30 October 202610 min read

Pattern Hair Loss in Men and Women: Causes and Options

Medical Review

Medically Reviewed by Dr. Pedro Yelamo Vera, MD

Licensed Physician No. 484814280 · Official Medical College of Bizkaia (Spain)Last reviewed: 31 October 2026

Pattern hair loss in men and women: how it looks, why it happens, which tests help, the treatments in Spain and when thinning hair is something else.

A female doctor listens empathetically to a male patient with thinning hair, seen from behind the patient.

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Pattern hair loss is the most common type of hair loss in both men and women. Doctors call it androgenetic alopecia. It runs in families and is linked to male hormones. The hair follicles slowly shrink and grow finer, shorter hair. It is not dangerous, but it is usually permanent. Treatment can slow it, and works only while you use it.

TL;DR

Pattern hair loss affects nearly half of men over 50 and about half of women over 60, says the Spanish Academy of Dermatology (AEDV).
Men tend to lose hair at the temples and crown. Women tend to thin along the parting, and the front hairline stays.
A doctor can usually diagnose it by looking at your scalp. Blood tests help rule out other causes, such as thyroid problems or low iron.
The main medicines are minoxidil and, mostly for men, finasteride or dutasteride. They work only while you keep using them.
Sudden, patchy, painful or scaly hair loss is not pattern hair loss. It needs a doctor's check.

Dr. Pedro Yelamo Vera is a GP licensed in Spain (Colegiado No. 484814280).

For a medical emergency, call 112 or go to the nearest local emergency department. Do not wait for a video consultation or an online reply.

What is pattern hair loss?

Each hair grows from a follicle in the skin. In pattern hair loss, your genes make some follicles sensitive to male hormones (androgens). Women make these hormones too, in smaller amounts. Over the years, these follicles shrink. They make thinner, shorter, lighter hairs, until some stop.

MedlinePlus explains that the follicles stay alive. That is why treatment can sometimes thicken hair again. On a Spanish report you may see alopecia androgenética, or calvicie de patrón masculino or femenino.

How does it look in men?

MedlinePlus describes the usual pattern in men:

The hairline moves back at the temples and forms an "M" shape.
The crown thins and the bald area slowly widens.
Later, a horseshoe of hair may remain around the sides and back.

The speed varies a lot from one man to another. A father, mother or grandparent with the same pattern makes it more likely. Hair loss can come from either side of the family.

How does it look in women?

Female pattern hair loss is different. Many women first notice a wider parting. The hair on top and at the crown gets less dense. MedlinePlus calls this the "Christmas tree pattern". The front hairline usually stays where it is, and full baldness is rare.

It becomes more common with age, and Mayo Clinic lists the menopause among the hormone changes that affect hair. Family history, heavy periods and some medicines may play a part. Some women also have signs of higher male hormones, such as acne, irregular periods or more facial hair. This can point to a condition such as polycystic ovary syndrome (PCOS), and a doctor will want to check it.

How is pattern hair loss diagnosed?

A doctor can usually tell from the pattern, your story and your family history. They look at the scalp, sometimes with a magnifier. In the UK, the NHS notes a GP can often find the cause just by looking at your hair.

Blood tests are not needed for every man with typical pattern hair loss. They are more useful in women, or when the picture is unclear. MedlinePlus lists thyroid disease and iron deficiency as causes to rule out. Common tests are a thyroid test (TSH), a blood count and ferritin. A doctor may add hormone tests if your periods are irregular. A skin biopsy is rarely needed.

Could it be another type of hair loss?

Yes. Mayo Clinic describes several types that look different:

Sudden shedding all over. Hair comes out in handfuls a few months after a shock, illness, surgery or childbirth. It is usually temporary. Doctors call it telogen effluvium.
Round, smooth bald patches on the scalp, beard or eyebrows. One cause is alopecia areata.
Scaly patches with broken hairs, sometimes red or swollen. This can be a scalp fungal infection (ringworm), which is common in children.
Hair loss from tight styles, such as braids or extensions.
A receding hairline in an older woman, sometimes with lost eyebrows. This may be frontal fibrosing alopecia. Mayo Clinic advises early treatment to prevent lasting baldness.

Losing 50 to 100 hairs a day is normal, according to the NHS.

Worried your hair is thinning, or not sure what type of hair loss you have?

You can book a video visit with a GP licensed in Spain, in English or Spanish. He looks at your scalp on camera and your photos, asks about your health and family, and explains your options.

Get your hair loss assessed

What treatments work for pattern hair loss?

You do not have to treat it. MedlinePlus says no treatment is needed if you are happy with how you look. If you want to slow it down, these are the main options:

Minoxidil. It can slow hair loss and help some hair regrow, in men and women. The lotion or foam is sold in Spanish pharmacies without a prescription. Tablets for hair are a separate, off-label use that only a doctor can decide on. Read our guide to minoxidil in Spain.
Finasteride and dutasteride. These tablets block the hormone that shrinks the follicles. They need a prescription in Spain. The NHS says women should not use finasteride. See our guide to finasteride and dutasteride.
Hormone-blocking medicines for women. The AEDV consensus names spironolactone as a first hormonal option for women before the menopause. It is a prescription medicine.
Hair transplant. Small groups of hair are moved from areas that still grow well to thin areas. It often takes several sessions and can be expensive.
Cover-ups. A new hairstyle, hair fibres or a hairpiece. MedlinePlus calls these the cheapest and safest choice.

Platelet-rich plasma (PRP) injections and laser caps are still being studied, says MedlinePlus. Be wary of clinics that promise regrowth. The NHS advises seeing a GP before you pay a commercial hair clinic.

How long until treatment works?

Hair grows slowly, so patience matters. The AEDV advises keeping a treatment for at least 6 to 12 months before judging it. If you stop, the hair you kept is usually lost again, warns MedlinePlus. Photos taken every few months in the same light help you see the change.

What about pregnancy, breastfeeding and children?

Pregnancy. The AEDV advises against hair-loss medicines during pregnancy, including lotions, because some is absorbed. Finasteride, dutasteride and other hormone blockers must not be used by women who are pregnant or planning a pregnancy.
After childbirth. Heavy shedding a few months after a birth is common. It usually settles by itself.
Breastfeeding. Ask a doctor before using any hair-loss medicine while you breastfeed.
Children. Pattern hair loss is rare in young children. Patchy or scaly hair loss in a child is more often ringworm or alopecia areata. It needs a doctor, not a hair product.

When should you see a doctor about hair loss?

See a doctor if:

Hair falls out suddenly, in patches or in handfuls.
The scalp itches, hurts, is red, scaly or has pus.
Hair loss started after a new medicine.
A woman also has acne, irregular periods or new facial hair.
You feel tired, cold, short of breath, or have heavy periods.
The loss is affecting your mood or confidence.

Hair loss on its own is not an emergency. See a doctor today if a child has scaly patches with swelling, pus or fever.

Talking it through with a doctor by video

Dr. Yelamo is a GP licensed in Spain. He sees adults, children and pregnant patients by video, every day from 07:30 to 20:30 (Spain time). In the visit he will:

Look at your scalp on camera and at clear photos you send.
Ask when it started, the pattern, your family history, periods and medicines.
Tell you if blood tests would help, and read the results with you.
Explain the options, the trade-offs and when to see a dermatologist.

He does not promise any test or prescription before the visit. Where clinically appropriate, following a genuine evaluation. Treatment and prescriptions are issued solely at the doctor's discretion based on evidence-based clinical guidelines.

A prescription is never guaranteed: it is issued only where clinically appropriate after a genuine evaluation, as a private electronic prescription under Spanish law. This service is for urgent, non-emergency care. In an emergency, call 112.

See how the Urgent Care video visit works. It lasts 15 minutes and costs €50.

This guide is general information. It does not replace a consultation with your doctor.

Frequently asked questions

Is pattern hair loss permanent?

Usually yes. The follicles shrink slowly over years. Treatment can slow the loss and sometimes thicken hair, but only while you keep using it.

Can women get pattern hair loss?

Yes. It is the most common type of hair loss in women. It usually shows as a wider parting and thinner hair on top, with the front hairline kept.

Do I need blood tests for hair loss?

Not always. Men with a typical pattern often need none. Women, and anyone with unusual loss, may be checked for thyroid problems, low iron or high male hormones.

Is minoxidil sold without a prescription in Spain?

The lotion and foam are sold in Spanish pharmacies without a prescription. Minoxidil tablets for hair, finasteride and dutasteride need a prescription.

How long does hair loss treatment take to work?

Spanish dermatologists advise using a treatment for at least 6 to 12 months before judging whether it works.

Is sudden hair loss the same as pattern hair loss?

No. Hair falling out in handfuls or in patches has other causes, such as a recent illness, childbirth, alopecia areata or a scalp infection. See a doctor.

Sources

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This content is written and reviewed by a licensed physician with reference to the following official health authorities.