Hair Loss in Women — Causes, Treatments, and PRP Therapy

Last updated: 5 March 2026

Hair loss in women is far more common than many people realise. Research published in the British Journal of Dermatology estimates that 40% of women will experience visible hair loss by age 50, yet the condition remains significantly underdiagnosed and undertreated compared to male pattern baldness. The psychological impact can be devastating — a study in the Journal of the American Academy of Dermatology (2017) found that women with hair loss reported significantly higher rates of anxiety, depression, and reduced quality of life compared to age-matched controls.

This comprehensive guide examines the causes of hair loss in women, the diagnostic process, and the full range of treatment options including the increasingly popular PRP (Platelet-Rich Plasma) therapy.

Understanding Female Hair Loss: Types and Causes

Female Pattern Hair Loss (FPHL)

The most common type of hair loss in women, FPHL affects approximately 30 million women in the UK and US combined. Unlike male pattern baldness, which typically follows a receding hairline pattern, FPHL presents as diffuse thinning over the crown and frontal scalp, with the frontal hairline generally preserved. The Ludwig classification system grades FPHL into three stages of increasing severity.

FPHL is primarily driven by a genetic predisposition to androgen sensitivity at the hair follicle level, combined with the effects of dihydrotestosterone (DHT). However, unlike in men, the role of androgens in FPHL is more complex — many women with FPHL have normal androgen levels, as demonstrated by a study in the Journal of the European Academy of Dermatology and Venereology (2017).

Telogen Effluvium

Telogen effluvium (TE) is the second most common cause of hair loss in women. It occurs when a physiological or emotional stressor pushes a larger-than-normal proportion of hair follicles into the resting (telogen) phase simultaneously, resulting in diffuse shedding 2 to 4 months after the triggering event. Common triggers include:

• Childbirth: Post-partum hair loss affects up to 50% of women and typically resolves within 6 to 12 months.
• Surgery or illness: Significant physical stress can trigger TE.
• Severe emotional stress: Including bereavement, divorce, or job loss.
• Nutritional deficiencies: Particularly iron, ferritin, vitamin D, zinc, and biotin.
• Medication changes: Including starting or stopping hormonal contraceptives.
• Rapid weight loss or crash dieting: Particularly diets severely restricting protein or calories.
• COVID-19: Post-COVID TE has been extensively documented, with a study in The Lancet (2021) reporting significant hair shedding in up to 25% of patients 3 to 6 months after infection.

Alopecia Areata

An autoimmune condition in which the immune system attacks hair follicles, causing patchy hair loss. It can affect any hair-bearing area and ranges from small patches to complete scalp hair loss (alopecia totalis) or total body hair loss (alopecia universalis). Research in Nature Reviews Disease Primers (2017) identified the role of CD8+ T-lymphocytes and interferon-gamma signalling in the pathogenesis of alopecia areata.

Other Causes of Female Hair Loss

• Traction alopecia: Caused by prolonged tension on hair from tight hairstyles, braids, or extensions. If addressed early, it is reversible.
• Thyroid disorders: Both hypothyroidism and hyperthyroidism can cause diffuse hair thinning.
• Polycystic ovary syndrome (PCOS): Elevated androgens can cause both scalp hair thinning and increased facial/body hair.
• Scarring alopecias: Including frontal fibrosing alopecia (FFA), which has been increasing in prevalence among post-menopausal women. A study in the British Journal of Dermatology (2019) described FFA as an “epidemic” in recent years.
• Iron deficiency: Even without anaemia, low ferritin levels (below 30 ng/mL) have been associated with increased hair shedding, as shown by Park et al. in the Journal of Korean Medical Science (2013).

“Hair loss in women deserves the same clinical attention as any other medical concern. A thorough diagnostic workup is essential because the treatment approach depends entirely on identifying the correct underlying cause. What looks like simple thinning could be hormonal, nutritional, autoimmune, or a combination of factors.” — Dr. Priya Chen, Axiom Aesthetics

Diagnosing Female Hair Loss

An accurate diagnosis is the foundation of effective treatment. The diagnostic process typically includes:

1. Detailed medical history: Including onset, pattern, family history, medications, diet, stress levels, menstrual history, and recent life events.
2. Clinical examination: Assessment of hair density, distribution, calibre, and scalp condition. The pull test and wash test help quantify active shedding.
3. Trichoscopy (dermoscopy of the scalp): A non-invasive examination using a polarised dermatoscope that can reveal miniaturisation, yellow dots, exclamation mark hairs, and other diagnostic features.
4. Blood tests: Full blood count, ferritin, iron studies, thyroid function, vitamin D, zinc, hormonal panel (DHEA-S, testosterone, SHBG), and ANA (if autoimmune alopecia is suspected).
5. Scalp biopsy: In cases where the diagnosis remains uncertain, a 4mm punch biopsy with horizontal sectioning can provide definitive information.

Treatment Options for Female Hair Loss

Topical Treatments

Minoxidil (Rogaine): The only topical medication approved for female pattern hair loss. Available in 2% and 5% concentrations. A pivotal study by Lucky et al. in the Journal of the American Academy of Dermatology (2004) demonstrated that 5% minoxidil was superior to 2% for women with FPHL. Minoxidil works by prolonging the anagen (growth) phase and increasing follicular blood flow. It must be used continuously to maintain results.

Topical finasteride/dutasteride: While oral finasteride is contraindicated in women of childbearing age, topical formulations are being investigated. A study by Suchonwanit et al. in the Journal of the American Academy of Dermatology (2018) showed promising results for topical finasteride 0.25% in post-menopausal women with FPHL.

Oral Medications

• Spironolactone: An anti-androgen medication used off-label for FPHL at doses of 100-200mg daily. Research by Sinclair et al. in the British Journal of Dermatology (2005) demonstrated stabilisation or improvement in 74% of women treated with spironolactone.
• Oral minoxidil (low dose): Increasingly used at 0.25 to 2.5mg daily. A study by Ramírez-Marín et al. in JAMA Dermatology (2022) found low-dose oral minoxidil effective and well-tolerated for female hair loss.
• Nutritional supplementation: Iron, ferritin, vitamin D, biotin, and zinc supplementation when deficiencies are identified.

Light Therapy

Low-Level Laser Therapy (LLLT): FDA-cleared devices (such as laser caps and combs) use red light wavelengths (typically 650-670nm) to stimulate hair follicle activity. A randomised, double-blind study published in the American Journal of Clinical Dermatology (2014) by Lanzafame et al. demonstrated a 37% increase in hair growth compared to placebo in women with FPHL after 26 weeks of treatment.

PRP Therapy for Hair Loss: The Science and Evidence

What Is PRP?

Platelet-Rich Plasma (PRP) therapy uses the patient’s own blood, processed to concentrate platelets to 3 to 8 times their normal blood concentration. These concentrated platelets release growth factors — including platelet-derived growth factor (PDGF), transforming growth factor-beta (TGF-β), vascular endothelial growth factor (VEGF), epidermal growth factor (EGF), and insulin-like growth factor (IGF-1) — that stimulate hair follicle activity, prolong the anagen phase, and promote new blood vessel formation around follicles.

How PRP Hair Treatment Works

1. Blood draw: 20 to 60ml of blood is taken from the patient’s arm.
2. Centrifugation: The blood is processed in a centrifuge to separate red blood cells from platelet-rich plasma. The processing protocol significantly affects the quality and platelet concentration of the final product.
3. Activation and injection: The concentrated PRP is injected directly into the scalp at the level of the hair follicles, using a series of small injections spaced approximately 1cm apart across the thinning area.

Clinical Evidence for PRP in Hair Loss

The evidence base for PRP in hair loss has grown substantially in recent years:

• A meta-analysis by Evans et al. in Aesthetic Plastic Surgery (2020) analysed 10 randomised controlled trials and concluded that PRP significantly improved hair count and hair thickness compared to placebo.
• A split-scalp study by Gentile et al. published in Stem Cells Translational Medicine (2015) demonstrated a mean increase of 33.6 hairs per cm² on the PRP-treated side compared to the control side at 3 months.
• A comprehensive review by Giordano et al. in the Journal of Cosmetic Dermatology (2022) reported improvements in both hair density and hair shaft diameter across multiple studies, with response rates between 60% and 85%.
• Alves and Grimalt published in Dermatologic Surgery (2016) that women showed a particularly strong response to PRP, with greater improvement in hair density compared to male patients.

PRP Treatment Protocol

At Axiom Aesthetics, our PRP hair restoration protocol typically consists of:

• Initial course: 3 to 4 sessions spaced 4 to 6 weeks apart
• Maintenance: Sessions every 3 to 6 months to sustain results
• Combination approach: PRP is often combined with topical minoxidil and nutritional optimisation for maximum benefit

Most patients begin to notice reduced shedding within 2 to 4 weeks of their first session, with visible improvement in density becoming apparent at 3 to 6 months.

“PRP therapy has become a valuable addition to our hair loss treatment toolkit. What I find particularly compelling is the growing body of evidence showing that it works through multiple mechanisms — stimulating dormant follicles, increasing blood supply, and creating a more favourable microenvironment for hair growth. Combined with the excellent safety profile of using the patient’s own blood, it offers a treatment approach that many women find appealing.” — Dr. Priya Chen

Advanced and Emerging Hair Loss Treatments

• Microneedling with PRP: Combining dermaroller or dermapen treatment with PRP. A study by Dhurat et al. in the International Journal of Trichology (2015) found that microneedling combined with minoxidil outperformed minoxidil alone in androgenetic alopecia.
• Exosome therapy: Stem cell-derived exosomes containing growth factors and signalling molecules. Early clinical data is promising, though larger trials are needed.
• Hair transplantation (FUE): Follicular Unit Extraction is a permanent solution for localised thinning, transplanting hair from donor areas (typically the occipital scalp) to thinning areas. Modern FUE techniques produce natural, undetectable results.
• JAK inhibitors: Baricitinib received FDA approval for severe alopecia areata in 2022, representing a breakthrough for autoimmune hair loss. Published in the New England Journal of Medicine by King et al., it demonstrated significant hair regrowth in a substantial proportion of patients.

Lifestyle and Nutritional Support for Healthy Hair

While medical treatment addresses the underlying cause, supporting hair health through nutrition and lifestyle is important:

• Protein intake: Hair is made of keratin (a protein). Ensure adequate protein consumption — at least 0.8g per kg of body weight daily.
• Iron-rich foods: Red meat, spinach, lentils, and fortified cereals. Aim for ferritin levels above 40 ng/mL for optimal hair growth.
• Omega-3 fatty acids: Found in oily fish, walnuts, and flaxseeds. A study in the Journal of Cosmetic Dermatology (2015) demonstrated that omega-3 supplementation improved hair density.
• Stress management: Chronic stress contributes to telogen effluvium. Regular exercise, adequate sleep, and stress-reduction practices support healthy hair cycling.
• Gentle hair care: Avoid excessive heat styling, chemical treatments, and tight hairstyles that place tension on follicles.

Frequently Asked Questions

How quickly will I see results from PRP hair treatment?

Most patients notice reduced hair shedding within 2 to 4 weeks of their first PRP session. Visible improvement in hair density and thickness typically becomes apparent at 3 to 6 months, with continued improvement over 6 to 12 months as dormant follicles reactivate and hair shafts thicken. Results vary between individuals, and factors such as the degree of hair loss, underlying cause, and overall health influence the response.

Is PRP hair treatment painful?

The scalp injections cause mild to moderate discomfort, often described as a series of small pinches. At Axiom Aesthetics, we use topical anaesthetic cream applied 30 to 45 minutes before treatment to minimise discomfort. Most patients tolerate the procedure well and return to normal activities immediately afterward.

Can hair loss in women be reversed completely?

This depends on the cause and how early treatment begins. Telogen effluvium is typically fully reversible once the triggering factor is addressed. Female pattern hair loss can be stabilised and often improved, but early intervention produces better results — miniaturised follicles are much easier to rescue than follicles that have been lost entirely. Traction alopecia is reversible if caught before scarring occurs. Scarring alopecias, unfortunately, cannot regrow hair in areas where follicles have been permanently destroyed.

Are there any side effects of PRP treatment?

Because PRP is derived from your own blood, the risk of allergic reaction or rejection is essentially zero. Common side effects include mild scalp tenderness, swelling, and redness at injection sites, resolving within 24 to 48 hours. Some patients experience a mild headache on the day of treatment. Serious complications are extremely rare.

When should I see a specialist about my hair loss?

We recommend seeking a professional assessment if you notice increased shedding lasting more than 3 months, visible thinning of the ponytail or part width, receding hairline, or patchy hair loss. Early intervention is key — the sooner hair loss is diagnosed and treated, the better the outcomes. If you have a family history of hair loss or are experiencing hair loss alongside other symptoms (fatigue, weight changes, irregular periods), prompt evaluation is particularly important.