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Getting to the Root of Hair Loss in Women

Hair restoration physicians stress importance of medical evaluation and early intervention during National Hair Loss Awareness Month

by Staff
August 11, 2025
Woman looking sad

When it comes to hair loss, women usually experience diffuse thinning at the top of the head – especially along the part line – without significant hairline recession.

Pixabay

6 min to read



For many women, the first noticeable signs of hair loss can be subtle: more hair on the hairbrush, thinner ponytails, a widening of their part line, or increased scalp visibility under bright lighting. Yet for other women, massive shedding in a short period of time can raise considerable concern.

Now, in observance of National Hair Loss Awareness Month in August, a hair restoration expert with the International Society of Hair Restoration Surgery (ISHRS) explains the different types of female hair loss and how advancements in medical and surgical treatment options available to women are leading to improved outcomes.

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“It is important to understand that male and female hair loss often differ in both pattern and progression,” said ISHRS member Dr. Nina Otberg, a dermatologist and hair transplant surgeon in Berlin, Germany. “In men, the pattern typically presents as a receding hairline and thinning at the crown, eventually leading to baldness. In contrast, women usually experience diffuse thinning at the top of the head – especially along the part line – without significant hairline recession. Unlike in men, complete bald areas are rare in women.”

How Genes Influence Female Pattern Hair Loss

The most common type of hair loss in women is female pattern hair loss, which involves a shortening of the hair’s growth (anagen) phase. In other words, the hair doesn’t grow as long as it used to. With each new hair cycle, the hair shaft becomes thinner. Since not every hair is affected equally, early signs of hair loss can be subtle.

Dr. Otberg explained that much like in men, genetics appear to play a significant role in female pattern hair loss. For example, if a woman’s mother, father or grandparents experienced thinning hair, she may be more likely to develop thinning hair as well. However, female hair loss tends to be more complex, often involving hormonal and environmental factors in addition to genetics.

Sudden Shedding Could Indicate Telogen Effluvium

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One of the most common forms of non-scarring hair loss is telogen effluvium, which is characterized by unexplained, massive shedding. Telogen effluvium can be triggered by a wide range of underlying factors, including:

  • Menopause

  • Nutritional deficiencies (iron, B12, vitamin D, biotin, protein, zinc, selenium)

  • Chronic stress or oxidative stress

  • Pregnancy and postpartum hormonal changes

  • Hormonal fluctuations during perimenopause and post menopause

  • Thyroid disorders

  • Autoimmune diseases

  • Polycystic ovary syndrome (PCOS)

In the case of the different stages of menopause, Dr. Otberg explained that the hormonal changes occurring can impact the hair growth cycle. For example, progesterone levels initially decline, followed by a drop in estrogen levels – which can disrupt hair growth and trigger thinning, particularly in women already predisposed to female pattern hair loss. Treatment options for menopausal-related hair loss may include hormone replacement therapy (HRT), topical minoxidil, or other individualized therapies depending on a patient’s health history and goals.

“Many women are unaware that menopause and certain conditions or underlying factors can significantly impact hair health, which is why a thorough medical evaluation and diagnosis are essential,” said Dr. Otberg.

Feeling the Heat from Styling Tools

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Excessive heat from flat irons, curling irons, or chemical treatments like relaxers and bleach can damage the hair shaft and lead to breakage or traction alopecia (a type of hair loss caused by repeated pulling on the hair from certain hairstyles such as braids). Dr. Otberg noted that the good news is that this type of damage is often reversible – provided that the hair follicles are still intact and the damaging practices are discontinued promptly.

Hair Transplants Offer a Permanent Solution

According to results of anew member surveyconducted by the ISHRS, more women turned to hair transplants as a permanent solution for hair loss, as the number of female hair restoration surgical patients treated by ISHRS members worldwide in 2024 increased by 16.5% from 2021.

Dr. Otberg explained that while hair transplants can be an effective option for women and produce permanent, natural-looking results, a thorough consultation is necessary to ensure a woman is a good candidate for this surgical procedure. For example, women with stable, localized thinning (especially at the frontal scalp or temples) and good donor hair tend to have the best outcomes from hair restoration surgery – especially when combined with ongoing medical therapy.

“Continual refinements in the art and science of hair restoration surgery have made this option appealing to women experiencing hair loss who want permanent results that are virtually undetectable,” said Dr. Otberg. “In our practice, we have observed a notable increase in female patients – likely driven by better public awareness and education, more available treatment options, and a reduction in the stigma surrounding hair loss.”

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Non-Surgical Treatment Options Expanding

For women who are not good candidates for a hair transplant or want a less invasive treatment option, non-surgical therapies offer effective alternatives depending on the type and extent of hair loss. Significant advancements in non-surgical treatments for hair loss include:

  • Topical and low-dose oral minoxidil

  • Low-level laser therapy (LLLT)

  • Platelet-rich plasma (PRP) injections

  • Anti-androgen medications, such as spironolactone

Dr. Otberg shared that other options such as DHT blockers and hormonal therapies may be considered, although these are less extensively studied in women.

Supplements Alone are not the Answer

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While the market for hair supplements has exploded in recent years, high-quality studies on supplement efficacy to combat hair loss are limited. Supplements such as biotin, vitamin D, and iron may help, but only if deficiencies in these supplements are confirmed by testing.

“Supplements alone will not reverse female pattern hair loss, and women should be cautious of marketing claims and consult a hair restoration physician to ensure that any supplement use is based on actual nutritional needs identified through testing,” said Dr. Otberg. 

Treating Hair Loss Worth the Investment

Hair loss in women is not simply a cosmetic issue – it can be a signal of deeper health concerns driven by hormones, stress, nutritional deficits, or genetics that should be investigated. Since hair is strongly tied to a woman’s identity and self-esteem, regaining control over hair health with an effective medical or surgical treatment option can have a profound psychological benefit.

“Hair disorders in women remain underdiagnosed and undertreated, yet many women feel more empowered and reassured once they understand the cause of hair loss and begin treatment,” said Dr. Otberg. “Greater awareness, better access to care, and earlier intervention can help women reclaim both their hair and their confidence.”

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About the ISHRS: The International Society of Hair Restoration Surgery (ISHRS) is a global non-profit medical association and the leading authority on hair loss treatment and restoration with 1,200 members throughout 80 countries worldwide. Above all, the ISHRS is dedicated to achieving excellence in patient outcomes by promoting the highest standards of medical practice, medical ethics, and research in the medical hair restoration industry. The ISHRS also provides continuing medical education to physicians specializing in hair transplant surgery and is committed to delivering the latest information on medical and surgical treatments to consumers suffering from hair loss, and most commonly from androgenetic alopecia – male pattern baldness and female pattern hair loss. It was founded in 1993 as the first international society to promote continuing quality improvement and education for professionals in the field of hair restoration surgery. For more information and to locate a physician, visitwww.ishrs.org.

About the Survey: Conducted by Relevant Research Consulting of Evanston, IL, USA, the ISHRS 2025 Practice Census is a compilation of information provided solely by participating physicians. The information published in this survey was developed from actual historical information and does not include any projected information. The margin of error for the sample is within plus or minus 5.4 percent at the 95 percent confidence level. For a full reprint of the ISHRS 2025 Practice Census Report, visit Hair Restoration Statistics.

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