Science-Backed Treatments for Female Pattern Hair Loss

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Though it may not get as much attention as male pattern baldness, female pattern hair loss (sometimes called androgenetic alopecia) is very common. As many as half of all women may experience hair loss in their lifetime.

There is a dizzying array of possible options to address hair loss. But some are costly, and some don't work or may even cause more hair damage. Before deciding on a hair-loss treatment, it's best to talk to a healthcare provider. Here's a list of science-backed treatment options for female pattern hair loss.

What causes female pattern hair loss?

Female pattern hair loss causes hair thinning on the front and top of the scalp. Unlike male pattern baldness, female pattern hair loss rarely causes complete baldness.

It's not exactly clear why some people develop female pattern hair loss, but there are a few possible explanations. Research shows that as people get older and go through menopause, hair spends less time in any growth phase, which leads to hair thinning. Hair follicles also become thinner, which means the hairs themselves are thinner and don't cover the head as densely.

Genetics may play a role in female pattern hair loss. You may be more likely to develop female pattern hair loss if others in your family have it. But researchers haven't found an exact genetic cause for female pattern hair loss.

What are the best treatments for female pattern hair loss?

There are several treatment options for female pattern hair loss. Some of them are considered "off-label." This means the FDA approved the medication to treat other conditions but not female pattern hair loss. However, these medications have been extensively researched. The American Academy of Dermatology and other experts consider them safe and effective treatment options for female pattern hair loss.

Here are the best treatment options for female pattern hair loss.

1. Minoxidil

Minoxidil (Rogaine) is an FDA-approved treatment for female pattern hair loss. It's one of the best-known treatment options for hair loss and has been around since 1991. For women, it's available over the counter as a 2% solution or a 5% foam. It's also available off-label as a pill. Oral minoxidil is usually saved for people who don't respond to over-the-counter options, however.

Minoxidil is very well studied and there is a large body of evidence that shows it works to restore hair growth. But it's important to keep in mind that it can take up to 4 monthsto see the effects of minoxidil. Experts recommend using it consistently for 1 year before deciding it's not working.

Minoxidil 2% solution needs to be applied twice a day, while the 5% foam only needs to be applied once a day. You apply the medication directly to your scalp and massage it in with your fingers. Experts recommend applying it 2 hours before going to sleep so that the medication has enough time to dry before you go to bed.

Minoxidil causes very few side effects, which also makes it a popular option. The most common side effect is scalp irritation or redness. One thing to be aware of is that minoxidil causes hair shedding in the first few weeks of use. This is normal and happens because the hair is moving from a resting phase to a growth phase. This is not a sign that the medication isn't working or that minoxidil is making your hair loss worse.

2. Finasteride

Finasteride (Propecia) is FDA-approved to treat male pattern baldness. It helps minimize hair loss by blocking testosterone's effect on hair. Though it's not approved for female pattern hair loss, it is a first-line treatment for this condition. Finasteride is available as an oral medication. The typical dosage is 2.5 to 5 mg per day. Most people see results in about six months.

Finasteride should not be used by people who are pregnant or are likely to become pregnant. Otherwise, people tend to experience very few side effects with the medication, which makes it a popular option.

3. Flutamide

Flutamide (Eulexin) is an FDA-approved medication for treating prostate cancer. It's not as commonly used to treat female pattern baldness as minoxidil or finasteride. But there is evidence that it helps improve hair growth.

The typical dosage is 125 to 250 mg daily. People usually stay on this initial dose for 1 year and then may be able to decrease the dose over time. Most people see results in 6 months. Flutamide can cause side effects such as lower libido and stomach upset. In rare cases, it may lead to liver injury.

4. Spironolactone

Spironolactone (Aldactone) is FDA-approved to treat a number of medical conditions, including heart failure, high blood pressure, leg swelling, and certain types of acne. There is some evidence that it can help hair growth by blocking hormones that contribute to hair loss. Studies show spironolactone can restore hair growth when used alone or with minoxidil or laser therapy.

People normally start this medication at 50 mg per day. Then the dosage gradually increases to 100 or 200 mg per day.

Spironolactone can cause many side effects, including headache, decreased libido, menstrual irregularities, dizziness, and fatigue. It can also increase potassium levels in the blood. You may need to have your potassium level checked regularly if you take spironolactone and have a history of heart or kidney problems or take any medications that increase your potassium level.

You cannot take spironolactone if you are pregnant or planning to become pregnant.

5. Low-level laser therapy

Low-level laser therapy is designed to reverse hair thinning or hair loss. In studies, this therapy increased hair density after 24 to 26 weeks and worked better than topical minoxidil alone. It's unclear exactly how laser therapy helps, but experts think it may be related to anti-inflammatory effects. Laser therapy is not a very affordable option, however, with devices ranging in price from $500 to $5,000.

There are several FDA-approved laser-therapy devices available to make hair appear thicker and fuller. These devices come in many forms, including hairbands, caps, and combs. Right now, there's no evidence that one brand works better than any other.

6. Platelet-rich plasma (PRP)

Platelet-rich plasma (PRP) is a type of surgical procedure that can help restore hair growth for female pattern hair loss. Platelets are blood cells that help form blood clots by releasing proteins called growth factors. There's some evidence that growth factors can also stimulate hair follicles to regrow hair. While PRP has helped some people with hair loss, the research isn't a slam dunk. Experts say more evidence is needed to show that it really works.

PRP is a surgical procedure. Every few weeks, you get your blood drawn. That blood gets spun down to remove the platelet cells, which are then injected into your scalp. You may need to do this for 3 to 4 months and then get regular "boosters" every 6 to 12 months. The procedure is time consuming and can be uncomfortable. Many people report post-injection headaches, scalp pain, redness, and swelling.

The cost of PRP can range from around $500 to $2,500 or more per treatment. You can expect to pay the full cost out of pocket, because insurance doesn't cover PRP for hair loss. The price also doesn't guarantee results.

What else can females do for hair loss?

The American Academy of Dermatology lists several other treatment options for female pattern hair loss. If you're interested in alternatives, you and your provider may want to discuss some of the following:

• Microneedling: This involves poking small needles into the skin. People usually need 3 to 6 monthly sessions. Microneedling can cost $100 to $500 per treatment.

• Hair growth vitamins: There's conflicting evidence about the role vitamins play in hair growth. But they are an inexpensive option and are available over the counter. You don't need vitamins that are marketed for hair growth - simply find a multivitamin that contains iron and vitamins D, A, C, and B complex.

• Wigs and concealers: Wigs or concealers cause no side effects and provide immediate results. They're available in synthetic and natural options.

• Hair transplants: Hair transplants require a surgical procedure that moves healthy hair follicles to areas where there's less hair growth. A dermatologist or plastic surgeon can perform a hair transplant. But the procedure can be quite expensive, ranging from $3,000 to $20,000.

Is treatment for hair loss covered by insurance?

Hair loss medications prescribed by a healthcare provider may or may not be covered by your insurance. FDA-approved medications and treatments are more likely to be covered by insurance, however.

You're also more likely to get coverage if you have another condition that's leading to hair loss along with female pattern baldness. For example, your hair loss may be caused by alopecia areata, an autoimmune condition. In this case, your health plan would likely cover some female pattern hair loss treatment as part of your overall care plan.

Is hair loss treatment for women covered by Medicare?

Medicare considers hair loss a cosmetic problem and won't generally cover medications or other treatments. If you have an underlying health condition that's causing hair loss, your insurance may cover treatments as part of your care.

Can I use my HSA or FSA account for hair loss treatments?

Your ability to use pre-tax funds from your flexible spending account (FSA) or your health savings account (HSA) to pay for hair loss treatments is limited. You can't use these funds to pay for anything used to promote hair regrowth, since this is considered a cosmetic treatment rather than a qualified medical expense.

Expenses resulting from a separate medical condition that causes hair loss would qualify for HSA or FSA payment. You may be able to use HSA or FSA funds to cover supplements for hair loss related to vitamin deficiencies if the vitamin issues are caused by your underlying health condition. You'll also need to get a letter of medical necessity from your provider that says vitamins are necessary for treatment.

Similarly, if you lose your hair after undergoing chemotherapy to treat cancer, or because of another disease or treatment, you may be able to purchase a wig with FSA and HSA funds if you have a letter of medical necessity.

In addition, you may be able to receive a free wig if you are undergoing cancer treatment.

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