Root Hair Institute


For many individuals, their hair and the way it looks can make them feel confident and allow them to express themselves. Thinning hair can affect that confidence. Although thinning hair at the crown is often talked about in men, it can also occur in women.

By age 50, 40% of women will experience female pattern hair loss (FPHL). Thinning hair is an issue that can come about due to many different reasons. When you get to the root causes, you’ll be able to address any underlying causes and start appropriate treatment.

Keep reading for a crash course in hair thinning in the crown in females and potential solutions.

Causes of Hair Thinning at the Crown

Before anything else, it is important to understand why your hair is thinning. There are many different types of hair loss (called alopecias) including FPHL, telogen effluvium (shedding hair loss), autoimmune hair loss (alopecia areata), and others including scarring types of hair loss. Even with a certain type of hair loss such as telogen effluvium, there may be underlying contributors or causes such as internal causes. It is important to determine the right diagnosis in your case as the recommended treatments will differ based on the type of hair loss. Additionally, if there is something internal contributing, then your hair loss may not improve until that underlying issue is addressed. This is why it is important to get evaluated by a medical professional experienced with diagnosing and treating hair loss.

We will review just a few of the many potential types, causes, and factors contributing to hair loss below.

Female Pattern Hair Loss

The most common cause of hair thinning in women is FPHL also called androgenetic alopecia (AGA). In men AGA is often much more openly discussed including issues with a receding hairline, thinning, and/or baldness. However, FPHL/AGA can also occur in women and is the most common type of hair loss in women. Unlike in men, this type of hair loss usually does not cause balding. Instead, it typically leads to gradual thinning with noticeable widening of the part. This can occur in the front, throughout the middle, and towards the back including over the crown.

This type of hair loss usually progresses very slowly and gradually over time, and thus, often therapies are recommended to help strengthen and thicken the existing hair and decrease further hair thinning.

A Lack of Nutrients

A deficiency of a number of nutrients including iron, Vitamin D, protein, Vitamin B12, zinc, selenium, biotin, and others can lead to hair loss. These low levels of nutrients also lead to increased shedding or hair fall which can then present with visible hair thinning in a number of areas including the crown. It is important to be evaluated by a medical provider to determine if a laboratory work up is needed in your case.

Generally, hair is very sensitive to dietary changes including a lack of protein or calories. It is also sensitive to oxidative stress and inflammation, and eating a well-balanced diet rich in anti-oxidants with avoidance of inflammatory foods may also be helpful.

Always consult with your doctor prior to making any changes to your diet. You can also discuss your individual nutritional and dietary needs with your doctor, a dietitian, and/or nutritionist to determine how your diet can be optimized to help support your hair.

Autoimmune Disease

There are also autoimmune disease that can cause hair loss. These include conditions like Alopecia areata that can cause non-scarring hair loss in various areas throughout the scalp including potentially the crown. This type of hair loss usually presents with patches of hair loss but can also cause total scalp hair loss and/or loss of eyebrows, eyelashes, and/or body hair.

Additionally, other autoimmune conditions such as systemic lupus erythematosis and Hashimoto’s thyroiditis can also lead to hair loss. Thus it is important to see a medical doctor to see if a laboratory work up is warranted. Make sure to mention any other sypmtoms you may be experiencing such as fatigue, feeling cold, fevers, joint pain, mouth ulcers, shortness of breath, cough, chest pain, etc.

If you are found to have an underlying autoimmune condition, it will be important that you address these in a holistic manner under the care of your doctor.

Damaging Hair Care Practices

Chemicals and heat can over time cause damage and breakage to the hair. If heat or chemical treatments are applied close to the scalp, they can potentially cause damage to the hair follicle itself.

For example, getting repeated chemical hair treatments such as a hair perm can damage your hair over the long term. Adding color to your hair or applying too much heat can do the same. It is important to discuss thinning hair with your beautician or hair stylist, so that more gentle methods can be used or these treatments be avoided if necessary. In colored or chemically treated hair, it can be helpful to avoid sulfates. Additionally, if heat will be used, using lower temperature settings and using heat protectant are paramount.

Reaction to Medications

A number of medications can cause increased hair shedding or hair loss. These medications include blood pressure medications, antidepressants, anti-seizure medications, chemotherapy, hormonal therapy, and others. It is important to discuss any concerns about hair loss related to medications with your doctor. They may be able to prescribe an alternative or change your dosage. Always consult with your doctor before changing or stopping your medications.

Hormonal Changes

There are a variety of health-related issues that can lead to hair loss and thinning. Hormonal changes are a big health change that can have dramatic results. For example, around the time of menopause (peri-menopause), it is common for women to notice FPHL for the first time or worsening of FPHL. Additionally, altered levels of hormones including high androgens such as testosterone or low thyroid can lead to hair loss.

If you are concerned, you may have hormone-related hair loss or hormonal imbalance, make sure to discuss this and any symptoms you are experiencing with your doctor.

Thinning Due to Age

Certain types of hair loss such as FPHL can worsen over time as discussed above. However, even in those without FPHL, they may have thinning of their hair throughout their scalp (not in a patterned way). Some doctors refer to this age-related thinning as senescent alopecia.

Blood Loss From Menstruation

In women who are menstruating, the increased monthly blood loss can lead to a higher change of iron deficiency. Low iron levels can contribute to hair loss as discussed above. If you have heavy periods and hair loss, consider discussing this with your doctor as they may recommend checking iron levels. Additionally, it is important to discuss if you have irregular menstrual cycles with your doctor, as this can be a sign of many conditions. One such condition is polycystic ovarian syndrome (PCOS) which can lead to both irregular menses and hair loss.

High Stress Levels

High stress levels can have many downstream effects on the body including causing or contributing to worsening of hair loss. Common stressors include work, family, health issues, and for many hair loss patients their hair loss. This can become a cycle of stress worsening hair loss, and the hair loss causing more stress. It is important to take steps to reduce stressors when possible and manage stress. Potential ways to manage stress include yoga, meditation, prayer, spending time with friends and family, having a sense of community, regular exercise, spending time outdoors, getting adequate rest and sleep, and spending time doing hobbies you enjoy. There are also support groups for those with hair loss.

Treatments and Prevention

When you want to treat or prevent hair thinning at the crown, there are a variety of steps that you can take. Again, the most important step is to first get checked out by a professional to determine what type of hair loss you have and what treatments are appropriate in your case.

Here are some different types of treatment to be aware of.

Hair Supplements

This is one of the most popular solutions people try at home. Supplements can be especially helpful if you are deficient in a nutrient that the supplement contains. If this is the case, individuals will often see significant improvement after starting the supplement. However, if you are not deficient in something, then the supplement may not have as dramatic of an effect if any.

It is important to be aware that many hair supplements contain biotin, and biotin can affect the results of many laboratory tests. It is important to always consult with your doctor prior to starting any supplement.

Hair Serum, Solution, or Foam

There are a number of hair serums, solutions, and foams that can be applied to the scalp. One example is over the counter minoxidil. This is the only FDA-approved treatment for FPHL. However, it is not FDA-approved for other types of hair loss. It is generally well-tolerated but does have potential side effects, and thus it is important to discuss this with your doctor prior to starting.

Hair Rejuvenation

There are also a number of other options available including prescription solutions or foams you apply to the scalp, prescription pills, red light therapy, and scalp injections. In some cases, hair transplant surgery may also be appropriate.

However, it is again important that you get checked out by a medical provider specializing in hair loss prior to considering these treatments to first get a diganosis and learn about what options may be right for you. Be sure to discuss potential side effects, risks, what kind of results you should expect, and how long therapy would need to be continued.

Hair Thinning at the Crown in Females: Finding Causes and Solutions

The above helps to explain some of the potential causes of hair thinning at the crown for females and what you can potentially do about it. If you really want to get a customized treatment plan to your type of hair loss and your case, it is important to see a medical provider specializing in hair loss to get a diagnosis and discuss your treatment options.

Our specialists at Root Hair Institute include board-certified dermatologists and hair restoration surgeons. If you’re ready to schedule a consultation, contact us at 425-947-9485 to book an appointment.