What causes female hair loss and why is it still so misunderstood?

*Heather’s hair was always thin, but in the summer of 2020, she noticed it was also falling out. Under the unforgiving glare of a bright bathroom mirror light, she parted her hair in a panic to reveal sparse patches of scalp. 

“It’s like I haven’t been the same person since. I know it’s only hair, but it’s also all I can think about. Why it’s happened, how to fix it, how I can ever feel confident in myself again,” the 32-year-old writer told Euronews Health. 

Approximately one-third of women will experience some form of hair loss, known as alopecia, in their lifetime, according to Harvard Health. This number increases to as many as two-thirds in post-menopausal women.

Compared to male pattern balding, female hair loss is under-researched and underfunded, experts say.

“Most hair loss research historically focused on male pattern baldness due to the high prevalence and visibility of the condition,” said Dr Zainab Laftah, a consultant dermatologist at Healthcare UK The Shard. 

“As a result, there has been a greater emphasis on understanding male-specific hormonal mechanisms and developing treatments targeted primarily for men. Female hair loss, which can have a more diffuse and complex presentation involving different hormonal and environmental factors, has received relatively less attention,” she added. 

In recent years, the condition’s ubiquity has come to light through women forming online spaces for discussion, including Facebook groups and the subreddit r/femalehairloss, which has over 56,000 members. 

“Finding these communities has helped me immensely,” Heather said.

“Just being able to openly talk to other women that are going through the same experience and actually understand what it’s like has been very comforting, especially because most hair loss support groups are dominated by men”. 

She noted, however, that spending too much time in these groups can sometimes be detrimental to her mental health. 

“Due to there still being no clear solutions to female hair loss, discussions can turn into endless ruminations that keep you too focused on the problem and lead to feeling even more hopeless,” she said.

What causes female hair loss?

Every day, most of us will lose between 50 and 100 hairs without realising it, according to the UK’s National Health Service (NHS). 

When hair loss becomes more severe, it is usually diagnosed as one of three main conditions, each with different triggers and treatment options. 

The most common is androgenic alopecia or female pattern hair loss, which is characterised by a widening of the mid-hair parting and gradual thinning along the crown and temples. 

“Hormonal changes, such as those seen in menopause or thyroid disorders, can also contribute significantly. Often there is a genetic component,” Laftah said. 

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Telogen effluvium is a temporary form of hair loss, triggered by a stressful event such as illness, rapid weight loss or pregnancy that results in excess shedding of hair follicles entering the telogen or resting phase of the hair growth cycle.

Once the underlying stressor is resolved, the hair should grow back. 

The third condition is alopecia areata which is an autoimmune disease.

It’s where “the immune system mistakenly attacks the hair follicles, leading to sudden hair loss in small, round patches on the scalp or other parts of the body,” Laftah said. 

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The psychological impact

While female hair loss can sometimes be linked to an underlying medical condition or treatment, it is most often harmless. The psychological toll tends to be the most difficult aspect.  

“The mental effects of hair loss have been enormous. My life was basically gone,” said *Martha a 20-year-old student who started losing her hair at just 15. 

“I get really anxious about it at times and am quite paralysed. I am slowly getting better though. My mother is now supportive. I can speak to her more openly about this and that makes it a bit better,” she said. 

With the condition less talked about or seen, many women with hair loss tend to feel very alone, either isolating themselves or struggling to come to terms with their self-image. This is exacerbated by the social stigma surrounding unfair beauty standards imposed on women, they say. 

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“It sometimes makes me feel worse as a woman, because society has this image of full beautiful hair being a sign of femininity, and I don’t have that, and that feels like I failed as a woman,” said *Carla a 31-year-old office administrator who has androgenic alopecia.

Social media hair loss influencers, like Olivia Mcveigh, who shares wig styling tutorials to her over 200,000 followers on TikTok, are working to combat this mindset, bringing greater awareness to the condition and promoting acceptance. 

“Following these accounts reminds me that it is totally possible to live a full and happy life despite hair loss,” Heather said. 

“I even purchased my first wig because of it, and although I’m still nervous to wear it out in public, as soon as I tried it on I felt this overwhelming relief. For a moment, I felt confident in my own skin again”. 

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How is female hair loss treated?

While dependent on the type of hair loss, the main treatment for female androgenic alopecia is topical Minoxidil, a blood pressure medication that was found to stimulate hair growth as a side effect. 

“Oral medications like spironolactone, which reduces the effects of androgens, and low-dose oral minoxidil can also be prescribed off-label,” Laftah said. 

However, these treatments are not guaranteed to work for everyone and can be expensive. Once stopped, the hair loss will return. 

Laftah added that other hormonal treatments such as oral contraceptives or hormone replacement therapy (HRT) might be recommended if the hair loss is caused by a hormonal imbalance such as polycystic ovary syndrome (PCOS). 

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Earlier this year, a pill called ritlecitinib, which is marketed as Litfulo, was recommended on the NHS for the first time as a treatment for alopecia areata.

Known as a Janus kinase (JAK) inhibitor, it works by “targeting the inflammatory pathways involved in autoimmune hair loss”.

Laftah also noted that research involving stem cell therapy and exosome therapy – both of which aim to stimulate hair follicles at a cellular level – is ongoing, along with the development of anti-androgen creams. 

*Names have been changed at the request of interviewees.

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