Female Pattern Hair Loss (FPHL)


Last updated: March 2024

Also known as: Androgenetic Alopecia in women

What is female pattern hair loss?

Female pattern hair loss (FPHL) is the term used to describe genetic hair thinning in females.

Who gets female pattern hair loss?

FPHL can affect women of any age but it is more common after menopause. Around 40% of women show signs of FPHL by age 50. 1

What causes female pattern hair loss?

Most women with FPHL have a genetic predisposition to this condition that could be inherited from either or both parents. However, some women with FPHL do not have any paternal or maternal family history of baldness.

At the scalp level, hair follicles are more sensitive to the effects of androgen hormones that are required to drive this condition. This does not imply any underlying hormonal abnormalities. In fact, the vast majority of women with FPHL have normal hormonal profiles. Routine hormonal testing is not required but may be recommended by your doctor if you have other signs of androgen excess such as acne, irregular periods, excessive body hair, etc.

FPHL is not caused by changes to your diet, infections or hair styling practices.

What does female pattern hair loss look like?

FPHL presents as generalised thinning of hair and widening of the scalp parting. Some affected women also experience thinning at the frontal hairline or temples. There may be an increase in hair shedding. These changes usually lead to a reduction of the hair volume that may be evident by a shrinking hair ponytail. Some women get episodic bursts of accelerated hair shedding for a few months in between longer stable periods of little activity.

How is female pattern hair loss diagnosed?

FPHL is usually diagnosed clinically. In some cases, a biopsy may be required to rule out other hair loss conditions that can mimic FPHL.

How is female pattern hair loss treated?

Treatment options will vary depending on the individual and their needs.

The main aim of FPHL treatment is to slow or halt the progression of hair loss. The secondary aim is to try and stimulate some hair regrowth. However, this may not happen for all individuals.

Treatment options may include:

  • topically applied products, such as minoxidil
  • oral tablets, such as spironolactone and cyproterone acetate or Androcur®
  • cosmetic camouflage techniques (i.e., . scarves, hats)
  • synthetic hair fibres such as Toppik ®

What is the likely outcome of female pattern hair loss?

On long-term or indefinite medical treatments, progression of FPHL can be slowed and hair regrowth is a realistic expectation of treatment for some women. Without treatment, diffuse hair thinning progresses and hairs become sparser with more scalp visibility over time.

  1. Famenini S, Slaught C, Duan L, Goh C. Demographics of women with female pattern hair loss and the effectiveness of spironolactone therapy. J Am Acad Dermatol. 2015 Oct;73(4):705-6. doi: 10.1016/j.jaad.2015.06.063. PMID: 26369846; PMCID: PMC4573453.
Dr Leona YipMarch 2024
Dr Leona YipNovember 2020


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