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Female pattern alopecia in Adult
See also in: Hair and Scalp
Other Resources UpToDate PubMed

Female pattern alopecia in Adult

See also in: Hair and Scalp
Contributors: Vivian Wong MD, PhD, Mary Gail Mercurio MD, Susan Burgin MD
Other Resources UpToDate PubMed


Female pattern alopecia is frequently referred to as androgenetic alopecia. It is most commonly noticed after menopause, although it may begin any time after puberty. The incidence of androgenetic alopecia in women is thought to be less than that in males, although some argue that differences in expression only make it seem that this is the case. Both frequency and severity increase with age.

Hereditary transmission of female pattern alopecia is consistent with a polygenic trait where many genes are involved in its susceptibility. In susceptible hair follicles, dihydrotestosterone (DHT) binds to the androgen receptor, and the hormone-receptor complex activates the genes responsible for the gradual transformation of large terminal follicles to miniaturized follicles. The role of DHT is less certain in pattern hair loss in women compared with men. In contrast to men, female pattern alopecia usually presents as diffuse thinning of the central portion of the scalp with sparing of the frontal hairline. Hair thinning is often more evident in the frontal portion of the scalp, resulting in "Christmas tree pattern" thinning of the central part.


L64.9 – Androgenic alopecia, unspecified

1108009 – Female pattern alopecia

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Differential Diagnosis & Pitfalls

  • Telogen effluvium – anemia, thyroid disease, medications, major illness
  • Anagen effluvium – toxins, chemotherapy
  • Alopecia areata
  • Traumatic – Traction alopecia or Trichotillomania
  • Alopecia associated with Virilism
  • Scarring alopecia secondary to infections, Radiation-induced alopecia, autoimmune disease, burns, infiltrating Metastatic cutaneous carcinoma, or Sarcoidosis
  • Frontal fibrosing alopecia
  • Congenital triangular alopecia

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Last Reviewed:07/19/2017
Last Updated:01/11/2022
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Patient Information for Female pattern alopecia in Adult
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Female pattern alopecia in Adult
See also in: Hair and Scalp
A medical illustration showing key findings of Female pattern alopecia
Clinical image of Female pattern alopecia - imageId=3016860. Click to open in gallery.  caption: 'Diffuse thinning of the hair on the frontal scalp with an intact frontal scalp line.'
Diffuse thinning of the hair on the frontal scalp with an intact frontal scalp line.
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