Female Hair loss

Female hair loss is a far more common condition than ever thought. The false belief that hair loss in women is extremely rare, makes them reluctant to seek professional help and advice.

A confidential consultation with us can provide you with the reassurance and confidence needed to take a positive step to remedy the situation.

Hair loss in women is challenging to correctly diagnose. The reason being, is that a number of conditions mimic the same diffuse pattern, in which the hair over the top and crown becomes thinner. There is often some investigation needed to first isolate the true cause before properly treating it.

How do we diagnose your hair loss?

At Vertex, we will first take a detailed medical and family history, followed by a thorough microscopic examination of your hair and scalp.

It is likely that you will need some blood tests: full blood count, glucose levels, serum ferritin (iron stores), thyroid hormones and -where relevant- specific hormone levels amongst others. The treatment you require, whether medical, surgical or simply cosmetic, will depend on the identified cause of the hair loss.In many cases, where there is permanent hair loss and a sufficient area of normal hair growth, hair transplantation can be considered, but only once the underlying problem has been correctly diagnosed and treated.

What happens next?

One very important aspect of your treatment is long-term planning. During your consultation, you will be taken through the advantages and disadvantages of all the treatment options available to you. It is imperative that you make an informed choice.

Some women are more suitable to surgical treatment than others (and some are not suitable candidates at all). We shall seek to give you a realistic idea of the type of result you can expect from your treatment, whether it be medical or surgical.

Ludwig scale of female pattern hair loss


When assessing your hair loss at home, stand in front of a mirror and hold a mirror behind and over your head, just as they do in a hairdressing salon. You may require the help of a friend or family member. (Ludwig Diagram provided)

Type I: At this stage, most women may find it difficult to notice any hair loss, as the frontal hairline remains relatively unaffected. Hair loss may occur on the top and front of the scalp. Such hair loss may be noticeable when the hair is parted down the centre of the scalp, as more and more scalp is visible over time.

Type II: At this stage, women may notice each of the following: thinning, shedding, general decrease in volume and a centre part that widens over time. Depending on the severity, a hair transplant procedure may be a viable option for women who exhibit these features.

Type III: This is the most extreme classification of female hair loss. At this point,  hair is so thin that it becomes difficult to camouflage the scalp. This makes the scalp clearly visible to the naked eye.

It is important to know that females exhibiting a familial pattern hair loss as described in the three stages above will never go skin bald. It is also almost impossible for females in this group to lose their frontal hairline completely, in the same way that male pattern hair loss presents. On the other hand, some women may exhibit a similar pattern of loss to that in men. This typically involves a degree of temporal recession, and if no underlying cause is identified, it can be surgically corrected.

Other causes of male hair loss

Traction Alopecia

This is caused by tight braiding or pulling on the hair (e.g. tight ponytail hairstyle) and is temporary if the traction is short-term, but becomes permanent with prolonged pulling. One male example of this is seen in some Sikh men after years of tying up their long hair. It is most usually seen as a bald area at the very front of the hairline. Hair transplant surgery can restore hair permanently, as long as the cause of the problem stops.

The use of electric hair straighteners – particularly if over-used and pulled too hard – can bring on traction alopecia.

Chemical Scarring and Burns

Chemicals used in hairdressing – dyes, bleaches, perms, straighteners and relaxers – may cause hair breakage, rather than true hair loss. However, if the substances are used incorrectly, then they can actually cause damage to the skin and to the hair follicles, causing permanent hair loss. Similarly, burns to the skin can destroy the hair follicles and cause a balding patch. In both of these cases, hair transplantation might be a treatment option, but this depends on the amount of scar tissue present.

In some cases of less severe damage, a gentle shampoo followed by a vitamin E containing is sufficient to relieve the damage.

Physical and emotional Stress

Severe illness, surgery, medical conditions (such as thyroid abnormalities or low blood counts), rapid weight change or emotional stress can cause or accelerate hair loss. Once the source of the stress stops, hair usually grows back within few months.

Plastic surgery

Face or brow lifts, or surgeries involving excessive puling on the face, may cause hair loss around the frontal hairline can occur. This can be effectively treated with hair transplantation. Hair loss following facial cosmetic surgery can be temporary and will grow back after time. Neverthless, it may be permanent in certain cases. A consultation with us can identify your particular condition and advise you on the best action to take.

Alopecia Areata (AA)

This is believed to be an auto-immune condition, whereby the body produces antibodies against hair, ultimately leading to hair loss. The condition typically appears as one or more isolated patches of complete baldness. In more severe forms, there might be a total baldness of the scalp (alopecia totalis) or even total loss of all body hair (alopecia universalis). Sometimes, medical treatment can be successful in treating the mild forms of AA. In many cases, the condition clears up by itself, but may recur at a later stage. Contrary to some beliefs, AA is not associated with pain and is not an inherited condition.


There are hundreds of drugs known to cause hair loss – these include some forms of blood thinning drugs, thyroid medications, chemotherapy for cancer and contraceptive pills. Again, the effects should be reversible once the drug is changed or stopped. Your primary doctor or pharmacist can help assess any adverse reaction related to your medications. It is also important to bring a list of your medications with you, should you schedule a consultaton with us.

Skin conditions and Cicatricial alopecias

Skin problems such as eczema, psoriasis, scarring conditions and infections can cause temporary or permanent hair loss. If the hair loss is permanent, we offer a choice of surgical treatments to restore hair to the area, but only when the underlying skin condition has been successfully treated or has become inactive. Many of these conditions tend to be chronic, or at least flare up now and again. Surgery should only be considered when the skin condition is definitely inactive. In some cases, a thorough evaluation and biopsy of the scalp is necessary to diagnose and quantify the underlying skin pathology.

Chemotherapy and Radiotherapy

Many of the drugs used in chemotherapy act through attacking the cancer cells and disrupting their growth. Unfortunately, they can also affect the normally dividing cells in the body – including hair follicles. A potentially effective way to reduce hair loss during chemotherapy is to wear a ‘cool cap’ that inhibits the amount of chemotherapy-related drugs reaching the scalp. Fortunately -in most cases- hair will grow back following the completion of the course.

Similarly, rays used in radiotherapy treatment of cancer will cause hair loss in the area exposed to the treatment.

In cases where hair fails to regrow, or is not satisfactory-following chemo or radiotherapy-we can certainly assist you to alleviate your hair loss problem. We will certainly liaise with the medical team looking after you prior to any form of treatment. While we do understand the anxiety associated with hair loss and the impact it might have on your overall quality of life, we do take your safety and your ultimate goal in fighting cancer as a priority.


Trichotillomania is a compulsion disorder whereby a person uncontrollably pulls their hair out. They may do so from their scalp, eyebrows or even eyelashes. It is a psychological condition where the person is simply unable to stop themselves from carrying out this action. Usually there is an intense urge to pull the hair out and an immense relief after pulling it out. Pulling out hair on the scalp or other areas can ultimately leave bald patches.

Sufferers may experience guilt, embarrassment, shame or other negative feelings.

The first line treatment should be counselling and psychological therapy. Treatments such as hair transplant surgery may only be considered if it’s assured that the urge to pull hair has stopped completely.

Pregnancy and Childbirth

Many women experience some degree of hair loss few months after giving birth. This is due to a delay in the normal ‘shedding’ process during pregnancy. The hair usually gets thicker during pregnancy due to increased levels of estrogen -which prolongs the growing stage – reducing the amount of hair fall in the shower or on the hair brush.

After delivery, hair cycling returns to its normal state. This accounts for an apparent ‘hair loss’. The scalp hair balance should normally be restored 6-12 months after childbirth.