A Guide to Curly Hair Balding and Bald Spots

Though we tend to associate hair loss with men, it’s also extremely common in women. In fact, almost half of all women will experience hair loss at some point in their lives. 

Various issues may cause you to lose more hair than normal, whether you have curly hair, straight hair, or wavy hair. That said, some forms of hair loss impact women with curly hair more frequently than women with straight hair.

The good news is that curly hair balding is treatable with a mix of good hair care habits and medication. 

Read on to learn about female hair loss for curly hair types, and what you can do to keep your hair thick, strong, and healthy. 

Hair loss can occur for various reasons, from nutritional deficiencies to hormonal changes. Many causes of hair loss are consistent across all hair types, but some tend to be more common in women with curly hair.

Let’s dive into the details.

Female Pattern Baldness

One of the most common causes of hair loss in women is androgenetic alopecia. Often referred to as female pattern baldness, this type of hair loss occurs when androgen hormones (male sex hormones) damage your hair follicles and prevent them from producing new hairs. This can happen to all hair types.

The chief hormone behind androgenetic alopecia is dihydrotestosterone (DHT), which your body produces as a byproduct of testosterone.

Although testosterone is usually thought of as a male hormone, both men and women produce and rely on testosterone for certain bodily functions. 

If you’re genetically predisposed to hair loss, the DHT that your body produces as a byproduct of testosterone can bind to receptors throughout your scalp. Over time, exposure to DHT can shrink hair follicles, preventing the hair growth cycle from proceeding.

In men, androgenetic alopecia usually causes a receding hairline, typically in the form of a bald patch at the crown of the scalp or complete baldness. As a woman, you may instead notice your hair getting thinner around your part line (if you have one) or in spots all around your head.

Hair loss caused by DHT exposure is permanent, so it's important to act quickly to prevent it from worsening. 

While androgenetic alopecia is one of the most common forms of hair loss, hormones aren’t the only issue that can cause you to lose hair.

Traction Alopecia and Central Centrifugal Cicatricial Alopecia (CCCA)

Traction Alopecia, also known as ponytail hair loss, is a form of hair loss that’s caused by wearing hairstyles that put a lot of pressure on your roots. Repeated stress can cause your hair to thin, making it look like you’re losing hair over time.

For example, tight ponytails, cornrows, or braids can cause tension that leads to breakage and hair loss. Traction alopecia is more common in Black women due to the treatments typically used to tightly braid or straighten tightly curled hair.

In fact, research shows that it impacts one-third of Black women with curly hair who wear various forms of protective hairstyling for a long, continuous period of time. Protective styles are exactly what they sound like: those that protect your natural hair.

Central Centrifugal Cicatricial Alopecia (CCCA) is another form of Alopecia that almost exclusively impacts Black women with curly hair. It’s characterized by hair loss at the crown of the head that spreads outwards over time. Other symptoms include scarring and inflammation.

Some research suggests that CCCA can be caused by a few factors, from bacterial and fungal infections to genetics, autoimmune disease, and more. 

More studies are needed to understand the causes better and to identify the best treatments. 

Telogen Effluvium and Other Medical Issues

Another common form of hair loss is telogen effluvium. This temporary form of hair loss tends to occur as a reaction to other health issues, such as:

• Infections and illnesses that cause fever

• Chronic stress

• Surgery

• Trauma

• Nutritional deficiencies

• Sudden changes in hormone levels 

Unlike female pattern hair loss, which causes permanent hair loss around the part line or in various spots around the head, telogen effluvium usually causes diffuse shedding that affects the entire scalp.

If you have telogen effluvium, you may notice that your hair looks thinner than normal and that large amounts of hair fall out when you brush or shower. In some cases, it might become easy to see your scalp through your hair, especially under bright artificial light.

Another type of stress or anxiety-related hair loss is trichotillomania, which you can learn more about here.

Other health issues can also cause shedding or hair loss, including polycystic ovary syndrome (PCOS), pregnancy, autoimmune disorders, and some types of medication. 

Hair loss stems primarily from hormonal, genetic, health, or environmental factors. So, individuals with curly hair can experience female hair loss for the same reasons that women with straight hair do.

However, CCCA primarily affects Black women with curly hair who are over 30 years old.

Moreover, certain hairstyles and styling methods common among women with curly hair can heighten the risk of Traction Alopecia.

Specifically, tight hairstyles like ponytails, braids, cornrows, and dreadlocks can exert excessive tension on the hair roots, contributing to this type of hair loss.

Also, curly hair has a unique shape that makes it more prone to breakage and loss of moisture. While this doesn’t necessarily lead to hair loss, it can if it happens unchecked for a long period of time. This is especially true for those with thin curly hair.

While hair loss and bald patches can be distressing, the good news is that they’re usually treatable.

It’s best to speak with a healthcare provider, like your dermatologist, so they can pinpoint the underlying cause and then identify the best course of action.

For example, researchers think the best treatments for CCCA are topical or injectable steroids and some antibiotics, which work as anti-inflammatories.

In general, one of the most effective ways to treat female hair loss is to use a topical medication called minoxidil. Minoxidil, available as a liquid solution or foam, works by moving hair follicles into the anagen (growth) phase of the hair growth cycle. It also stimulates blood flow to the scalp and hair.

Numerous studies have found that minoxidil helps treat hair loss and improve hair growth in men and women. 

In one study, both 2% and 5% minoxidil produced measurable improvements in hair growth in women over 48 weeks. You can find Hers’ 2% minoxidil solution and 5% minoxidil foam for women online as part of our range of women’s hair loss products. 

Other treatment options include:

• Oral minoxidil. This once-a-day pill might be prescribed off-label to those who prefer pills to topicals or for people who didn’t get results from topical minoxidil.

• Topical finasteride and minoxidil spray. This topical treatment combines 6% minoxidil and 0.3% finasteride in a prescription-strength spray. It’s currently only FDA-approved for men but has demonstrated considerable results for women as a hair loss treatment.

• Spironolactone. Female pattern hair loss is sometimes treated with medications called anti-androgens. These medications, such as spironolactone, lower your levels of male sex hormones like testosterone and dihydrotestosterone (DHT), which can cause hair loss.

You can also take some preventative measures (like styling alternatives).

In addition to treating hair loss after it starts to develop, it always helps to take steps to prevent it from occurring in the first place. 

A lot of it comes down to your hair care routine. Try the following habits and lifestyle changes to protect your hair and promote optimal growth and thickness. Find out some curly haircare tips below, especially for anyone with thin curly hair:

• Use a hair loss prevention shampoo. While the wrong shampoo can harm your hair, the right one can help keep it looking thick, full, and healthy. Try a shampoo specifically made to control shedding and keep your hair full of volume after every wash. A clarifying shampoo can also be a great option for any curly girls who use a lot of heavy products.

• Eliminate harsh hair products. For example, look out for things that contain resins, like silicone. These can create buildup and block your natural scalp oils from nourishing your hair strands. Instead, opt for nourishing ingredients.

• Use a moisturizing deep conditioner. Look for things that have both nourishing and detangling ingredients. And try not to skip this step when wash day rolls around. Conditioner plays a key role in moisturizing hair. If you have time, you could even indulge in some leave-in conditioner — that’ll make it easier to comb through tangles.

• Do a hydrating hair mask. Masks can restore moisture to frizzy hair and can also help restore scalp health. They can also be a great addition to a relaxing self-care routine (especially if you throw a scalp massage into the mix) — and stress reduction is known to help reduce hair loss.

• Limit tight hairstyles. Tight ponytails, braids, dreadlocks, and cornrows can all pull on your hair follicles, potentially causing traction alopecia. Looser braids, knotless braids, chunkier twists, and natural curls are all less abrasive alternatives. Whichever you choose, limiting your use of tight hairstyles and letting your naturally curly hair relax, especially during the night, can help prevent ponytail hair loss.

• Eat a balanced diet. Some nutritional deficiencies, such as iron or biotin deficiency, can cause you to shed hair. Try to eat a balanced diet with lots of fruit, vegetables, and lean protein sources.

• Avoid damaging your hair with heat. Any devices that apply heat to your hair, such as curling irons and straighteners, can damage the hair shaft and cause breakage and hair loss. To keep your hair healthy, limit its exposure to heat. For example, air dry your hair instead of blow drying. When you use a blow dryer, hold it a reasonable distance from your scalp. If you curl or straighten your hair, select the lowest heat setting and limit your use of these tools to once a week. Fine hair is usually extra sensitive to heat.

• Don’t brush your hair too often. Excessive brushing can put tension on the hair follicle and contribute to hair breakage and shedding. Instead, it’s best to brush your hair only when you need to style it. To limit damage, use a wide-tooth comb, and don’t pull on your hair as you brush. 

• Brush your hair when wet. This tip only applies to women with curly hair. You may often hear that you should do the opposite, but that’s only true for people with straight hair. If you have tightly curled or textured hair, brushing it when wet decreases the chances of hair breakage.

Hair loss and shedding can affect every hair type, from straight to wavy and curly. That said, some factors increase the likelihood of hair loss for women with curly hair.

Here’s what to keep in mind about curly hair loss:

• Both Traction Alopecia and Central Centrifugal Cicatricial Alopecia are more common in Black women with curly hair. They have different treatment methods, so be sure to speak with a doctor to determine the best treatment plan.

• You can take various steps to prevent hair thinning, from wearing looser hairstyles to eating a balanced diet and upgrading your haircare products.

• Hair loss medications are also available. Some options include minoxidil, topical finasteride, and spironolactone.

And we’ll emphasize it again: If you notice hair loss, consult with a healthcare professional to help determine the root cause and the best ways to treat it. 

You can access our selection of hair loss products for women online to clean up your haircare routine today.