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Hair Loss in Older & Elderly Women: Causes, Treatment

Sara Harcharik Perkins, MD

Reviewed by Sara Perkins

Written by Sheryl George

Published 06/29/2021

Updated 11/14/2023

Listen, a lot of great things come with age— experience, wisdom and self-acceptance, to name a few. But alongside those perks come things that we’d rather not deal with, including chin whiskers and hair loss. But here’s some wisdom for you: if you’re dealing with hair loss, you’re far from alone.

Studies have shown that fewer than 45 percent of women go through life with a full head of hair. So as much it may seem like hair loss is an issue just for dudes, it’s not. 

Female pattern hair loss is the most common cause of hair loss for women, and prevalence increases with age. Many older women also notice hair loss or a decrease in hair health as they go through menopause. You can learn more about how menopause can affect hair growth in our guide on hair growth rate by age

In this article, we’ll dive into potential causes of hair loss in older women, along with exploring which treatments can be the most effective. Let’s get into it!

Hair Loss in Older & Elderly Women: Causes, Treatment

Listen, a lot of great things come with age— experience, wisdom and self-acceptance, to name a few. But alongside those perks come things that we’d rather not deal with, including chin whiskers and hair loss. But here’s some wisdom for you: if you’re dealing with hair loss, you’re far from alone.

Studies have shown that fewer than 45 percent of women go through life with a full head of hair. So as much it may seem like hair loss is an issue just for dudes, it’s not. 

Female pattern hair loss is the most common cause of hair loss for women, and prevalence increases with age. Many older women also notice hair loss or a decrease in hair health as they go through menopause. You can learn more about how menopause can affect hair growth in our guide on hair growth rate by age

In this article, we’ll dive into potential causes of hair loss in older women, along with exploring which treatments can be the most effective. Let’s get into it!

What Causes Hair Loss in Older Women?

Hair loss can be caused by a variety of factors, but the most common reason for hair loss in both men and women is genetics. And while hair loss can happen at any age, it becomes increasingly more common as you get older.

While approximately 12 percent of women aged between 20 and 29 years experience hair loss, over 50 percent of women over the age of 80 experience this condition.  

Hair loss can be complicated, but if you learn how to recognize the signs early and are quick to start treating it, you may be able to keep the hair you have, and even get some of what you’ve lost back.  

You can check out our guide on female pattern hair loss for a deep dive on causes and treatments, but let’s dig into some of the root causes you may want to consider. Genetics

Let’s start with the most common reason for hair loss in both men and women: genetics. Thanks, fam. But although we know this is the major underlying cause, the genetic predisposition to hereditary hair loss (or androgenetic hair loss) isn’t fully understood yet.  

While men with male pattern baldness may see a receding hairline or a prominent bald spot, hereditary hair loss looks a little different in women. You might find that your part is getting wider or you may see diffuse thinning over the top of the head.

You can learn more about the various signs of hair loss in women in our comprehensive guide. 

In both sexes, the hormone believed to be responsible for hair loss is the same: dihydrotestosterone (DHT), a hormone that your body produces as a byproduct of testosterone. 

Similar to how genetics play a role in whether you have blonde hair or brown, they also play a role in how sensitive you may be to DHT. In some people, DHT can affect their hairline by attaching to hair follicles and causing them to shrink.

As these hair follicles get smaller (or miniaturized), they can no longer support healthy hair. Instead, they produce thinner vellus-like hairs. These shorter, finer hairs cover the scalp poorly, leading to thinning or balding

DHT-related hair loss is often seen in women with polycystic ovary syndrome (PCOS). PCOS is characterized by a hormonal imbalance that can lead to irregular menstruation, acne, excess hair elsewhere on the body (hirsutism) and weight gain.

So if you’ve been diagnosed with PCOS or think you may have symptoms of PCOS, you could likely be dealing with androgenetic alopecia.

Menopause

Unfortunately, menopause doesn’t just bring on hot flashes — you can add hair loss to the list too. Menopause is known to cause some hormonal changes in women, usually over the age of 45,  and that hormonal havoc can lead to thinning hair. 

When women experience menopause, estrogen and progesterone drop. This can create an uptick of male hormones like testosterone and dihydrotestosterone in the blood, which can then lead to the loss and thinning of hair. This type of hair loss usually appears as thinning hair on the central part of your scalp and forehead.

Our guide on menopause hair loss and treatments is a great resource if you want to know more. 

Hair Styling

A lifetime of tightly pulled back hairstyles can also take a toll on your hairline. This form of hair loss, called traction alopecia, is caused by hairstyles (like tight ponytails, hair extensions, braids, and buns) that pull on the hair and cause targeted hair loss over time. 

If you’re experiencing hair loss around your temples and think you may have traction alopecia, our guide on ponytail hair loss is another great resource. 

Telogen Effluvium

There can be a lot happening in your personal life as you get older, whether it be a loss of a loved one, drastic weight loss or a sudden illness. These types of stressful events can lead to a type of excess shedding known as telogen effluvium.

If you’re experiencing sudden hair loss or have noticed hair falling out with a white bulb, you may want to read up on our guide to stress hair loss.  

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The Most Common Causes of Hair Loss in Elderly Women

Hair loss in women occurs for a variety of reasons, but hair loss in older women can also be due to factors that come specifically with age.

  • Aging. Just like you may notice fine lines or other changes in your skin over time, hair also can reflect the years. Studies have shown that hair diameter changes as you age and is likely to create the biggest impact on hair aging. In addition, postmenopausal women were shown to have significantly lower hair strand diameters than premenopausal women.

  • Health problems. Age tends to bring more wisdom, but it can unfortunately also bring on health issues. If you’re dealing with any health problems like autoimmune diseases, thyroid disorder or polycystic ovary syndrome (PCOS), they can trigger hair loss.  

Other people who may not have underlying health issues can still develop an autoimmune condition called alopecia areata. According to the American Academy of Dermatology, this disease develops when the body attacks its own hair follicles. It’s best to speak with your healthcare provider to fully understand how your medical conditions can affect your hairline

  • Medications. Some medications can cause a variety of side effects, including interfering with your normal hair cycle. Drug-induced hair loss is usually reversible once you stop taking said medication, but when it comes to stopping any medication or figuring out if a medication is responsible for your hair loss, it’s best to speak with your healthcare provider to understand what’s going on. 

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Treatment Options for Hair Loss in Older Women

While hair loss may feel complicated, the right treatment doesn’t have to be. There are lots of effective and easy-to-use hair loss treatments available now. Talk to your healthcare provider or dermatologist to figure out which is the best one for you. Here are some you may want to consider:

  • Topical minoxidil : Minoxidil (commonly sold as Rogaine®) works by increasing the blood supply to your hair follicles and prompting your hair to enter the anagen, or growth, phase of its cycle. And it’s FDA-approved to treat female hair loss. In a 2014 placebo-controlled trial, researchers found that both 2% and 5% versions of minoxidil improved hair thinning. Hers has two formulations available:  

    • Minoxidil drops: This easy-to-apply 2% solution can help target areas of hair loss like a wide part. 

    • Minoxidil foam: A 5% strength foam, this can be easily distributed to help quickly cover overall thinning. 

  • Oral minoxidil : Studies have shown that low-dose oral minoxidil can be an effective treatment for numerous hair disorders, including female-patterned hair loss (FPHL). This once-daily pill is especially great if you don't want to fuss with your styling options, although it’s only used as an off-label treatment for women.

Additionally, if you’ve tried topical minoxidil in the past and it didn't work for you, you may have better luck with the oral form. Minoxidil requires the presence of an enzyme called follicular sulfotransferase, and not everyone has high enough levels of this enzyme in their hair follicles.

So while a topical treatment will not work for those people, an oral form may help grow new hair.

  • Spironolactone: An once-daily anti-androgen pill, spironolactone helps decrease testosterone levels in the blood and lessens its effect in the body. It’s often prescribed off-label to treat female pattern hair loss, or female androgenetic alopecia. Read our guide to spironolactone for hair loss for a deeper dive into how it could help treat your hair loss and hormonal acne.  

  • Topical Finasteride Spray: Another topical solution to treat hair loss in older women, topical finasteride and minoxidil spray is a solid choice for postmenopausal hormonal hair. This selective 5-alpha reductase inhibitor helps decrease the conversion of testosterone into the hormone DHT, which can create hair loss in some. 

Healthy Hair Habits

Maintaining proper hair care is also critical if you’re dealing with thinning hair. Give your strands some TLC by being extra gentle. That means taking it easy when you wash and towel dry hair (no vigorous rubbing!) to avoid breakage. Additionally, keep your hot tools and hair dryer at a lower temperature to help fend off hair damage

Lastly, think about your hair from the inside out. Make sure to have a healthy diet and check with your healthcare provider to see if you have any nutritional deficiencies that might be getting in the way of healthy hair growth. If it turns out you need a vitamin boost, check out our biotin gummies.

Want to learn how to have your fullest mane? Read our guide on how to get thick hair for more tips.

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Causes of Hair Loss in Older Women: Takeaways

Remember, it’s totally normal to experience hair loss, and it’s even more common to experience hair loss if you’re over 50. You are most definitely not alone, even if it’s not a club you want to be a part of. 

However, you don’t have to just go through the rest of your life with a combover. There are plenty of hair loss treatments that can help you get a fuller head of hair again. Here are the things to keep in mind: 

  1. Know that you are not alone. Hair loss for women can feel really isolating but more than half of women experience hair loss in their life. 

  2. Identify the root cause. Figure out whether you have traction alopecia vs. female pattern hair less or another issue. This will help you figure out the best course of treatment.

  3. Act fast. Once you figure out the root cause, get your game plan in place. Whether it be minoxidil, a supplement or finasteride, stay consistent with applying or taking your medication so you can get the best results.

Ready to make moves? Meet with one of our medical providers online from the comfort of your home and get a healthcare provider-recommended hair loss consultation today.

12 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 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2684510/
  2. Trüeb, R. M. (2021, December 14). Understanding Pattern Hair Loss—Hair Biology Impacted by Genes, Androgens, Prostaglandins and Epigenetic Factors. NCBI. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8719969/
  3. Goluch, Z. S. (2016, March 29). Nutrition of women with hair loss problem during the period of menopause. NCBI. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4828511/
  4. Pulickal, J. K., & Kaliyadan, F. (2022, August 8). Traction Alopecia - StatPearls. NCBI. Retrieved April 25, 2023, from https://www.ncbi.nlm.nih.gov/books/NBK470434/
  5. Androgenetic alopecia. (2015, August 1). MedlinePlus. Retrieved from https://medlineplus.gov/genetics/condition/androgenetic-alopecia/#synonyms
  6. Hughes, EC & Saleh, D. (2022)Telogen Effluvium. StatPearls - NCBI Bookshelf Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK430848/
  7. Trüeb, R. M., Rezende, H. D., & Reis Gavazzoni Dias, M. F. (2018). A Comment on the Science of Hair Aging. NCBI. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6369639/
  8. 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 https://academic.oup.com/jcem/article/93/11/4381/2627273
  9. Blume-Peytavi, Ulrike, Hillmann, Kathrin, Dietz, Ekkehart, Canfield, Douglas & Bartels, Natalie Garcia. A randomized, single-blind trial of 5% minoxidil foam once daily versus 2% minoxidil solution twice daily in the treatment of androgenetic alopecia in women (2011). Retrieved from https://pubmed.ncbi.nlm.nih.gov/21700360/
  10. Ramírez-Marín, Hassiel Aurelio & Tosti, Antonella Role of Oral Minoxidil in Patterned Hair Loss. (2022) Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9650732/
  11. Levy, L., & Emer, J. J. (2013, August 29). Female pattern alopecia: current perspectives - PMC. NCBI. Retrieved April 25, 2023, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3769411/
  12. Iamsumang, W., Leerunyakal, K., & Suchonwanit, P. (2020, March 2). Finasteride and Its Potential for the Treatment of Female Pattern Hair Loss: Evidence to Date. NCBI. 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.

Sara Perkins

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.

Publications:

  • 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. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10518328/

  • 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. https://academic.oup.com/ced/article-abstract/48/4/361/6869515?redirectedFrom=fulltext&login=false

  • 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. https://onlinelibrary.wiley.com/doi/10.1111/ijd.16700

  • 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. https://onlinelibrary.wiley.com/doi/10.1111/ijd.16209

  • 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. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7491373/

  • 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. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7753449/

  • 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. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7316470/

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