When we speak of female pattern hair loss, we mean female androgenetic alopecia: a progressive hair loss, localised on the top of the scalp, that sets in with time. It is not to be confused with diffuse, temporary shedding.
In this article you will find what is visible, how to recognise it in yourself with two simple tests, which stage you are at, what is really possible, and when to consult.
Female pattern hair loss: what exactly are we talking about?
Androgenetic alopecia affects only the top of the scalp, according to VIDAL. The French Society of Dermatology, through Dermato-INFO, points out that it rests on three inseparable factors: androgens, genetic predisposition and time. Dermato-INFO adds that it is not a disease in the strict sense, but a natural, frequent process that worsens with age. Diffuse shedding and female pattern hair loss are not managed in the same way: the first is often temporary, the second sets in and is managed over months.
The risk therefore climbs with the years. The table below sets out two published series. They come from two different sources, and they must not be mixed.
| Landmark | Share of women concerned | Source |
|---|---|---|
| By the age of 29 at the latest | 12% | CMAJ, 2026 |
| By the age of 50 at the latest | 25% | CMAJ, 2026 |
| At 70 and over | 41 to 50% | CMAJ, 2026 |
| Around 40 | 1 woman in 5 | VIDAL |
| Around 60 | 1 woman in 4 | VIDAL |
VIDAL points out that it can appear at any age, sometimes from puberty, and that it most often sets in after the menopause. It is generally more marked in spring and in autumn. VIDAL also puts at 80% the share of lasting hair loss in women.
For diffuse shedding, which is a different subject, read hair loss in women: the other causes.
Female pattern hair loss symptoms: what you see
In women, the front hairline is most often preserved. What changes is the parting, which widens, and the hair on top, which becomes finer and less dense. According to the CMAJ review, the loss comes from a progressive miniaturisation of the hair, and its distribution differs from the male pattern. Dermato-INFO notes that complete loss remains rare. VIDAL describes a diffuse loss over the whole of the top, with hair that persists but thinned, never becoming complete. In short, female hair thinning shows on the top and at the parting, not at the hairline.
You can check a first sign yourself with the parting test. Part your hair down a central parting, then compare the width of that parting with the width of the parting at the back of the scalp, an area usually spared. A central parting clearly wider than the back one deserves to be checked. This test makes no diagnosis: it only helps decide to consult.
A rarer form starts at the temples. Ludwig, in 1977, described cases where the recession is deep at the temples and follows the male pattern. According to the same author, these women have testosterone levels comparable to those of men, which justifies mentioning it to a doctor (Ludwig, 1977).
For the visual side, such as haircuts or camouflage, read thinning hair in women.
Female pattern hair loss: which causes, and which are not causes?
The three factors already mentioned explain female baldness. Heredity is a risk factor, and the CMAJ review also cites endocrine disorders: PCOS, adrenal hyperplasia, or certain ovarian and adrenal tumours. Before retaining that diagnosis, the CMAJ review asks for telogen effluvium — a diffuse loss linked to a passing trigger — to be ruled out.
In women, aromatase, an enzyme, converts part of the testosterone into oestrogens. This reduces the formation of DHT. Dermato-INFO concludes that female androgenetic alopecia is generally less severe than the male form.
Some factors favour or worsen the loss: the menopause, PCOS, certain contraceptive pills, a lack of iron or of vitamin B12, and certain medicines, according to Dermato-INFO. VIDAL adds menopausal hormone therapy and oral contraceptives.
Stress calls for a nuance. Dermato-INFO judges its role modest. VIDAL says only that stress and excess cholesterol could count among the risk factors.
Several received ideas hold on in conversation. Dermato-INFO reminds us that a cap does not make baldness worse. Shaving the head does not strengthen it, and a haircut at the full moon is of no use.
For the causes of diffuse shedding, read hair loss: causes and when to worry.
Which stage are you at? Ludwig's three grades
In 1977, Ludwig classified female baldness in three grades, starting from the crown of the scalp (Ludwig, 1977).
Grade I: perceptible thinning of the crown, limited at the front by a line 1 to 3 cm behind the frontal hairline.
Grade II: pronounced rarefaction in that same zone.
Grade III: complete denudation of that zone, the frontal fringe remaining preserved.
Ludwig also describes the crown area, surrounded by a band of dense hair: a frontal fringe of 1 to 3 cm and a temporo-parietal band of 4 to 5 cm (Ludwig, 1977).
Ludwig points out that, in some women, often not before the menopause, the crown can become literally bare, the frontal edge staying in place. According to VIDAL, what does not happen is the complete loss of the hair.
Dermato-INFO finally reminds us that the male and female patterns are not strictly reserved to one sex. A woman can therefore present a form usually associated with men, and the reverse. The Ludwig scale describes the three grades, and a grade announced without an examination decides nothing.
Reversible female androgenetic alopecia: what can be hoped for?
The short answer fits in two sentences. Female androgenetic alopecia can be slowed down, and a partial regrowth sometimes occurs. But the effect depends on continuing the treatment: once stopped, the loss resumes, according to Dermato-INFO.
Allow 6 to 12 months before judging a response, with sometimes a transient loss at the start, according to the CMAJ review. Many women give up too early, before the result can be read.
The limit is clear. Dermato-INFO explains that the miniaturisation of the hair can go as far as down. When there is almost no hair left to densify, no cosmetic will regrow an area that has been bare for a long time.
When to consult, and which examinations really help
Consult without waiting if the loss is sudden, if patches without hair appear, or if the scalp itches, burns or hurts. The CMAJ review then recommends a dermatological opinion. Irregular periods or other signs of an excess of androgens also deserve a work-up with a doctor.
The diagnosis remains clinical, that is to say based on the examination, according to CMAJ. A scalp biopsy is usually not indicated, still according to CMAJ. Dermato-INFO adds the dermatoscope: it shows hairs of different diameters, which is called anisotrichosis. A trichogram can be requested where there is doubt.
The pull test consists in gently pulling a small strand. According to CMAJ, six hairs or more that come away easily signal a positive test. In androgenetic alopecia, however, the test is often negative or limited to the centre.
For blood tests, the rule is simple. Ferritin and TSH are only requested if another diagnosis is suspected. A measurement of androgens is generally normal, therefore useless, according to CMAJ. Dermato-INFO judges the blood work-up generally useless and reserves the hormonal work-up for certain situations.
The most useful gesture fits in a photo. Take one every month, in the same light and with the same parting, to follow the progression. Dermato-INFO recommends these standardised photos as a follow-up tool. CMAJ also judges it justified to screen for depression and anxiety, because hair loss weighs on morale.
What can help: treatments and cosmetics
On the medication side, the CMAJ review cites two first-line treatments: minoxidil applied topically and spironolactone taken orally. They are prescribed. The choice is made with a doctor, who takes your situation into account. Their effect is judged over several months, and most are contraindicated during pregnancy. A transplant can be discussed with the doctor when the loss remains localised. For the full range of options, read hair loss treatment.
The Cochrane review by van Zuuren and colleagues, published in 2016, compiled 47 trials and 5,290 participants (van Zuuren, 2016). Topical minoxidil is the best-supported intervention: moderate to marked regrowth is nearly twice as frequent as with a placebo. Finasteride, for its part, is no more effective than a placebo.
A cosmetic replaces neither a diagnosis nor medical advice. The ORVOVA Roll-On Hair Growth Serum combines 4 dosed actives: rosemary at 3%, Redensyl at 3%, Aminexil at 2% and Anagain at 2%. Its 25 ml roll-on, with a massaging ball, is used once a day, morning or evening, without rinsing, on a clean or dry scalp, which is about one month of use. The ball is there to apply the serum and spread it. According to the brand, the first small hairs appear between 6 and 8 weeks, and the complete cycle is judged over 3 months. It is intended for men as well as women, all hair types, and it contains no minoxidil and no hormones.
For the whole range, see all our hair care.
Frequently asked questions about female pattern hair loss
What causes baldness in women?
Three factors combine: androgens, a genetic predisposition and time, according to Dermato-INFO. Hormonal disorders, such as PCOS, can also play a part, according to the CMAJ review.
How do you know if you have androgenetic alopecia?
Do the parting test and the pull test described above, then keep a monthly photo. The diagnosis remains clinical and belongs to the doctor, often a dermatologist. A widening parting that keeps getting wider from one month to the next is a good reason to consult.
Does hair grow back after androgenetic alopecia?
A partial regrowth is possible, and the progression can be slowed, provided the treatment is continued. Allow 6 to 12 months before judging the response. Every situation is followed with a doctor.
Female pattern hair loss: what percentage of women is concerned?
According to the CMAJ review, 12% of women are concerned by the age of 29 at the latest, and 25% by the age of 50 at the latest. VIDAL gives 1 woman in 5 around 40. The table above presents both series, without an average.
Can an anti-hair-loss serum be enough on its own?
No. A serum is a cosmetic: it supports density, it replaces neither a diagnosis nor medical management. If the parting keeps widening month after month, start with a dermatological opinion rather than piling up products.
In short
Female pattern hair loss is an androgenetic alopecia: progressive, localised on the top of the scalp.
The parting test and the pull test help decide to consult. They do not make a diagnosis.
Treatments are judged over several months, with a doctor.
