of using these simple microneedling devices, what precautions to take and other useful tips.


  1. What is a Derma Roller?Also called Derma rolling, Microneedling and also collagen induction treatment. It’s a simple DIY procedure in which thousands of tiny little needles are inserted into the surface of skin using a rolling or a stamping device. Do not get scared! Though it looks invasive and scary, the needles are just about 0.25 mm or 0.5 mm deep for the task. It can be safely used at home without any dermatologist consultation.


  1. What does this Derma Roller actually do – that is the Mechanism of Action ?

Rolling tiny needles on your skin induces minute microscopic wounds underneath the skin layers which induces collagen and elastin production.  We will not go into the detailed molecular level on how this happens. But Just remember two things that happen after Microneedling,
a] Neocollagenesis – meaning production of new collagen tissue under the skin and
b) Neovascularisation meaning formation of new blood vessels or capillaries which happen due to release of growth factors following needle piercing of the stratum corneum layer of the skin.


  1. What are the Medical Uses of Derma Rollers?

Apart from Hair regrowth and baldness treatment, its primarily used to treat:

  • Acne scar removal and also for
  • Facial Rejuvenation and anti aging treatment
  • Transdermal drug delivery – like PRP and mesotherapy can be combined with derma rolling.
  1. What size derma roller should I select?

Derma rollers size is based on its micro needle size ranging from 0.2mm to 3mm depending on what you want to treat. Like for removing deeper scars you may need deeper penetration. Never use deeper needles like 1mm or above without dermatologist consultation. And remember dermarollers greater than 0.3 mm in length are not approved by the FDA – Food and Drug Administration Department.

  1. What size is recommended for Hair loss Treatment?

For Hair growth to use it on a receding hair line or even to grow a patchy beard, you can use 0.25 mm weekly twice or 0.5mm derma roller weekly once. They come in stainless steel or titanium needles and Titanium needles are more durable.


  1. How to use Derma Roller for Baldness Treatment ?

Well, First of all you must remember to take some precautions on every use to avoid the chances of infection.

  1. Either use a fresh box packed derma roller every time or disinfect it by soaking in 70 percent isopropyl alcohol or rubbing alcohol, Soak it for approximately 10 to 15 minutes before every use. You can also use 6% hydrogen peroxide easily available at your local medical store. Its very inexpensive device and costs between 5 to 10 USD. You can purchase it even online, I have provided the links in description below.
    Well, the next precaution is:
  2. Never use somebody else’s derma roller on yourself. This can transfer infections including HIV, hepatitis B and hepatitis C, though its very rare if safety precautions followed properly.
  3. Also beware, some cheap quality derma roller needles can break into your skin, not too much to worry if its less than 0.5mm.
  4. Wash your face with a mild soap before starting the procedure.
  5. Local anaesthetic gel or cream or what you call as numbing cream is not required for 0.5mm or less micro needling because it will not cause any pain.
  6. HOW TO USE? Nothing complicated. Just place the device on your receding hair line or bald patch and roll it 6 – 10 times in each direction in different directions, just to make sure you are covering the entire skin for best results. Keep it like – one square inch every time, roll it in vertical direction 6 to 10 times – like 1 2 3 4 5 6 and then change to horizontal direction and roll again 6 to 10 times 1 2 3 4 5 6 and then optionally repeat in diagonally opposite directions. That’s it. The same derma rollers can be used for acne scar removal or depigmentation on face. You can additionally apply fresh aloe vera gel or vitamin C serum for much better results.


  1. Now Before the Secret Miracle combo treatment for Hair loss, I shall list out some side effects of this derma rolling:
  2. The area may develop redness for a couple of hours or more. That’s completely normal, nothing to panic.
  3. Skin may appear a bit swollen and hot for few hours.
  4. If irritation persists, please consults a doctor. Also do not use if you have bleeding tendencies.
  5. Now Finally, the Magical Treatment for Hairloss. Derma Roller combination with Minoxidil has shown great results according to a study. So Whats the protocol? You use a 0.25 or 0.3mm derma roller weekly once initially then weekly twice along with minoxidil solution. You can apply minoxidil before derma rolling or after derma rolling, It does not really matter. You should see the results in 3 to 6 months. This has also been successfully used in androgenetic alopecia, alopecia aerata and hair loss in women. You can also combine Mesotherapy with anti hair loss solution and PRP – that’s platelet rich plasma therapy with derma rollers. You can watch my detailed video on How PRP and mesotherapy is done from HERE.

Disclamier: Despite the fact that plasma needling is already being performed in many clinics and practices, the efficacy of this technique has yet to be confirmed in large-scale controlled clinical trials. Use at your own risk! All this information is  based on university research articles, the links are provided in the description of this video.


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