Alopecia advice: Pattern Hair Loss
All information is taken from the Alopecia UK website (with permission). For more help and advice on alopecia, visit the Alopecia UK.
What is pattern hair loss?
Pattern hair loss is the most common type of hair loss. It occurs in both men and women and becomes more common with increasing age. Around 50% of men over 50 and 50% of women over 65 are affected, though it can also start in younger adults and occasionally in early teen years.
Male pattern hair loss refers to the typical form of male balding where the frontal hair line recedes (moves back) and there is progressive balding over the top of the scalp.
In female pattern hair loss there is a more diffuse (spread out) pattern of thinning over the front and top of the scalp, but the hairline at the front typically does not recede. It is rare for this process to progress to complete balding.
As these names suggest, male pattern hair loss happens mainly in men and female pattern happens mainly in women, but sometimes a female pattern is seen in men and a male pattern in women.
What causes pattern hair loss?
In pattern hair loss, the hair follicle shrinks over time in a process called miniaturisation. The hair follicle is the mini-organ in the skin that produces the strands of hair. When it shrinks, the hairs growing from it gradually also become shorter and thinner, which can make the skin underneath more visible.
Pattern hair loss is often referred to as Androgenetic Alopecia (AGA). This is because male balding is caused by a combination of genetic factors and hormones known as androgens. The most important androgen in men is testosterone. This is converted to another androgen called dihydrotestosterone (DHT) which causes the balding process.
Pattern hair loss in women is also sometimes called AGA. While it is possible for pattern hair loss in women to be caused by high androgen levels, this is not the case for most women. Most women with pattern hair loss do not have hormonal abnormalities and other factors may be involved, including genetic or environmental factors (influences from outside the body). For this reason, the term female pattern hair loss is now preferred for this condition.
How is pattern hair loss diagnosed?
A General Practitioner (GP) or dermatologist can usually diagnose pattern hair loss by examining your scalp and hair loss pattern. They may also recommend tests to check:
- Hormone levels
- Iron stores (serum ferritin)
- Thyroid function
These tests help rule out other causes of hair loss.
Treatment options for pattern hair loss
Early treatment is often more effective, especially in younger patients with recent hair thinning. While there is no cure, there are some licensed treatments that can slow or prevent further hair loss and promote some regrowth:
For Men:
- Oral finasteride (available via private prescription only)
- Topical minoxidil solution or foam (available over-the counter, not on NHS prescription)
For Women:
- Topical minoxidil solution or foam (available over-the counter, not on NHS prescription)
- Low dose oral Minoxidil
- Anti-androgens such as the combined oral contraceptive pill, spironolactone
Other treatments for which there is some evidence of benefit in pattern hair loss include low-level laser light, platelet-rich plasma injections (PRP) and microneedling.
Hair transplantation can restore hair in thinning or bald areas, however continued treatment is needed to maintain the hair after it is restored. Find out more about hair transplantation surgery here.
Is pattern hair loss inherited?
Pattern hair loss often runs in families, which indicates that there is a strong involvement of genetics. However, the inheritance is complex and although having a close relative with pattern hair loss increases your risk, it does not guarantee you will develop it.
Male pattern hair loss is polygenic, meaning it is due to the action of multiple genes, each of which individually has only a small effect. Genetic research of female pattern hair loss is less advanced, and currently only one of the genes identified in male pattern hair loss has also been linked with female pattern hair loss.
Additional Information:
The British Association of Dermatologists have produced patient information leaflets about male and female pattern hair loss.
READ THE BAD PATIENT INFORMATION LEAFLET FOR MALE PATTERN HAIR LOSS
READ THE BAD PATIENT INFORMATION LEAFLET FOR FEMALE PATTERN HAIR LOSS
The British Hair and Nail Society also provide some useful information about the condition:
