Pattern Hair Loss

Is your hair gradually getting thinner? (Female and male pattern hair loss)

Androgenetic alopecia, better known as pattern hair loss, is gradual thinning caused by genetic sensitivity of the follicles to normal hormone levels. In women it usually shows as a widening parting. In men, a receding hairline or thinning crown. It is very common, it is not your fault, and well established treatments exist to slow it and in many cases partially reverse it.

Is this you?

• A parting that has slowly widened, or more scalp visible under bright light

• A receding hairline or a thinning crown that has crept up over years rather than weeks

• A ponytail that has lost thickness even though shedding seems normal

• Finer, shorter, wispier hairs where thick ones used to grow

These symptoms overlap with several other conditions, including telogen effluvium, thyroid related thinning and some scarring alopecias, so gradual thinning alone cannot confirm the cause.

What is happening and why

Pattern hair loss is less about hair falling out and more about hair growing back smaller. In genetically susceptible follicles, normal levels of androgens, a group of hormones present in everyone, gradually shrink the follicle with each growth cycle, a process called miniaturisation. Thick hairs are slowly replaced by finer, shorter, paler ones, until some follicles produce hairs too small to see. The pattern differs by sex, the parting and crown in most women, the hairline and crown in most men, but the mechanism is the same.

Because miniaturisation is gradual and progressive, earlier assessment protects more hair. But other conditions produce very similar thinning, and pattern loss frequently runs alongside a second process, such as telogen effluvium. Telling them apart requires examining the scalp, which is what the assessment is for.

How I assess it

The appointment begins with your history. I will ask about your family history, general health, medications and hormonal history, and how the thinning has behaved over time.

I then examine your scalp with trichoscopy. Under magnification, pattern hair loss has a recognisable signature: hairs of visibly different thicknesses growing side by side, an increased proportion of fine hairs, and changes concentrated in the classic zones. None of this can be judged from a mirror or a phone photo. I take clinical photographs to establish a baseline, so that months later you know whether things are stable, improving or progressing, rather than relying on anxious memory. Where hormonal or deficiency questions arise, I can arrange blood testing, or request it through your GP.

The assessment resolves what this page cannot: whether your thinning is pattern hair loss, something else, or, commonly, pattern loss plus a compounding factor that also needs addressing.

Treatment options, and why the right one depends on the cause

Well established approaches. It is well established that topical minoxidil, available from pharmacies, can slow pattern hair loss and improve density for many people, though suitability, formulation and realistic expectations are a conversation for assessment rather than a decision made at the shelf. Prescription options also exist, available through your GP or a prescriber, and whether they are appropriate for you is a medical discussion informed by a proper assessment.

Emerging and adjunctive in clinic therapies. Evidence is growing that microneedling can enhance results, particularly alongside established treatment. Early research suggests growth factor mesotherapy may help some people, and results vary. These are supporting treatments, and whether they are worth considering is discussed once the diagnosis is clear.

Self care, nutrition and styling. Good scalp health, eating well, and styling that flatters density all support whatever plan you choose. The right combination is worked out at assessment, because treating the wrong cause, or treating one cause when two are present, can waste months.

See also: traction alopecia. (Menopause cross link added here once that page is live.)

When to see your GP

Thinning that comes with other changes, such as irregular periods, acne or excess facial hair, can point to hormonal causes that need investigation. This forms part of my assessment, and where anything I find needs medical investigation or prescription treatment, I will refer you on and coordinate with your GP.

Getting help in Ipswich and Suffolk

I am based in Ipswich and work with women and men from across Suffolk, including Woodbridge, Felixstowe, Stowmarket and Bury St Edmunds. Pattern hair loss is highly manageable, but only once you are sure that is what it is, and that nothing else is running alongside it. The only way to know is to examine the scalp properly. That is what a consultation is for. You can book your consultation whenever you are ready.