What Actually Works for Thinning Hair in Women
Female hair loss carries a unique emotional weight. Whilst society often accepts balding as part of being male, women are expected to maintain thick, lustrous hair throughout their lives. When thinning begins, it can feel isolating and deeply distressing.
If you're noticing a wider parting, more scalp visible through your hair, or strands that seem finer and more fragile, you're not imagining it. Female pattern hair loss affects roughly one in four women by age 50, yet many suffer in silence, unsure where to turn for help.
This guide explains the biological reasons women lose hair, separates evidence-based treatments from marketing hype, and offers a practical roadmap for addressing thinning before it becomes irreversible.
Why Women Lose Hair Differently Than Men
Women and men experience hair loss through overlapping but distinct mechanisms. Understanding these differences is essential for choosing the right treatment approach.
Androgenetic alopecia (female pattern hair loss) is the most common cause. Like men, women produce androgens, including testosterone and its more potent derivative, dihydrotestosterone (DHT). In genetically predisposed individuals, DHT binds to receptors in hair follicles, causing them to shrink gradually. However, women typically retain their frontal hairline whilst experiencing diffuse thinning across the crown and midscalp. The classic "male pattern" of a receding hairline and bald spot is rare in women.
Hormonal fluctuations play a significant role. Pregnancy, childbirth, menopause, and conditions like polycystic ovary syndrome (PCOS) all disrupt the delicate hormonal balance that regulates hair growth. During pregnancy, elevated oestrogen prolongs the growth phase of hair follicles, leading to thicker, fuller hair. After delivery, oestrogen levels plummet, and large numbers of follicles enter the shedding phase simultaneously, a condition called postpartum telogen effluvium. This intense shedding usually resolves within six months but can be alarming.
Menopause brings a different challenge. As oestrogen declines, the protective effects against DHT weaken, allowing androgenetic hair loss to accelerate. Simultaneously, declining oestrogen reduces the overall thickness and density of individual hair strands.
Iron deficiency is particularly common in women and directly impacts hair growth. Ferritin (stored iron) levels below 40 ng/mL are associated with increased hair shedding and slower regrowth. Menstruation, vegetarian diets, and certain medical conditions deplete iron stores, making supplementation a critical first step for many women experiencing hair loss.
Thyroid dysfunction affects roughly 8% of women and often manifests as hair thinning. Both hypothyroidism (underactive thyroid) and hyperthyroidism (overactive thyroid) disrupt the hair growth cycle. If you're experiencing hair loss alongside fatigue, weight changes, or sensitivity to temperature, request thyroid function tests from your GP.
The Importance of Early Diagnosis and Blood Work
Before pursuing any treatment, it's essential to understand what's driving your hair loss. A comprehensive blood panel can identify correctable deficiencies and medical conditions that require specific interventions.
Request tests for ferritin (iron stores), thyroid-stimulating hormone (TSH), free T3 and T4 (thyroid hormones), vitamin D, vitamin B12, and a full blood count. If you have irregular periods, acne, or excess facial hair, ask for tests to evaluate PCOS, including testosterone, DHEA-S, and fasting glucose.
If blood tests come back normal, androgenetic alopecia is the most likely diagnosis. A dermatologist or trichologist can confirm this through scalp examination and, if necessary, a scalp biopsy (though this is rarely required).
Treatments That Genuinely Work for Female Hair Loss
Not all hair loss treatments are created equal. Some have robust clinical backing, whilst others rely on testimonials and clever marketing. Here's what the evidence supports.
Topical minoxidil is the only over-the-counter treatment approved for female pattern hair loss. It works by prolonging the anagen (growth) phase of hair follicles and increasing blood flow to the scalp. Women typically use the 2% or 5% formulation applied once or twice daily.
Clinical trials show that 60-70% of women experience at least moderate regrowth after six months of consistent use. However, minoxidil doesn't cure hair loss. Stopping treatment leads to shedding within a few months, as follicles revert to their baseline state. Common side effects include scalp irritation and, occasionally, unwanted facial hair growth if the solution drips onto the face.
Platelet-rich plasma (PRP) therapy has emerged as one of the most effective treatments for female pattern hair loss. PRP involves concentrating platelets and growth factors from your own blood and injecting them directly into the scalp. These growth factors stimulate dormant hair follicles, prolong the growth phase, and increase hair density.
A prospective study published in Dermatologic Surgery followed women with androgenetic alopecia who received PRP injections. After three treatments spaced one month apart, hair density increased by an average of 19 hairs per square centimetre, with hair follicle counts rising by approximately 15 follicles per square centimetre. Results were maintained at the six-month follow-up, with most participants reporting high satisfaction.
PRP works particularly well for women because it addresses multiple aspects of hair loss simultaneously. It reduces inflammation around the follicles, improves blood supply to the scalp, and directly stimulates cellular regeneration. Because it uses your own blood, allergic reactions are virtually nonexistent. Side effects are minimal, typically limited to mild swelling or tenderness at injection sites for a day or two.
Oral spironolactone is an anti-androgen medication that blocks DHT receptors, preventing the hormone from shrinking hair follicles. It's particularly effective for women with PCOS or other conditions involving elevated androgens. However, it requires ongoing use and regular monitoring by a GP or dermatologist, as it can affect potassium levels and blood pressure.
Iron supplementation is essential if your ferritin levels are low. Aim to raise ferritin above 70 ng/mL for optimal hair growth. Iron supplements should be taken with vitamin C to enhance absorption and away from calcium, tea, or coffee, which inhibit absorption. Improvement typically takes three to six months.
Finasteride is sometimes prescribed off-label for women, particularly postmenopausal women, but it's controversial. Finasteride blocks the enzyme that converts testosterone to DHT, effectively reducing DHT levels. However, it's contraindicated in women of childbearing age due to the risk of birth defects. The evidence for efficacy in women is less robust than in men, making it a second or third-line option.
Combining Treatments for Maximum Effectiveness
Hair loss rarely has a single cause, which is why combination approaches often produce the best results. Addressing nutritional deficiencies whilst simultaneously stimulating follicle activity creates a more favourable environment for regrowth.
For example, a woman with androgenetic alopecia and low ferritin might combine iron supplementation with PRP therapy and topical minoxidil. The iron corrects the underlying deficiency, minoxidil prolongs the growth phase, and PRP actively stimulates new hair production. This multi-pronged strategy targets the problem from multiple angles, maximising the likelihood of meaningful improvement.
Microneedling combined with PRP shows particularly strong results in women. Microneedling creates controlled micro-injuries in the scalp, which triggers collagen production and enhances PRP absorption. Studies comparing PRP alone versus PRP with microneedling consistently show superior outcomes with the combination.
Lifestyle Factors That Support Hair Health
Clinical treatments work best when supported by daily habits that optimise overall health and reduce stress on hair follicles.
Manage stress strategically. Chronic stress elevates cortisol, which disrupts the hair growth cycle and accelerates shedding. Women juggling careers, families, and personal responsibilities often neglect stress management, yet it's one of the most impactful (and cost-free) interventions. Regular exercise, adequate sleep, meditation, and even spending time outdoors reduce cortisol levels and support hair health.
Prioritise protein intake. Hair is composed primarily of keratin, a protein. Women following restrictive diets or plant-based eating patterns sometimes fall short on protein intake, particularly if they're not strategic about combining protein sources. Aim for at least 0.8 grams of protein per kilogram of body weight daily. Good sources include lean meats, fish, eggs, legumes, tofu, and Greek yoghurt.
Avoid overstyling and chemical treatments. Tight ponytails, braids, and hair extensions create tension along the hairline, leading to traction alopecia over time. Heat styling tools, bleaching, and chemical relaxers damage the hair shaft and weaken follicles. If you must use heat, keep temperatures below 180°C and always use a heat protectant spray.
Support scalp health. A healthy scalp is the foundation for healthy hair. Use a gentle, sulfate-free shampoo, avoid over-washing (which strips natural oils), and consider occasional scalp massages to improve circulation. If you have dandruff or seborrheic dermatitis, address it promptly, as chronic inflammation can impair follicle function.
What to Expect from Treatment
Hair regrowth is a slow process. Hair grows approximately 1 centimetre per month, and follicles need time to transition from resting to active growth phases. Most treatments require three to six months before visible improvement appears.
With PRP therapy, many women notice reduced shedding within the first month. New hair growth typically emerges around month three, with continued thickening and increased density through months six to twelve. Optimal results usually require an initial series of three treatments spaced four weeks apart, followed by maintenance sessions every six to twelve months.
Topical minoxidil shows early signs of response (reduced shedding, finer "baby hairs" along the parting) within two to three months. Full results manifest around the one-year mark.
Addressing nutritional deficiencies takes patience. Iron levels rise slowly, and it can take three to six months of consistent supplementation before you see improvements in hair density and reduced shedding.
Taking Control of Your Hair Health
Female hair loss isn't something you have to accept silently. Early intervention, evidence-based treatments, and consistent care can halt progression and, in many cases, restore much of what's been lost.
If you're ready to address thinning hair with a treatment backed by clinical research and delivered by experienced practitioners, PRP therapy offers a safe, effective, and minimally invasive option. The process is straightforward, the downtime is minimal, and the results are supported by substantial evidence.
For personalised advice and to discuss whether PRP therapy is right for your situation, reach out directly. Expert guidance early in the process can make the difference between preserving your hair and watching it thin year after year.
