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When you start to suspect that something’s (literally, in this case) off with your hair—a little thinning here, some excessive shedding in the shower there—the solution may seem straightforward enough: Figure out the source of the problem and find the best hair loss treatment to bring your strands back. That journey, however, is rarely a straight path. Dare we say, it’s a frizzy one.
That’s because there are many potential causes of hair loss, including genetics, styling habits, and underlying health conditions, all of which affect your follicles in different ways; the shedding can happen suddenly or gradually and involve symptoms like a wider part, overall thinning, or bald spots.
Even if the trigger appears obvious—you recently recovered from an illness, say, or you’ve been going overboard on chemical treatments, like bleaching or relaxers—it’s still a good idea to see a dermatologist if you can, since shedding can also stem from sneakier underlying issues like nutritional deficiencies or early hereditary hair loss. An expert will know how to determine whether your hair will grow back on its own or if you need a personalized treatment plan to turn things around.
As for what that plan might look like, we asked dermatologists to break down the best hair loss treatments for women, depending on the root of the issue.
Genetics | Stress | Tight hairstyles | Styling habits | Dandruff | Inflamed hair follicles | Hormone fluctuations | Autoimmune disorders
1. Treatments for genetic hair loss
Androgenetic alopecia, or female pattern hair loss, is the most common cause of thinning hair in women worldwide, per the American Academy of Dermatology (AAD). It’s hereditary, meaning people with this condition have inherited genes (from one or both parents) that make them more sensitive to androgens, hormones that have a reputation for triggering progressive hair loss by shrinking hair follicles and slowing new growth.
How to treat hereditary hair loss
Topical minoxidil is one of the best hair loss treatments for women, particularly those who have female pattern hair loss. It’s not yet clear how the magic happens, but researchers theorize that minoxidil reverses hair follicle shrinkage and lengthens the growth phase. This likely encourages hair to grow back fuller and speeds up the rate at which lost strands are replaced. It’s available over-the-counter—generically and under the brand name Rogaine—in both 2% and 5% formulations.
Even though you can get topical minoxidil without a prescription, it’s best to consult a dermatologist first so they can diagnose the exact cause of your hair loss and help you determine the concentration and dosage that’s right for you (typically, it’s either the 2% formulation twice a day or 5% once a day, per NYU Langone Health). And once you start using it, be ready to commit: Most new hair is lost after a few months if you stop.
“Low-dose oral minoxidil has also been gaining traction as an effective and generally well-tolerated treatment for women with androgenetic alopecia,” Kristen Lo Sicco, MD, associate professor of dermatology and director of the skin and cancer unit at NYU Langone Medical Center in New York City, tells SELF. This blood pressure medication isn’t currently FDA-approved for hair loss, Dr. Lo Sicco adds, but if you’re experiencing side effects using the topical version or aren’t seeing results, ask your doctor if an off-label prescription might make sense for you.
Spironolactone is another blood pressure drug that’s been shown to have anti-androgen effects (which is why it’s commonly prescribed as an off-label treatment for hormonal acne). It prevents androgen receptors from activating, which reduces the influence these hormones can have on your hair follicles.
Platelet-rich plasma (PRP) is showing promise in the hair regrowth department, too. It’s an in-office procedure that involves extracting the plasma from your blood, which is rich in growth factors (molecules that help cells grow), and injecting it into the scalp to encourage your sluggish follicles to get down to business. More research is necessary to nail down the optimal treatment protocol for hair loss in women, specifically, but the dermatologists we consulted agree that it’s generally a safe and effective option to consider.
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2. Treatments for stress-related hair loss
Intense stressors, both internal (giving birth) and external (losing your job, for instance) can trigger a type of hair loss called telogen effluvium. The body hits pause on hair growth until the stressor is over, then sheds the freeze-framed strands in bulk a few months later. This can also happen with nutritional deficiencies, like a lack of iron, vitamin D, biotin, or zinc. These nutrients play a significant role in maintaining the hair growth cycle, and running low (a form of internal stress) could result in an uptick in shedding or thinning.
How to treat telogen effluvium
“The most common treatment for telogen effluvium is removing the trigger if it can be identified—and also time,” Dr. Lo Sicco says. “If excess shedding extends beyond six months (which is considered chronic), then you might need to see a dermatologist for a consultation.” They’ll be able to check for underlying issues like nutritional deficiencies or thyroid disease, she adds.
If the likely culprit is something you can’t change (you’re still grinding your way through a rough patch, for example), then your doctor can recommend treatments to help offset its impact on your hair, such as minoxidil, Dr. Lo Sicco says.
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3. Treatments for hair loss caused by supertight hairstyles
Regular pulling on your hair via tight ponytails, braids, extensions, or weaves can cause traction alopecia—shedding caused by persistent tension, per the AAD. “This can eventually lead to damage and inflammation around the follicles that disrupts the normal growth cycle,” Hope Mitchell, MD, a board-certified dermatologist and the founder of Mitchell Dermatology in Ohio, tells SELF.
How to treat traction alopecia
One way to reduce the risk of traction alopecia is alternating your styling practices—the AAD recommends wearing a style for no longer than two to three months at a time. Keeping your hair natural between styled periods can help limit the chronic tension on your hair and scalp, Dr. Lo Sicco says.
Other things you can do: Opt for looser styles more often and avoid excessive use of accessories, like bobby pins and headbands, that tug on your hair. It’s also important to change your style right away if you notice any pain or crusty patches on your scalp, as these are signs that your look could eventually lead to hair loss.
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You can soothe any tender areas by applying a topical corticosteroid lotion or ointment to your scalp, which acts as an anti-inflammatory, Dr. Lo Sicco says. Hydrocortisone 1% is available over-the-counter—anything stronger requires a prescription. For symptoms of extreme inflammation, including stinging and acne-like bumps around the base of the hair, it’s a good idea to see a dermatologist. Depending on the severity, they may recommend corticosteroid injections for additional relief, she adds.
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4. Treatments for hair loss caused by harsh styling habits
Excessive use of intense heat (curling and straightening irons) and harsh chemicals (straightening and relaxing treatments are biggies) on your scalp and hair can put you at risk of developing a disorder called trichorrhexis nodosa, where weak points along the hair shaft cause your strands to break off easily. Underlying conditions, like anemia (iron deficiency) and hypothyroidism (an underproduction of thyroid hormones) can also trigger the disorder.
How to treat trichorrhexis nodosa
Start by nixing traumatic styling practices from your roster, Dr. Lo Sicco says, such as aggressive brushing (no teasing!), excessive heat styling, bleaching, and chemical hair straightening. If you don’t want to remove them from your life entirely, setting limits—like using heat once a week or less and spacing out relaxers as much as possible—can help to minimize physical stress on your hair without depriving you of your favorite ’dos, she adds.
Incorporating gentle, hydrating products into your hair care routine can also help strengthen your strands and improve texture. Dr. Lo Sicco suggests switching to a sulfate-free shampoo (sulfates are what make shampoo sudsy, but they can also strip hair of its natural oils) and following it up with a moisturizing conditioner to protect against further dryness and breakage.
If you make these changes and it seems like your hair didn’t get the memo (it’s still breaking off or appears like it’s not growing, for instance), it’s a good idea to, yep, see a dermatologist, Dr. Mitchell says. They’ll test for any underlying conditions that might be triggering trichorrhexis nodosa and help you put together a treatment plan.
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5. Treatments for hair loss caused by severe dandruff
Seborrheic dermatitis is an inflammatory condition that overreacts to organisms that live on the scalp—in this case, Malassezia yeast—and triggers itchy and flaky patches, as well as a rash that’s darker, lighter, or redder than the surrounding skin. When these flakes mix with the oil that’s produced by the scalp, they can clog your follicles and impair the hair’s nutrient supply, which ultimately weakens its structure.
How to treat seborrheic dermatitis
The most effective way to treat seborrheic dermatitis is by using an anti-dandruff shampoo that contains ingredients like ketoconazole, zinc pyrithione, and salicylic acid. “Ketoconazole and pyrithione zinc are antifungal and anti-inflammatory, while salicylic acid is an exfoliant that rids the scalp of flakes,” Michele Green, MD, a board-certified dermatologist based in New York City, tells SELF. “Once the buildup of yeast is gone and the itching ceases, any lost hair should grow back on its own.”
There are plenty of OTC options to choose from, like Nizoral Anti-Dandruff Shampoo ($16, Amazon) and Vanicream Dandruff Shampoo ($11, Target), but if you’re dealing with androgenetic alopecia in addition to major flakes, Dr. Lo Sicco recommends going with ketoconazole as your ingredient of choice (preferably, prescription-strength, which you can get from a dermatologist), since it also has anti-androgen properties. The treatment can be drying, though, so use it on your scalp only and wash the rest of your hair with your go-to shampoo, she adds.
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6. Treatments for hair loss caused by inflamed follicles
When hair follicles become inflamed from physical irritation (like shaving, traction, or wigs) or a bacterial or fungal infection (known as folliculitis) the resulting inflammation can compromise the integrity of the follicles and disrupt the normal hair growth cycle, Dr. Mitchell says.
How to treat folliculitis
Friction-induced folliculitis might require nothing more than laying off the hairstyling practice that triggered it until you’re fully healed. (Applying warm compresses to the affected area three to four times a day—for 15 to 20 minutes at a time—can help speed the process along, according to the AAD.) If your symptoms don’t go away or get worse after a week or two, make an appointment with a dermatologist or your primary care provider, in case an infection is to blame (which may require an antibiotic or antifungal medication). And no matter the underlying cause, “corticosteroids may be recommended to alleviate inflammation in more severe cases,” Dr. Mitchell says.
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7. Treatments for hair loss caused by hormonal imbalances
Hormonal changes associated with conditions like polycystic ovary syndrome (PCOS) and perimenopause can be a contributing factor to hair loss in women. Androgens are largely to blame: With PCOS, there are too many, and with perimenopause, a decrease in estrogen allows androgens to become dominant, according to Dr. Mitchell.
How to treat PCOS and perimenopause
Medications that help balance hormone levels are where it’s at for these conditions. In the case of PCOS, this might involve birth control pills to regulate your menstrual cycle and lessen the impact androgens can have on your hair follicles. “Anti-androgen medications, such as spironolactone, may also be prescribed to counteract the effects of excess androgens,” Dr. Mitchell says.
Meanwhile, she adds that hormone replacement therapy, starring estrogen and sometimes progesterone (the hormones responsible for ovulation and menstruation), can be effective in preventing the perimenopausal estrogen dips that can give androgens more leverage.
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8. Treatments for hair loss caused by autoimmune diseases
Autoimmune diseases essentially trick your immune system into attacking healthy body tissue by mistake. Some target the hair follicles or scalp specifically—like alopecia areata and discoid lupus erythematosus—while others (such as thyroid disease) affect another part of the body and can cause hair loss as one of many symptoms, Dr. Lo Sicco explains.
How to treat alopecia areata and other autoimmune disorders
Corticosteroids, such as hydrocortisone and prednisone, are commonly prescribed (topically, orally, or through injections) to both alleviate inflammation and curb the autoimmune response. “These medications help suppress the immune system’s overactivity and encourage hair regrowth,” Dr. Mitchell explains. The FDA also recently approved a new drug for severe cases of alopecia areata called Litfulo (generic name, ritlecitinib). The medication stimulates hair growth by quieting part of the immune system.
Another variety of medications, called immunomodulators, can help your immune system work more effectively too, depending on your specific condition. And don’t forget about wigs: “A wig can be an important part of your treatment regimen,” Dr. Lo Sicco says. Some research shows that they can increase the quality of life for people with alopecia areata.
Topical minoxidil can also help stimulate hair regrowth and promote healthier follicles, Dr. Mitchell adds. Before trying it, though, she recommends enlisting the help of a dermatologist, who can determine which concentration and dosage is right for you.
Whether you decide to take the OTC route or consult with a dermatologist, the AAD stresses that hair loss is complex and there’s no one-size-fits-all regimen. It may take some trial and error to narrow down which combo of hair loss treatments works best for you, but the above derm-recommended options will, hopefully, encourage your strands to make a comeback.
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