Alison Richards first noticed her long blonde hair thinning and shedding in her 20s. “There was one day in the shower where I just had hundreds of strands of hair, like fistfuls of hair coming out,” she recalls. It was terrifying, and she found online advice — often from ads and influencers — overwhelming and sometimes misleading.
By some estimates, half of all women will experience noticeable hair loss in their lifetime. Hair loss has many causes and not every remedy helps every person, so understanding the problem is the first step to finding effective care.
Hair growth cycles and shedding
Hair goes through growth, transition and rest phases. Individual hairs normally shed when replaced by new growth, and shedding is usually staggered. Stressful events — such as childbirth or illness, including COVID-19 — can synchronize hair cycles and trigger larger, temporary sheds. Most of the time these episodes resolve and hair regrows.
When hair doesn’t return
The most common cause of permanent hair thinning is androgenetic alopecia (female pattern hair loss), which typically begins at the crown and widens the hair part over time. Less common causes include alopecia areata, an autoimmune condition that produces one or more round bald patches, and scarring (cicatricial) alopecias, which can cause permanent loss along with scalp itching, tenderness, redness or pimples.
Why diagnosis matters
Different types of hair loss respond to different treatments, so seeing a clinician for a diagnosis is important. Dermatology appointments can be hard to get, and some primary care visits may not address the problem adequately. Patients report strategies like persistent scheduling calls or seeking telehealth options. Telehealth services can prescribe standard treatments for pattern hair loss, but they may miss less common or inflammatory conditions; an in-person dermatology visit is often best when the cause is unclear.
Treatments — established and newer
Topical minoxidil (Rogaine) is an over‑the‑counter foam that prolongs the hair growth phase and is effective for pattern hair loss, though some find it messy and it’s not recommended during pregnancy or nursing. Minoxidil is also available orally; some clinicians prescribe oral minoxidil plus spironolactone (an anti-androgen) off‑label for women, and some patients report benefit under medical supervision.
For alopecia areata, newer JAK inhibitor drugs approved in recent years target the overactive immune response and have shown greater hair regrowth than placebo in studies. Steroid injections have helped others with alopecia areata achieve regrowth as well.
Living with hair loss
Hair loss can be emotionally painful, but it isn’t “game over.” Many women adapt by using scarves, hats, wigs or going uncovered, and find community and support through groups such as Bald Girls Do Lunch and online forums. Thea Chassin, founder of that support group, notes that some women embrace life bald and that normalizing different choices about hair can help redefine beauty.
If you’re experiencing hair loss, seek a medical evaluation to identify the type and appropriate treatment, and look for support networks while exploring options.