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What Causes Female Hair Thinning at the Crown?

Sara Harcharik Perkins, MD

Reviewed by Sara Harcharik Perkins, MD

Written by Sheryl George

Published 05/20/2021

Updated 11/15/2023

Losing hair sucks, to put it bluntly. For some, it may show up as a wide hair part, an m-shaped hairline or thinning at the crown, but it can be tough to deal with no matter what it looks like. 

Male hair loss might seem more commonplace, while female hair loss can feel isolating and like no one is talking about it.

But more than half of all women eventually find themselves with less than a full head of hair, so you’re definitely not alone If you’re wondering specifically what causes female hair thinning at the crown, we’ve got you covered. 

Keep reading to learn more about the major causes of hair loss, what's happening behind the scenes and how to bounce back after seeing more of your crown — and not the cool tiara kind.

There can be a lot of factors that contribute to hair loss, from genetics to hormonal shifts to nutritional deficiencies. But one thing is certain: no matter what type of hair loss you have, it’s important to act quickly and early as possible. 

Getting a firm diagnosis and starting treatment early will help stop hair loss in its tracks (even if you may not see any regrowth of the hair you’ve already lost). Basically, keeping what you have is way easier than losing a bunch and trying to regrow it. 

But you probably also want to know why you’re losing hair in the first place. A few common causes of hair loss at the crown are: 

Female Hair Loss

  • Androgenetic alopecia: Also called androgenic alopecia, this most common form of hair loss seems to boil down to genetics, although the links aren’t totally clear yet. And when we say it’s common, we mean that up to 50 percent of males and females experience this kind of hair loss in varying degrees during their adult lives. 
    Androgenetic alopecia may be one potential culprit of women’s hair loss on the back of the head. Also referred to as female pattern hair loss (FPHL), this condition may be related to certain hormones called androgens.
    The connection is a little murky though, because the majority of women with FPHL neither have abnormal androgen levels nor do they have signs or symptoms of excess androgen. Yeah, we’re also hoping science will figure that one out soon. 
    Our guide to hair loss in women is a great resource if you want to learn more about androgenetic alopecia and types of hair loss. 

  • Telogen effluvium:  Drastic weight loss or a sudden illness like COVID-19 can actually make your hair fall out. This type of excess shedding after a stressful event is known as telogen effluvium. Additionally, sudden hair loss can happen if you have a reaction to medication or even a nutritional deficiency.
    Talk to your healthcare provider to rule out underlying medical conditions. We discuss this in more detail below, and our article on sudden hair loss takes a deeper dive into potential causes if you want to learn even more. 

  • Alopecia areata:  While this type of hair loss often starts on the scalp or face, it can also cause bald patches on the top of your head. This type of hair loss can also be tied to genetic predisposition where the body attacks its own hair follicle.

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Hormonal Changes

Sure, menopause is notorious for hot flashes, but for many, it can come with female pattern hair loss or telogen effluvium as well. During this time, estrogen levels are reduced, while androgen concentration goes up.

This increases your levels of dihydrotestosterone (DHT), the hormone that causes hair follicles to produce thinner, weaker hair. 

Over time, each hair follicle shrinks and the hair becomes finer and finer until there are only short vellus hairs or no hair growth at all. This cycle eventually leads to bald and/or thinning areas. For some, this pattern shows up most prevalently with thinning at the crown.

Some studies estimate that 20-60 percent of women experience some form of hair loss before reaching the age of 60. If you feel like this sounds a whole lot like what you’re going through right now, our guide to menopause hair loss is another great resource. 

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Health Conditions

Doesn’t thick, shiny hair seem like a beacon of good health? In that same vein, thinning hair might be a sign of a deeper health issue. 

The most common type of hair loss caused by health conditions is telogen effluvium, which can be brought on by a sudden illness, drastic weight loss, stress or other health issues: 

  • Weight loss: Losing a bunch of weight quickly before that beach vacay may seem like a good idea, but your hair might not feel the same way. Sudden weight loss and nutritional deficiencies from dieting may impact both hair structure and hair growth.

  • Nutritional deficiencies: Let’s talk more about nutritional deficiencies. The body is complex and while you may feel like it craves more gummy bears, your follicles may actually need zinc or biotin.
    Vitamins, minerals and other micronutrients play important roles throughout your body — including for your hair, although their important role in healthy hair follicle development isn’t clearly understood.
    So most importantly, make sure you have a healthy diet in place. Also check with your healthcare provider to see if your blood tests indicate any deficiencies that may be inhibiting healthy hair growth. This way, you can supplement appropriately.

  • Thyroid issues: Underlying health problems like autoimmune diseases and/or thyroid disorders (like hypothyroidism and hyperthyroidism) can trigger hair loss for some — specifically telogen effluvium.
    Additionally, hypothyroidism can make the strands you do keep look dry and dull, while hyperthyroid issues can lead to thinner hair and a brittle or greasy feel.

  • Medications: Certain drugs can cause reactions that lead to hair loss. Hair shedding can occur as a side effect of certain medications, including retinoids, beta-blockers, anticoagulants, anticonvulsants and thyroid medications.
    While it’s not a common side effect, it’s something you may want to check with your healthcare provider or dermatologist about if you’ve experienced sudden hair loss and have recently started a new medicine. 

Tight Hairstyles 

Love a high and tight pony? Sorry to break it to you, but your scalp may not. Tightly pulled-back styles like ponytails, braids or buns can cause traction alopecia. This form of hair loss happens when these hairstyles that pull on the hair cause targeted hair loss over time.

Learn more in our guide on ponytail hair loss if you think this may be an issue for you. 

There are several hair loss treatments on the market that can help address hair thinning at the crown and promote new growth. You should always speak with your healthcare provider to determine which one is right for you, but let’s get a little educated on some of of the most common options:

  • Topical Minoxidil 
    Commonly sold under the brand name Rogaine®, minoxidil is an FDA-approved topical or oral medication that stimulates hair growth. Though its exact mechanism of action is still unknown, it’s believed to work by encouraging more oxygen, blood and nutrients to go into the hair follicle. Hers has two formulations that can help hair thinning at the crown. 

    • Minoxidil drops: This dropper style format makes it easy to target a bald spot.

    • Minoxidil foam: An easy-to-apply foam that can be quickly applied directly to your scalp. 

  • Oral Minoxidil
    Oral minoxidil is a great pick for someone who doesn’t want to use a topical product. Studies have shown that low-dose oral minoxidil (OM) can be an effective treatment for numerous hair disorders, including female-patterned hair loss.
    Minoxidil requires the presence of an enzyme called follicular sulfotransferase, but some people don’t have high enough levels of this enzyme in their hair follicles. In those cases, an oral form may be a better option. 

  • Spironolactone for Hormonal Changes
    Spironolactone is a prescription medication that helps block androgen production, which in turn decreases your levels of DHT. Studies have shown that this once-daily pill can be helpful in treating hormonal female pattern hair loss and promoting new hair growth.

  • Cover Up Your Crown Balding
    Patience is a virtue, and hair loss treatments typically can take a couple of months for visible results. But in the meantime, you can instantly cover up a bald spot with a hair powder. These pigmented fibers lay on the scalp to cover thinning, instantly creating the look of hair at the crown. 
    But if you really want to know how to hide crown balding, a faux hair piece is your best bet. You can speak to your hairstylist to get a halo hair extension or wig to cover thinning. Our article on hairstyles for women with hair loss has more ideas too. 

  • Lifestyle Habits for Healthy Hair
    A little TLC in your hair care can go a long way. Make sure to shampoo your scalp for an optimal foundation for healthy hair growth. Not washing often enough can lead to high sebum levels which can be irritating to the scalp.

    If you’re already shampooing thoroughly and looking for more tips for healthy hair, check out our guide on how to get volume in your hair.

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We know nobody wants to feel like they look like a grandpa with a prominent bald spot at the crown. But the best way to avoid this is to act early to find the root cause of and right treatment for the hair loss you’re experiencing on the back of your head. 

There are options that can help you both temporarily and in the long run. If you think you’re experiencing signs of thinning in any other areas, our guide on female pattern hair loss is a great resource. But for hair thinning at the crown, here’s what you need to remember: 

  • Figure out the root cause for your hair thinning at the crown — from weight loss to hormonal changes or stress, knowing what’s going on will clue you into what treatment to try. 

  • Treat yo self ASAP. No, seriously. This is not a case of good things coming to those who wait. It’s better to act fast and keep the hair you have than waiting for it to get any worse. There are various hair growth treatment options that can help kickstart new growth and preserve the hairs you have.

  • Take cover. While you wait for hair loss treatments to kick in, try temporary and instant ways to conceal like a new haircut, hair extensions or hair powder. Ain’t no shame in that game, k? 

If you’re ready to get moving on a treatment, check out our hair loss treatments and get an online consultation to find out what’s right for you today.

18 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. Dinh, Q. Q., & Sinclair, R. (2007, June). Female pattern hair loss: Current treatment concepts. NCBI. Retrieved from
  2. Ho, Chin H., Sood, Tanuj & Zito, Patrick M. Androgenetic Alopecia
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  4. Brough, K. R., & Torgerson, R. R. (2017, February 24). Hormonal therapy in female pattern hair loss. NCBI. Retrieved from
  5. Hughes, EC & Saleh, D. (2022)Telogen Effluvium. StatPearls - NCBI Bookshelf Retrieved from
  6. Hair loss types: Alopecia areata overview. (n.d.). American Academy of Dermatology. Retrieved from
  7. Levy, L. L., & Emer, J. J. (2013). Female pattern alopecia: current perspectives. International journal of women's health, 5, 541–556.
  8. Goluch, Z. S. (2016, March 29). Nutrition of women with hair loss problem during the period of menopause. NCBI. Retrieved May 14, 2023, from
  9. Katta, R., & Guo, E. (2017, January 31). Diet and hair loss: effects of nutrient deficiency and supplement use. NCBI. Retrieved from
  10. Almohanna, H., Ahmed, A., Tsatalis, J., & Tosti, A. (2018, December 13). The Role of Vitamins and Minerals in Hair Loss: A Review. NCBI. Retrieved from
  11. van Beek, N., Bodó, E., Gáspár, E., Meyer, K., Zmijewski, M. A., Slominski, A., Wenzel, B. E., & Paus, R. (2022, July 29). Thyroid Hormones Directly Alter Human Hair Follicle Functions: Anagen Prolongation and Stimulation of Both Hair Matrix Keratinocyte Proliferation and Hair Pigmentation. The Journal of Clinical Endocrinology & Metabolism. Retrieved from
  12. O'Bryan, E. C., & Albanese, R. P. (2004). A Case Report of Fluoxetine- and Venlafaxine-Induced Hair Loss. NCBI. Retrieved from
  13. Pulickal, J. K., & Kaliyadan, F. (2022, August 8). Traction Alopecia - StatPearls. NCBI. Retrieved from
  14. Rossi, A., Cantisani, C., Mellis, L., Iorio, A., Scali, E.,& Calvieri, S. (2012, May). Minoxidil use in dermatology, side effects and recent patents. PubMed. Retrieved from
  15. Ramírez-Marín, Hassiel Aurelio & Tosti, Antonella Role of Oral Minoxidil in Patterned Hair Loss
  16. (2022) Retrieved from
  17. Burns Laura J., De Souza, Brianna, Flynn,Elizabeth BS, Hagigeorges, Dina, Senna, Maryanne M. (2020) Spironolactone for treatment of female pattern hair loss. Retrieved from
  18. Punyani, S., Tosti, A., Hordinsky, M., Yeomans, D., & Shwartz, J. (2021, February 15). The Impact of Shampoo Wash Frequency on Scalp and Hair Conditions. NCBI. Retrieved from

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.

Sara Harcharik Perkins, MD

Sara Harcharik Perkins, MD, FAAD is a board-certified dermatologist and Assistant Professor in the Department of Dermatology at the Yale School of Medicine. She is the director of the Teledermatology Program, as well as the Associate Program Director of the Yale Dermatology Residency Training Program. Her research focuses on telemedicine and medical education. Her practice includes general medical dermatology, high-risk skin cancer, and procedural dermatology.

Dr. Perkins completed her undergraduate education at the University of Pennsylvania and obtained her medical degree at the Icahn School of Medicine at Mount Sinai. She completed her medical internship at the Massachusetts General Hospital, followed by residency training in dermatology at Yale University, after which she joined the faculty.

Dr. Perkins has been a member of the Hims & Hers Medical Advisory Board since 2018. Her commentary has been featured in NBC News, Real Simple, The Cut, and Yahoo, among others.


  • Ahmad, M., Christensen, S. R., & Perkins, S. H. (2023). The impact of COVID-19 on the dermatologic care of nonmelanoma skin cancers among solid organ transplant recipients. JAAD international, 13, 98–99.

  • Ahmad, M., & Perkins, S. H. (2023). Learning dermatology in medical school: analysis of dermatology topics tested in popular question banks. Clinical and experimental dermatology, 48(4), 361–363.

  • Belzer, A., Leasure, A. C., Cohen, J. M., & Perkins, S. H. (2023). The association of cutaneous squamous cell carcinoma and basal cell carcinoma with solid organ transplantation: a cross-sectional study of the All Of Us Research Program. International journal of dermatology, 62(10), e564–e566.

  • Ahmad, M., Marson, J. W., Litchman, G. H., Perkins, S. H., & Rigel, D. S. (2022). Usage and perceptions of teledermatology in 2021: a survey of dermatologists. International journal of dermatology, 61(7), e235–e237.

  • Asabor, E. N., Bunick, C. G., Cohen, J. M., & Perkins, S. H. (2021). Patient and physician perspectives on teledermatology at an academic dermatology department amid the COVID-19 pandemic. Journal of the American Academy of Dermatology, 84(1), 158–161.

  • Belzer, A., Olamiju, B., Antaya, R. J., Odell, I. D., Bia, M., Perkins, S. H., & Cohen, J. M. (2021). A novel medical student initiative to enhance provision of teledermatology in a resident continuity clinic during the COVID-19 pandemic: a pilot study. International journal of dermatology, 60(1), 128–129.

  • Cohen, J. M., Bunick, C. G., & Perkins, S. H. (2020). The new normal: An approach to optimizing and combining in-person and telemedicine visits to maximize patient care. Journal of the American Academy of Dermatology, 83(5), e361–e362.

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