Hair Loss & Follicle Decline in Women


FPB Causes   |   FPB Treatments   |   FPB Advice

I can not know what it feels like to be a female with hair loss.But after actively treating women’s hair scalp and hair follicles for 15 years, I am beginning to get a sense for the plight (and a thorough understanding of the conditions.)

Female Pattern Baldness (FPB)

While the follicles and the hair are very similar to that of a man, a number of factors make women’s follicles completely different. Unfortunately, with the widespread commercialization of men’s hair loss treatments, women may be less familiar with their own hair loss options.  But that is not a reason to settle for a un-satisfactory understanding and care.

Causes of Female Patterned Baldnesshairedges.com

Testosterone is the main culprit in Male Patterned Baldness. In Female Patterned Baldness, hormones are also to blame. Interestingly, Testosterone is produced in small quantities in a woman’s ovaries and her adrenal glands creating a similar but less severe condition in women called Female Patterned Hair Loss.  This is also referred to as Androgenic Alopecia and Diffuse Patterned Alopecia (DPA)- all representing the same condition.  However, due to the more complicated female hormone and endocrine system, diagnosing and treating the issue may be compounded.  Besides a number of hair-related medical conditions, overly aggressive styling may also contribute to hair loss in women.

Medications and Treatments for Female Pattern Baldness

One of the most popular anti-Testosterone medications, Finasteride, is not recommended for women with hair loss.  Fortunately many other options abound, including other FDA approved medications, vitamins and topical therapies ranging from Low Level Laser Light to Biocapillation™.  We often recommend healthier styling techniques and scalp hygiene measures all designed to maximize a healthy, full and substantial head of hair.  We take pride in confirming the cause and developing a treatment plan; ultimately, a shared vision between the patients goals and what we can realistically deliver.  Of course when appropriate, we will guide patients through the process of surgically restoring hair to the thinning areas.  This may include minor touch-ups, eyebrow transplants, test procedures, and at times, extensive hair transfers and rejuvenation for the most severe conditions.

Consult and Expert In Female Patterned Baldness for the Best Guidance

With many women, we may feel confident that hormones (and some genetics) are the problem.  However, with Unpatterned Hair Loss, other factors are contributing.  With 15 years experience in treating women with hair loss, Dr John E Frank, MD is usually able get a good sense of the diagnosis.  However, if there is are questions or concerns about a specific medical condition, then we can recommed a small biopsy, lab test or further analyses of the hair and scalp. Once confident with a diagnosis, then we can do something about it.

My advice is to get professional guidance.  A professional,  in-person appointment is optimal, but a video or Skype consult may suffice.  In my opinion, the commonly known Ludwig scale for female pattern hair loss is rudimentary and in-adequately portrays the actual extent of loss.  While oversimplifying women’s hair loss, it does not take into consideration a myriad of important nuances. It fails to differentiate between Patterned and Unpatterned Alopecia and disregards the importance of the Hair Cell Cycle. These must be clarified by an experienced doctor skilled in managing Female Hair Loss.


Dr John E Frank MD is the Board Certified Alopecia and Hair Follicle Surgeon. He is an Assistant Professor of Clinical Otolaryngology at Columbia University College of Physicians and Surgeons.  He has 15 years of experience treating all types of hair loss in women.