Medically reviewed by Vicky Davis, FNP
Written by Our Editorial Team
Last updated 05/20/2021
Losing your hair is scary, no matter who you are. But it can certainly be a nightmare if you’re a woman who otherwise always had a healthy head of hair.
You may be noticing more hair falling out in the shower or in your brush, or that the hair you have is just getting progressively thinner.
If the hair loss is on the back of your head specifically, this could be a clue to what’s causing it.
Identifying your symptoms and getting a diagnosis is the first step in finding an effective treatment for hair loss.
When you begin losing your hair, it can be isolating, and can certainly feel like no one understands what you’re going through.
However, as many as one-third of women experience alopecia (hair loss) at some form in their lives.
For older women, that numbers is even higher — two-thirds of postmenopausal women have hair thinning or bald spots, according to Harvard Medical School.
All that to say: you’re not alone.
There are several potential causes of female hair loss. How the hair loss is occurring will provide clues as to what’s causing yours—whether it’s a medical condition that needs a doctor’s treatment or something you can handle on your own.
This is one potential culprit of women’s hair loss on the back of the head. Also referred to as female pattern hair loss, or FPHL, androgenetic alopecia is a genetic condition caused by hormones known as androgens.
It can appear between the ages of 12 and 40 years old, so if your hair thinning and loss began at a younger age, it could be a clue that it’s FPHL.
With female pattern hair loss, the scalp gradually becomes more visible as hair thins.
The “pattern” in the name indicates this thinning often follows a predictable route–thinning first at the front and crown (or parietal) areas of the scalp.
Unlike male pattern hair loss, where hair recedes at the temples, FPHL leaves behind a line of hair at the front.
As this hair loss occurs over time, normal hairs are replaced with miniaturized hairs, which are typically shorter and finer.
Unlike androgenic alopecia, alopecia areata is believed to be an autoimmune condition. It results in patchy hair loss, and may present as a single round patch of baldness (or several such patches). In some cases, known as alopecia totalis, it can extend across the entire scalp.
Alopecia areata is less common than FPHL and occurs in 2% of the population, men and women alike.
It recurs and goes into remission spontaneously and can happen throughout your life, though it’s most common in children and young adults.
Telogen effluvium is a type of hair loss often caused by a traumatic event such as disease, surgery or severe psychological stress.
It can also be caused by a recent child delivery or certain medications, and can also signal the early stages of androgenetic alopecia.
Telogen effluvium is marked by all-over dramatic hair shedding. It can be a fairly sudden hair loss, when compared to gradual thinning as with female pattern baldness.
You’re likely to notice this type of hair loss in the shower or in your brush.
Of course, these three aren’t the only reasons women experience hair thinning, though they are more common. Some medications, disease, and even hairstyles can cause hair thinning.
Traction alopecia, though unlikely to cause thinning at the back of your head, can be caused by wearing tight ponytails. And various infections can cause damage to the hair follicles.
Knowing the cause of your hair loss is crucial tor identifying the right treatment. You may be able to determine this on your own, based on your symptoms, though if you’re at all unsure, talking with a healthcare professional can help.
A healthcare provider will ask questions about your medical history, the duration and severity of your symptoms and medications you’re taking to help determine the cause of your hair loss.
He or she may also examine your scalp and hair to look for telltale signs of certain hair loss types.
Some treatment options for female hair loss may not require a prescription, and you can start them right away.
Once you have a diagnosis, of course, your healthcare professional can suggest what’s best. Hair loss treatments for women include:
Minoxidil is a topical treatment that may be used for many types of female hair loss, including androgenetic alopecia.
In scientific studies, it’s been shown to promote mild to moderate hair regrowth in women specifically.
Minoxidil does not require a prescription, and you’ll typically apply drops of the medicine directly to your scalp twice daily.
We commonly think of tretinoin as acne and anti-aging medication—but it may also have value in treating female pattern hair loss, particularly when used in conjunction with minoxidil.
Steroid injections may be prescribed if your healthcare provider determines your hair loss is caused by alopecia areata.
Less commonly, topical corticosteroids may be used, though they’re not as effective.
Anthralin is a drug that works on your immune system, and is therefore prescribed for alopecia areata. It’s typically reserved for extreme cases, where hair loss is widespread.
Occasionally hormones or hormone therapy, such as estrogen or spironolactone, may be prescribed to treat androgenetic alopecia, though they are less common due to the effectiveness of minoxidil.
Finasteride is a commonly prescribed treatment for male pattern hair loss. However, it is not used in women of childbearing age, as it can lead to deformities in the male fetus.
Trials involving postmenopausal women have also shown finasteride to not be useful for this group.
Finding the right treatment for the hair loss you’re experiencing on the back of your head boils down to getting a proper diagnosis.
Androgenetic alopecia, alopecia areata and telogen effluvium are all potential culprits.
Waiting too long to get treatment can only make the emotional stress from your hair loss worse. Fortunately, there are treatment options for female hair loss that you can start right away.