What Causes Female Hair Loss on the Back of Head?

Female pattern hair loss can affect many parts of your scalp. But can it cause hair loss at the back of the head? And is there a way to stop it?

Hair loss can show up as a wide hair part, an m-shaped hairline, or thinning at the crown in females. Your crown is the top portion of the back of your head. Regardless of where you’re experiencing thinning, losing hair can be stressful. 

But you’re not alone. Over half of all women experience thinning hair at some point. 

So, what could be causing hair loss at the back of your head?

Read on to learn more about the major causes of hair loss and how to stop thinning from progressing.

Hair loss can happen for many reasons — genetics, hormonal shifts, or even nutrient deficiencies. But whatever the reason, the sooner you act, the better. 

Keeping the hair you have is easier than trying to regrow it when it’s gone. An early diagnosis and quick start on treatment can help stop hair loss right in its tracks — even if it doesn’t necessarily bring back what you’ve lost. 

Before you can treat thinning hair, you need to know what’s causing it. Curious why your hair is falling out? Here are a few potential causes for thinning hair on top of the head in females:

Androgenetic Alopecia 

This form of hair loss has many names: androgenic alopecia, male or female pattern hair loss (FPHL), and pattern baldness. It’s the most common type of hair loss, affecting up to 50 percent of men and women. 

While genetics definitely play a role, the specifics are still a bit of a mystery, especially in women.

In male pattern hair loss, androgens — particularly dihydrotestosterone (DHT) — are strongly linked to the condition. DHT binds to androgen receptors in the hair follicles, causing them to shrink over time. This process, called follicular miniaturization, leads to thinner hair and, eventually, hair loss. In men, this typically presents as a receding hairline or balding at the crown.

In female pattern hair loss (FPHL), the relationship with androgens is less clear. Many women with FPHL do not have abnormally high androgen levels, suggesting that other factors — such as increased sensitivity to DHT, genetics, aging, or hormonal changes — may be involved. Experts believe that while DHT may still contribute to FPHL, its role is not as direct or dominant as it is in men.

Instead of a receding hairline or bald spots, women typically experience diffuse thinning across the top and crown of the scalp, often with a gradually widening hair part. The hairline usually remains intact, but overall volume decreases, giving the appearance of thinner hair. Thinning at the crown is also commonly seen.

Interestingly, symptoms of androgenic alopecia are more likely to appear or worsen around menopause, potentially due to changes in hormone levels. Learn more in our guide to menopause hair loss.

Telogen Effluvium

Excessive hair shedding can occur after a significant physical stress or a major emotional event, with a sudden increase in shedding starting a few months later. This condition, known as telogen effluvium, leads to hair falling out across your scalp, not just from the crown. 

Common triggers include:

• Extreme stress and trauma

• Severe illness, like COVID-19 

• Major surgery

• Drastic weight loss

• Nutritional deficiencies, like iron deficiency

• Hormonal shifts, such as after childbirth 

• Certain medications

• Health conditions, like thyroid disorders 

If you notice any sudden hair loss, it’s a good idea to speak with a healthcare professional. Hair loss might be your body’s way of sending out an SOS. 

Alopecia Areata

Alopecia areata is an autoimmune disease, in which the immune system mistakenly attacks hair follicles, disturbing hair growth. 

It often leads to round or oval bald patches that can appear anywhere on the scalp, including the back of the head.  

Traction Alopecia

Love a high and tight pony? Your scalp might not. 

Tightly pulled-back styles like ponytails, braids, or buns can lead to traction alopecia, a form of hair loss caused by repeated tension on the hair. 

Generally, traction alopecia affects the parts of your scalp that are most affected by your hairstyle. In some cases, this might include the crown or back of the head.

Learn more about this form of hair loss in our guide to ponytail hair loss.

There are a variety of hair loss treatments available to tackle thinning at the crown and encourage new growth. 

While it’s important to talk with your provider about the right hair loss treatment for you, we dive into some effective options below:

Topical Minoxidil 

Topical minoxidil (AKA Rogaine^®) is the only FDA-approved treatment for female pattern hair loss. And it’s available over-the-counter (OTC), so no need for a prescription. 

While experts still don’t know its exact mechanism of action, it’s believed that one of the ways it works is by increasing blood flow to the hair follicles, thereby enhancing oxygen and nutrient delivery. Minoxidil also appears to shift more hair follicles into the growth or anagen phase of the hair cycle, slowing down hair loss and promoting hair regrowth. 

Topical minoxidil is available as minoxidil drops and minoxidil foam. You can apply product directly to any area with thinning hair.

Oral Minoxidil

Not a fan of topical products? Or maybe topical minoxidil didn’t work for you? Oral minoxidil is another effective option. 

For topical minoxidil to be effective, your hair follicles need enough of an enzyme called follicular sulfotransferase. If your levels are low, the oral form might be a better fit for you. 

Studies show that low-dose oral minoxidil is an effective treatment for various hair disorders, including female-patterned hair loss.

Finasteride

Oral finasteride is a well-known treatment for male pattern baldness, but it can also help some women with hair loss.

Specifically, it may be a good fit for women with androgenic alopecia who aren’t planning to get pregnant. That’s why healthcare professionals often prescribe it off-label to postmenopausal women dealing with pattern hair loss. 

In addition to the oral form, topical finasteride is available and is often combined with other treatments. Our hair growth spray combines topical finasteride with topical minoxidil, and is often prescribed to postmenopausal women with female pattern hair loss.

Learn more about finasteride for women. 

Spironolactone for Hormonal Changes

Spironolactone is an anti-androgen medication that blocks androgen receptors in hair follicles and can also reduce androgen production, reducing DHT levels.

This daily prescription pill can help treat hormonal female pattern hair loss by slowing down hair thinning and may encourage new hair growth. It’s also effective for acne caused by hormonal imbalances, such as those seen in PCOS.

Lifestyle Habits for Healthy Hair

Adding a bit of TLC to your hair care routine can do wonders for healthy hair growth. 

Here’s what to focus on:

• Eat a balanced diet. A healthy, varied diet ensures you get all the nutrients necessary for overall health and healthy hair growth. Worried about a deficiency? Try our hair-friendly biotin gummies.

• Use the right shampoo and conditioner. Our hair loss shampoo and conditioner feature ingredients that support scalp health. Plus, nourishing treatments and hair masks can help keep your hair healthy and strong, reducing breakage. 

• Be gentle on your hair. Avoid tight hairstyles, excessive heat styling, and harsh chemical treatments. You should also gently towel-dry or brush hair to prevent hair breakage.

Learn more hair care routine tips in our guides healthy scalp care and how to get volume in your hair.

Cover Up Your Crown Balding

Patience is key when it comes to hair loss treatments — they often take a few months to show results.

While you wait, you can easily cover up thinning or balding areas with hair powder. These pigmented fibers adhere to existing hair, instantly giving the appearance of fuller hair at the crown or any other area of thinning.

For a more dramatic change, a faux hair piece is the way to go. Chat with your hairstylist about getting a halo hair extension or wig to cover thinning areas. 

Looking for more inspiration? Check out our article on hairstyles for women with hair loss.

Spotting hair loss at the back of your head? It’s best to act quickly. Identifying the cause of your thinning early gives you a head start on treatment and boosts your chances of keeping your strands. 

When it comes to hair thinning at the crown, here’s what you need to remember: 

• Figure out the root cause. The most common cause of hair loss at the back of the head is androgenetic alopecia (or female pattern hair loss). Other factors such as nutritional deficiencies, hormonal changes, or severe stress, can also contribute to hair thinning. 

• Get treatment ASAP. The sooner you act, the more likely you are to stop further hair loss and keep the hair you have. Your first step is speaking with a healthcare professional.

• Consider your treatment options. Many hair growth treatment options are available that can help preserve the hairs you have and promote regrowth. These include minoxidil, spironolactone, and finasteride.

• Take cover. While you wait for hair loss treatments to kick in, you can conceal thinning with a new haircut, hair extensions, or hair powder. 

Ready to get moving on a treatment? Check out our hair loss treatments and get started today with an online consultation with a hair loss pro.