What causes alopecia in women? The most common reasons and what to do next

Whether it first appears as a widening parting, bald patches, or more hair than usual coming away in the shower, hair loss can feel really unsettling. For many women, hair is wrapped up in how they feel about themselves, which means changes are often felt emotionally as well as physically.

Alopecia is the medical term for hair loss. It covers a wide range of conditions — from temporary hair loss that resolves on its own, to more persistent or progressive forms that require treatment. Understanding what causes alopecia and recognising which type you might be experiencing are often the first steps towards finding the right support.

The earlier you look into it, the more options you tend to have. Here’s what you need to know.

What is alopecia, and what are the different types?

Alopecia describes hair loss from the scalp or elsewhere on the body. There is no single form of it — the term covers several distinct conditions, each with different causes, patterns, and outcomes.

A key distinction is whether the condition is scarring or non-scarring. In non-scarring alopecia, the hair follicles remain intact, which means hair growth may eventually return. In scarring alopecia, inflammation causes permanent damage to the follicles and prevents regrowth, so noticing the signs early can help to prevent long-term hair loss [1].

Common types of alopecia in women include:

• Female pattern hair loss (androgenetic alopecia): The most common cause of hereditary hair loss in women. It tends to appear as a gradual thinning across the crown rather than complete baldness [2].
• Alopecia areata: An autoimmune disease in which the immune system attacks healthy hair follicles, leading to round or small patches of hair loss on the scalp or body [3].
• Telogen effluvium: A temporary hair loss condition triggered by illness, hormonal changes, or a very stressful event. Shedding typically appears two to three months after the trigger [4].
• Traction alopecia: Hair loss caused by repeated tension on the roots from tight hairstyles — often worsened by chemical treatments or heat styling — particularly around the temples [5].
• Frontal fibrosing alopecia: A type of scarring alopecia that causes a slowly receding hairline, often alongside eyebrow loss. It is more common in postmenopausal women [1].
• Lichen planopilaris: A rare inflammatory condition that can lead to permanent scarring alopecia and patches of hair loss [1].

Because treatments vary widely between types, getting a proper diagnosis from a GP or dermatologist is the most useful first step.

What causes alopecia in women?

In most cases, several factors are at the root of female alopecia — from genetics and hormonal shifts to autoimmune and skin conditions, nutritional deficiencies, and stress.

Genetics and family history

Family history is one of the biggest risk factors for alopecia, particularly female pattern hair loss. If close family members on either side have experienced thinning or female pattern baldness, you may be more predisposed to hereditary hair loss [2]. This type of hair loss tends to develop gradually and becomes more noticeable from midlife onwards.

Hormonal changes

Hormones play a central role in regulating the hair growth cycle. Pregnancy, perimenopause, menopause, and stopping hormonal contraception can all contribute to hair thinning and increased shedding [4]. During menopause, declining oestrogen levels can cause follicles to shrink and the growth cycle to slow. Hair follicles can become more sensitive to certain hormones over time, which may contribute to female pattern hair loss [2].

Autoimmune conditions

Alopecia areata is an autoimmune disease in which immune cells attack healthy hair follicles, disrupting normal hair growth and leading to patchy hair loss or bald spots. Some people notice distinctive “exclamation mark hairs” — strands that are narrower at the base — around the edges of affected areas [3].

In more severe cases, alopecia areata can progress to complete hair loss across the scalp or body. People living with other autoimmune conditions, such as rheumatoid arthritis or thyroid disease, may have a slightly higher risk. The exact cause of alopecia areata is still not fully understood; both genetic and environmental factors are thought to play a role [3].

Stress and illness

Physical stress on the body — including surgery, illness, or childbirth — as well as emotional stress, can sometimes trigger increased hair shedding. Known as telogen effluvium, this type of temporary hair loss typically appears two to three months after the trigger [4]. It is usually reversible once the underlying cause or stressor is resolved, though it can take several months for visible regrowth to appear.

Nutritional deficiencies

Hair follicles need a steady supply of nutrients to function well. Iron deficiency is one of the most common nutritional contributors to hair loss in women. Low vitamin D, zinc, protein intake, and — more rarely — biotin deficiency can also play a role [6]. Addressing deficiencies through diet — or supplementation under your clinician's guidance — can help support healthy hair growth. A blood test is the most reliable way to identify what, if anything, is missing.

Medications and medical treatments

Certain medications have side effects that can interfere with the hair growth cycle. These include some antidepressants, blood pressure drugs, cholesterol-lowering medications, chemotherapy, and some hormonal treatments [4]. If you think a medication could be contributing to your hair loss, speak with your clinician before you make any changes — there may be alternatives worth exploring.

Skin and scalp conditions

Inflammatory conditions affecting the scalp — such as psoriasis, fungal infections, and eczema — can damage hair follicles and interrupt healthy hair growth [1]. In rare cases, a scalp biopsy may be recommended to confirm the diagnosis, particularly where scarring alopecia is suspected. Traction alopecia is particularly common in people who regularly wear tightly pulled hairstyles such as braids, weaves, cornrows, or extensions [5].

Can alopecia be prevented?

Not every type of alopecia is preventable — hereditary hair loss and autoimmune conditions like alopecia areata are largely outside our control. Taking some small steps may help reduce further hair loss and support healthier hair in the future:

• Avoid tight hairstyles that place repeated tension on the hair follicles
• Limit excessive heat styling and harsh chemical straighteners
• Eat a varied diet with plenty of iron, protein, and essential nutrients
• Manage stress where possible through regular movement and rest, and seek mental health support if you need it
• Speaking with your clinician promptly if you notice sudden hair loss, bald patches, or rapid shedding

Acting early can make a real difference in slowing progression for some types of alopecia.

Can alopecia be treated?

Treatment options depend on the underlying cause of alopecia and the type of hair loss involved. Some approaches aim to reduce inflammation, while others aim to stimulate hair growth or slow further hair loss. Because not all treatments work for every type of alopecia, it’s essential to identify the cause first [2].

Common options include:

• Minoxidil: A topical treatment approved for female hair loss that can help stimulate hair growth with consistent use. Results can take several months to become visible [2].
• Steroid creams or injections: Often used for alopecia areata to reduce immune system activity around affected follicles [3].
• Platelet-rich plasma (PRP) therapy: This injectable treatment uses growth factors from a patient’s own blood, although evidence for its effectiveness in hair loss is still mixed [7].
• Hair transplant surgery: In some cases, transferring healthy follicles from elsewhere on the scalp can help restore hair in hair loss-affected areas.
• Wigs and hairpieces: Synthetic wigs or real hair wigs can be a helpful option for people with alopecia who are managing significant hair loss during or between treatments.
• Juniper Hair Renewal Treatment: Juniper also offers hair loss treatment for eligible patients on the Weight Reset Programme who are experiencing hair shedding during weight loss.

Support organisations, including Alopecia UK and the National Alopecia Areata Foundation, can also connect people affected by alopecia with practical advice and peer support groups.

When should you see a doctor about hair loss?

Losing 50 to 100 hairs a day is completely normal — it’s just your hair cycling through its natural growth phases [8]. But it’s worth speaking to your GP if you’re noticing:

• Sudden hair loss or a rapid increase in shedding
• Patchy hair loss, bald spots, or round patches on the scalp or body
• Scalp itching, pain, redness, white patches, or changes to skin texture
• Hair loss alongside other symptoms such as fatigue, weight changes, or mood shifts
• Ongoing shedding that does not settle over time

Your GP can arrange blood tests, check for underlying conditions, and refer you to a dermatologist if needed. A scalp biopsy might be recommended if the diagnosis isn’t clear [1].

Hair loss is very common in women, more than many people realise. With the right diagnosis, it’s often possible to slow what’s happening, encourage regrowth, or at least feel better informed and supported to manage it.

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