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What causes women’s hair to thin on top?

Hair thinning and loss on the top of the head is a common issue that affects many women as they age. While genetics play a major role, there are various other factors that can contribute to hair thinning in women. Understanding the potential causes can help identify solutions to slow down thinning and hair loss.

The Normal Hair Growth Cycle

It’s normal to lose some hair each day as part of the hair growth cycle. The average scalp has about 100,000 hairs that continuously grow in cycles. Each follicle grows hair for 2-6 years, rests for a few months, and then grows new hair. Most people lose 50-100 hairs per day as part of this cycle. More noticeable hair shedding can occur after physical or emotional stress, major illness, or childbirth.

Hair thinning becomes a concern when you start losing more hair than normal or develop bald patches. This can result from the hair growth cycle being disrupted or hair follicles becoming damaged and unable to grow new hair.

Genetic Factors

Genetics play a major role in hair thinning and loss on the top of the head and across the entire scalp. This condition is known as androgenetic alopecia or female pattern baldness. It’s associated with hormonal changes and family history.

Women with a family history of female pattern baldness are more likely to experience thinning hair. It’s linked to having genes that make scalp hair follicles sensitive to normal levels of androgens like testosterone. This causes the follicles to shrink and produce thinner hair over time.

Female pattern baldness typically starts with gradual thinning on the top of the head. Over time, the center part widens, and more of the scalp becomes visible. Genetic hair loss tends to start around age 40-50 in women but can begin as early as puberty.

Hormonal Changes

Hormonal imbalances and changes can disrupt the hair growth cycle and cause temporary or permanent hair loss. Some key hormones that influence hair growth include:

  • Estrogen – Helps grow and maintain hair
  • Progesterone – Works with estrogen to grow hair
  • Testosterone – Small amounts aid hair growth, but excess causes thinning
  • Thyroid hormones – Regulates metabolism and hair growth

When these hormones are out of balance due to perimenopause, menopause, postpartum changes, thyroid disorders, or other conditions, hair thinning often results. The most sudden hair loss is typically seen after pregnancy when estrogen levels quickly drop.

Perimenopause and Menopause

During the lead-up to menopause, fluctuating estrogen and progesterone levels commonly cause hair thinning in women over 40. Lower estrogen disrupts the hair growth cycle and testosterone becomes more predominant. This combination leads to overall hair loss.

After menopause, hair loss may continue due to lower estrogen production. The rate of hair regrowth also slows down significantly for some women.

Post-Pregnancy Hair Loss

Many women experience sudden hair shedding 2-4 months after giving birth. During pregnancy, increased estrogen prevents normal hair loss. After delivery, estrogen levels quickly drop while testosterone increases. This hormone change leads to rapid hair loss, but it’s usually temporary.

Thyroid Disorders

Both hypothyroidism and hyperthyroidism can trigger hair thinning and loss. Too much or too little thyroid hormone disrupts the hair growth cycle. Some of the signs of a thyroid disorder include:

  • Dry, thinning hair
  • Hair that feels brittle or coarse
  • Hair loss, usually evenly distributed
  • Excessive shedding

Nutritional Deficiencies

Being deficient in certain nutrients can starve hair follicles and cause shedding, thinning, and slowed regrowth. Some key nutrients for healthy hair include:

  • Protein
  • Iron
  • Zinc
  • Vitamin D
  • Vitamin B12
  • Omega-3 fatty acids

Heavy dieting, restrictive eating disorders, bariatric surgery, and very low-fat diets can result in nutrient deficiencies that contribute to diffuse hair loss. Daily multivitamins can help fillNutritional deficiencies can develop at any age and negatively impact hair health.


Certain prescription medications and medical treatments are linked to temporary or permanent hair loss. Some examples include:

  • Acne medications like retinoids
  • Blood thinners
  • Antidepressants
  • NSAIDs
  • Beta-blockers
  • Birth control pills
  • Chemotherapy
  • Radiation therapy

The medication itself or resulting vitamin/mineral deficiency can cause hair shedding. Hair loss is most pronounced with chemotherapy. It may be reversible after treatment stops.

Scalp Conditions

Inflammatory scalp conditions can cause hair thinning and loss around affected areas. Some examples include:

Alopecia Areata

This autoimmune disorder causes patchy hair loss, typically starting with coin-sized bald spots. It can lead to complete hair loss (alopecia totalis) or body-wide hair loss (alopecia universalis).

Lichen Planopilaris

This inflammatory condition causes scarring alopecia. It involves scaling patches, redness, and irreversible hair loss.

Discoid Lupus

An autoimmune condition that can lead to scarring and scarred areas of hair loss, mainly on the scalp.

Fungal Infections

Fungal infections like tinea capitis (ringworm) attack hair follicles leading to scaling, redness, and hair breakage/loss in affected areas.

Lichen Planus

This rash-like condition can involve the scalp and cause inflammation around hair follicles, resulting in scarring and permanent hair loss.

Traction Alopecia

This type of hair loss happens when the hair is put under constant tension through tight hairstyles, braiding, weaves, or hair extensions. It can lead to receding hairlines and thinning around the frontal/temporal regions.

The tension damages the hair follicles. If detected early, hair regrowth is possible by avoiding tight hairstyles that pull on the hair.

Telogen Effluvium

Stress to the body from childbirth, major surgery/illness, severe stress or rapid weight loss can shift large numbers of resting hair follicles into the shedding phase. This results in sudden heavy shedding 2-4 months later called telogen effluvium.

While alarming, telogen effluvium is temporary and the growth phase rebounds 6-9 months later. Mild shedding may continue from the stress even after regrowth occurs.

Poor Hair Care Habits

Certain hair care habits can damage hair follicles and lead to thinning if done excessively over time. These include:

  • Tight ponytails
  • Brushing wet hair forcefully
  • Backcombing
  • Using curling/flat irons at very high temps
  • Chemical processing – perms, relaxers, dyes
  • Overwashing hair

Improper care weakens hair and causes breakage over time. The safest approach is to avoid harsh chemical treatments and minimize heat styling when possible.

Underlying Medical Conditions

Sometimes, hair loss can signal an underlying medical issue that needs proper diagnosis and treatment. Medical conditions that may cause hair thinning/loss include:

  • Autoimmune diseases like lupus or rheumatoid arthritis
  • Skin conditions like psoriasis or eczema
  • Ulcerative colitis, Crohn’s disease
  • Liver or kidney disease
  • Diabetes
  • Polycystic ovary syndrome (PCOS)
  • Anemia – iron deficiency
  • Eating disorders
  • Cancer, lymphoma

Your doctor can run tests to check for any underlying disorders and provide proper treatment. Hair regrowth may occur once the condition is under control.

Aging Process

As we age, hair follicles shrink, and the growth cycles shorten. Hair becomes thinner and grows slower. Women over 50 tend to experience hair that is thinner in texture versus the thick, coarse strands of youth.

The aging process combined with changing hormones causes 50% of women to experience some degree of hair loss by age 50, often focused on the top of the head and frontal region.

Preventing Further Hair Loss

While thinning hair on top is largely genetic for many women, taking proactive steps can often slow down shedding and help make the most of the hair you have left.

Some tips for minimizing hair loss include:

  • Ask your doctor to check for underlying disorders and nutrient deficiencies. Address hormonal imbalances.
  • Eat a varied, nutrient-rich diet and take a daily multivitamin.
  • Reduce stress and get enough sleep.
  • Avoid super tight hairstyles, limit heat styling, and use mild hair products.
  • Gently massage the scalp to increase circulation.
  • Use volumizing shampoos and conditioners made for thinning hair.
  • Ask your stylist for face-framing layers and volume boosting cuts if hair is thinning.
  • Consider trying FDA approved treatments like minoxidil (Rogaine) or low level light therapy devices.
  • Talk to your doctor about prescription options like spironolactone oral tablets.
  • Consider topical Serenoa Repens (saw palmetto) for anti-androgen properties.

When to Seek Medical Advice

Make an appointment with your doctor or dermatologist if you notice any of the following warning signs related to hair thinning/loss:

  • Sudden shedding episodes or rapid hair loss
  • Bald patches/spots
  • Receding hairline
  • Hair falling out in clumps
  • Scalp itchiness, redness, burning, or pain
  • Newly grown hair that is brittle/dry
  • Hair loss after starting new medications
  • Other bothersome or suspicious symptoms

A doctor can pinpoint the cause, check for underlying conditions, and provide medication or procedures if appropriate. Early intervention provides the best chance to regrow hair or prevent future loss.

Medical Treatment Options

If hair loss is caught early and the cause is treatable, doctors may prescribe medications or recommend procedures to help stimulate regrowth. Options may include:

  • Minoxidil – Topical solution that can stimulate hair growth and slow loss. Brand name is Rogaine.
  • Low-level laser therapy – Low light beams help reactivate follicles.
  • Corticosteroid injections – Help treat patchy alopecia areata hair loss.
  • Anti-androgens – Spironolactone tablets block androgens, useful for female pattern hair loss.
  • Iron supplements – If iron deficiency anemia is causing shedding.
  • Biotin – Helps produce keratin for hair growth.
  • PRP injections – Injected platelets stimulate follicles.
  • Hair transplant – Plugs from the back of the scalp replanted into thinning areas.

Cosmetic Solutions for Thinning Hair

There are also cosmetic products and solutions that can disguise hair thinning, create fullness, and make hair look thicker. These include:

  • Volumizing shampoos, conditioners, sprays, and mousses.
  • Coloring/highlighting hair to blend gray and add depth.
  • Styling tricks like layers, side-swept bangs, lift at the roots.
  • Hair thickening fibers like Toppik that cling to hair.
  • Volumizing haircuts with layers to add fullness.
  • Clips, headbands, scarves, hats to cover thin spots.
  • Hair thickening masks, serums, oils to strengthen hair.

Dealing with Thinning Hair Emotionally

It’s natural to feel self-conscious, less confident, or concerned when you start noticing more scalp due to thinning hair. Some tips that may help:

  • Remember that hair loss is common – you’re not alone.
  • Focus on inner confidence and other positive traits.
  • Find flattering hairstyles that downplay thinning and feel comfortable.
  • Invest in a quality human hair topper, extensions, or wig for fuller look.
  • Talk to friends and family about your feelings.
  • Consider joining support groups to share experiences.
  • Look into counseling or therapy to handle self-esteem issues.


Noticing hair thinning and loss on the top of the head can be distressing for women, but the problem is incredibly common. While genetics play a major role, hormone changes, health conditions, medications, poor nutrition, hair damage, and aging can all influence hair growth. Working with your doctor to rule out underlying issues and using both medical and cosmetic solutions can help to retain hair and restore confidence.