Medically reviewed by Katelyn Hagerty, FNP
Written by Our Editorial Team
Last updated 7/27/2021
Curling irons. Straight irons. Messy buns. High ponies. Hair extensions. Tight braids.
Women create and wear tons of different styles, but no matter which you prefer, there’s one look that is never in fashion: thinning hair.
As awful as it may feel to gaze in the mirror and notice bare scalp where there used to be hair, you can take comfort in knowing that you are not alone: Fewer than 45% of women go through life with a full head of hair. Female hair loss is a thing.
Here’s what to do if you notice patches of hair loss in the front of your head (otherwise known as: frontal hair loss), as well as information on what might be happening in the first place.
If you’re losing the hair on the crown of your head (the round part on the top of your head), you have what is called androgenic alopecia — more commonly referred to as female pattern hair loss (FPHL) or female pattern baldness. This is the most common type of hair loss in women.
But if you’re losing the hair in the front of your head in spots around the hairline, you may have frontal fibrosing alopecia (FFA). This type of frontal hair loss is more rare, and mostly affects postmenopausal women.
There are many reasons why you may be losing the hair in the front of your head. As mentioned above, one factor could be frontal fibrosing alopecia. While the causes of FFA remain unknown, there are some theories.
Since cases have risen exponentially in the past few decades — especially in western countries — some researchers believe there may be an environmental trigger.
It’s also possible that some types of sunscreen and makeup may cause FFA, but more research is needed to support this theory. (So don’t stop applying sunscreen on your face! There is plenty of research on skin cancer!)
What’s more likely — considering FFA is predominantly seen in peri-menopausal and post-menopausal women — is that a hormonal shift like a lack of estrogen may trigger the condition. (As if hot flashes weren’t enough to deal with!)
If you think you have FFA, a healthcare professional can help diagnose you. He or she will take a thorough history and may recommend a scalp biopsy.
The earlier you are diagnosed and the quicker the intervention, the more likely you are to prevent permanent damage to hair follicles. (So definitely don’t procrastinate with this one!)
Not all frontal hair loss is FFA. There could be some other causes, too.
This form of hair loss (due to stress) is also sometimes telogen effluvium, which is common.
The good news is this it’s normal and temporary. (And it’s not actually categorized as “hair loss” since your hair will grow back. Instead, it’s called “hair shedding.” But still, losing hair can be disconcerting!)
The worst part about your cute, tight pony? Once you seriously damage your hair follicles your hair can’t grow back. (JoJo Siwa, are you listening?)
If you see broken hairs along your hairline, a receding hairline or patches of missing hair where your styles are pulled too tightly, then you need to stop pulling on your hair so that it can start to regrow.
Knowing if your frontal hair loss is FFA, hair shedding (like what happens after giving birth) or damage caused by hairstyles that affect your hair follicles will help determine which course of treatment is best for you.
For women with FFA, management can be complex. Treatment depends on the severity of the symptoms (which can include itching and inflammation), biopsy findings and the extent of hair loss.
Some treatments include topical solutions like corticosteroids or foams, calcineurin inhibitors and anti-inflammatory shampoos. If that doesn’t help, the next step could be corticosteroid injections in the scalp.
Additionally, some more severe cases may require oral anti-inflammatory medications.
Since changing hormones may sometimes trigger frontal hair loss in women, finasteride (a DHT blocker) has been shown to be effective alone or in combination with other treatments for this disease.
There are other treatment options that have been effective for FPHL that some may recommend for FFA, however more research is needed in order to prove the effectiveness in treating FFA.
These treatments include Platelet-Rich Plasma (PRP) and the use of low-level lasers. There is also some evidence that Light-Emitting Diodes may potentially be helpful in treating FFA. However, additional studies with larger sample sizes and a control group are necessary.
If your frontal hair loss is caused by something other than FFA, like shedding or damage, there are things you can do to help regrowth.
First (and most obvious!) is to stop wearing hairstyles that may cause damage. If your hairstyle hurts, then it’s too tight. Loosen up!
But even after you hit pause on the high ponies and tight braids, you still may want to do something to prevent thinning hair. Minoxidil is a topical solution that can help with certain types of hair loss. (Unfortunately, it has not proven to be highly effective in hair regrowth after FFA.)
Frontal hair loss in women can be devastating, but the sooner you discover it’s happening, the sooner you can try to fix it. The first step is to figure out if you have FFA, or if something else is causing the hair along your frontal hairline to thin (or disappear!).
Even a mild form of female hair loss, like diffuse thinning can be distressful. (You don’t necessarily have to be catching clumps of hair in the shower to freak out.)
A healthcare professional can help diagnose the cause of your hair loss, and set you up with the best hair loss treatment plan — from changing your hairstyle to prescribing topical or oral medications.
With the right hair treatment and hair care, you can do your best to stop the progression of frontal hair loss, and even help your hair grow back again.