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Female Pattern Baldness in 20s: Causes & Treatments

Kristin Hall

Reviewed by Kristin Hall, FNP

Written by Rachel Sacks

Published 02/18/2023

Nothing might shake your confidence more than excessive hair loss or going bald — especially if you’re young. When you’re in your 20s, female hair loss might seem like something you don’t need to worry about until the distant future.

But for some, hair loss starts very early. There are a wide variety of culprits of hair thinning, from female pattern baldness to certain medical conditions to stress. Knowing what causes early-stage female pattern baldness in your 20s can certainly help you figure out the best treatment.

Whether it’s patches of hair loss or overall thinning of hair, female pattern baldness can be detrimental to your confidence. Read on to learn more about female pattern baldness in your 20s, as well as how to treat this condition.

Is Female Pattern Baldness in 20s Common?

You should know that some hair loss is inevitable and normal. The average person will lose about 100 hairs each day, so don’t be alarmed if you see some strands of hair come out when you brush or wash your hair. You can learn more about hair loss in young women in our guide.

But thinning hair associated with female pattern baldness is different from the everyday loss of hair or common shedding. If you're experiencing noticeable hair loss at a younger age, you might wonder if you’re the only person going through female pattern baldness in your 20s.

Nearly all women experience female pattern hair loss, with 40 percent of women affected by age 50. Although female pattern baldness in your 20s is not as common as hair loss in middle age, it can still happen.

Around 12 percent of women begin losing hair before the age of 29, some studies have found. So if you’re noticing a widening scalp or thinning hair, you’re not alone.

There are three common types of hair loss in women:

  • Anagen effluvium. This form of hair loss is commonly caused by medications that poison hair follicles and stop them from growing, like chemotherapy.

  • Telogen effluvium. This hair loss is caused by a large number of hair follicles falling out when they reach the telogen phase, or resting phase, of the hair cycle.

  • Androgenetic alopecia (or androgenic alopecia). Also known as female pattern hair loss or female pattern baldness, this is a common type of baldness. Female pattern baldness or baldness in women are also terms you may hear used for diffuse alopecia, a type of androgenetic alopecia. 

Androgenetic alopecia is caused by hormones called androgens, which are responsible for important bodily functions like normal hair growth. When these hormones are imbalanced, it can lead to androgenetic alopecia.

However, while this hormonal imbalance can cause issues, the role of androgens in women isn’t totally clear — which is why the term “female pattern hair loss” is usually used instead of androgenetic alopecia.

Female pattern hair loss is most likely caused by a shortened anagen phase, or the growth phase — one of the three phases of the hair cycle. Growth happens in the anagen phase, and around 90 percent of the average person’s hair is usually in this phase.

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What Causes Female Pattern Baldness?

There can be several reasons why female pattern baldness occurs at a relatively young age.

One cause of common baldness in women is genetics, also called hereditary hair loss. Hereditary hair loss can happen if you inherit certain genes from one or both of your parents.

Stress can also play a role in early-stage female pattern hair loss in your 20s. High stress levels can contribute to certain types of hair loss.Telogen effluvium, for example, can occur after a particularly stressful event, such as childbirth or extreme weight loss.

Vitamins can also play a role in hair growth or loss. Vitamin D is a major contributor to the hair cycle and growth. This and other vitamins help produce strong hair follicles and keep hair healthy, so deficiencies in these vitamins can cause hair loss.

Certain medical conditions may also contribute to female pattern baldness and androgenetic alopecia. An underlying endocrine condition, such as a tumor on the ovary gland or overproduction of androgen, could be the reason for common baldness.

Regardless of the cause, you might be wondering if treatment for female pattern baldness in your 20s exists. Fortunately, there are a few methods you can try.

How to Treat Female Pattern Baldness

Treatment for female pattern baldness can help stop your hair loss from getting worse, but treatment works better the sooner you’re able to start.

Female pattern baldness treatment might consist of a few different medications to address excessive hair loss.

Minoxidil

The only medication approved by the Food and Drug Administration (FDA) to treat female pattern hair loss is minoxidil, also known as Rogaine. Minoxidil is available in 2% or 5% formulas.

Though this drug doesn’t fully restore the hair you’ve lost, it can help a significant amount of hair grow back and give you a thicker head of hair.

It can take a few months of continuous treatment to see results from minoxidil. Adverse effects are also possible, including redness, dryness or itching. You can read more about these in our minoxidil side effects article.

Spironolactone

Spironolactone (Aldactone®) is used for several conditions, including hypertension, heart failure, low potassium levels, hormonal acne and more. This medication can also be used for female pattern hair loss.

This medication is considered to have an antiandrogenic effect, as it blocks androgen production and may help you regrow the hair you’ve lost.

Spironolactone can cause many adverse effects, including:

  • Fatigue

  • Headache

  • Irregular menstruation

  • Tender breasts

  • Decreased libido

You should not take spironolactone during pregnancy or if you’re planning to become pregnant soon.

Finasteride

While it’s only FDA-approved for male pattern hair loss, finasteride is recommended off-label by some healthcare providers for female pattern baldness.

While results are mixed about where this is an effective treatment, some research shows that finasteride can help regrow hair lost due to female pattern baldness.

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Final Words on Early Female Pattern Baldness

Few people expect to experience female pattern baldness in their 20s. But it can happen, and while it might seem like the end of the world, there are ways to treat your condition.

Female pattern baldness at a younger age can be caused by stress, genetics or a type of hair loss known as androgenetic alopecia (or androgenic alopecia). If you’re noticing extensive hair loss, bald patches or a widening part in your hair, it’s best to consult with a healthcare provider to figure out the cause. You can also learn more about female pattern baldness at any age from this article.

From there, you can find a treatment plan that’s best for you. Hair loss treatments for women are plentiful, from medication to shampoos and more. Other ways to cope with female balding include talking to your support system and loved ones, avoiding certain hairstyles or covering up your hair if you wish to do so.

16 Sources

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references.

  1. Shannon, F., Christa, S., Lewei, D., & Carolyn, G. (2015). Demographics of women with female pattern hair loss and the effectiveness of spironolactone therapy. Journal of the American Academy of Dermatology, 73(4), 705. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4573453/
  2. Fabbrocini, G., Cantelli, M., Masarà, A., Annunziata, M. C., Marasca, C., & Cacciapuoti, S. (2018). Female pattern hair loss: A clinical, pathophysiologic, and therapeutic review. International Journal of Women's Dermatology, 4(4), 203-211. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6322157/
  3. Androgenetic alopecia. (2015, August 1). MedlinePlus. Retrieved from https://medlineplus.gov/genetics/condition/androgenetic-alopecia/
  4. Dinh, Q. Q., & Sinclair, R. (2007). Female pattern hair loss: Current treatment concepts. Clinical Interventions in Aging, 2(2), 189-199. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2684510/
  5. Burg, D., Yamamoto, M., Namekata, M., Haklani, J., Koike, K., & Halasz, M. (2016). Promotion of anagen, increased hair density and reduction of hair fall in a clinical setting following identification of FGF5-inhibiting compounds via a novel 2-stage process. Clinical, Cosmetic and Investigational Dermatology, 10, 71-85. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5338843/
  6. Hair Loss in Women: Causes, Treatment & Prevention. (2021, February 10). Cleveland Clinic. Retrieved from https://my.clevelandclinic.org/health/diseases/16921-hair-loss-in-women
  7. Bhat, Y. J., Latif, I., & Hassan, I. (2020). Female Pattern Hair Loss—An Update. Indian Dermatology Online Journal, 11(4), 493-501. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7413422/
  8. Thinning hair and hair loss: Could it be female pattern hair loss? (n.d.). American Academy of Dermatology. Retrieved from https://www.aad.org/public/diseases/hair-loss/types/female-pattern
  9. Telogen Effluvium - StatPearls - NCBI Bookshelf. (n.d.). NCBI. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK430848/
  10. Asghar, F., Shamim, N., Farooque, U., Sheikh, H., & Aqeel, R. (2020). Telogen Effluvium: A Review of the Literature. Cureus, 12(5). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7320655/
  11. Amor, K. T., Rashid, R. M., & Mirmirani, P. (2010). Does D matter? The role of vitamin D in hair disorders and hair follicle cycling. Dermatology online journal, 16(2), 3. Retrieved from https://pubmed.ncbi.nlm.nih.gov/20178699/
  12. Almohanna, H. M., Ahmed, A. A., Tsatalis, J. P., & Tosti, A. (2019). The Role of Vitamins and Minerals in Hair Loss: A Review. Dermatology and Therapy, 9(1), 51-70. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6380979/
  13. Treating female pattern hair loss. (n.d.). Harvard Health. Retrieved from https://www.health.harvard.edu/staying-healthy/treating-female-pattern-hair-loss
  14. Gupta, A. K., & Foley, K. A. (2014). 5% Minoxidil: treatment for female pattern hair loss. Skin therapy letter, 19(6), 5–7. Retrieved from https://pubmed.ncbi.nlm.nih.gov/25807073/
  15. van Zuuren, E. J., Fedorowicz, Z., & Schoones, J. (2016). Interventions for female pattern hair loss. The Cochrane database of systematic reviews, 2016(5), CD007628. Retrieved from https://pubmed.ncbi.nlm.nih.gov/27225981/
  16. Iamsumang, W., Leerunyakul, K., & Suchonwanit, P. (2019). Finasteride and Its Potential for the Treatment of Female Pattern Hair Loss: Evidence to Date. Drug Design, Development and Therapy, 14, 951-959. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7060023/

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

Kristin Hall, FNP

Kristin Hall is a board-certified Family Nurse Practitioner with decades of experience in clinical practice and leadership. 

She has an extensive background in Family Medicine as both a front-line healthcare provider and clinical leader through her work as a primary care provider, retail health clinician and as Principal Investigator with the NIH

Certified through the American Nurses Credentialing Center, she brings her expertise in Family Medicine into your home by helping people improve their health and actively participate in their own healthcare. 

Kristin is a St. Louis native and earned her master’s degree in Nursing from St. Louis University, and is also a member of the American Academy of Nurse Practitioners. You can find Kristin on LinkedIn for more information.

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