Crowning Glory Dermatology

Hair Today, Gone Tomorrow

female pattern baldness, thinning hair for women

My attachment to my long hair rivals Samson’s.  Growing up in the 1970s my mother imprisoned my budding femininity in a pixie cut.  The beauty credo she was trying to instill in me was “nothing is prettier than practical” and believed long hair would attract Silly Putty, gum and nonsense.  She never relented, even after an elderly German couple told me at age seven what a “handsome young man I was” (see photo below, it was taken five minutes before said compliment).

I was a girl trapped inside a boy’s haircut.

Freedom came on my 13th birthday when in an act of defiance, I grew it all the way down to the middle of my back.  Thick, lustrous and wavy, my long hair transformed me from “meh” to “wow” and boys noticed.  It became a beauty hallmark of mine and couldn’t think of living life any way but long and lush.

Until I went bald at the age of thirty-six thanks to a breast cancer diagnosis and multiple rounds of chemo.   Contemplating my potential demise had a way of making my hair loss seem inconsequential, and I enjoyed the taste of bad ass that came with G.I. Jane buzz cut when it started to grow back in.  Unexpected on me, especially when paired with kitten heels, argyle and cashmere.

3 months post chemo

G.I. Me. 3 months post chemo

More difficult were the in between growing out years of looking like Greg Brady in drag, but eventually my long hair returned, like an old friend I hadn’t seen in a while.  A little less glorious, a little thinner and weaker but loved just the same.

So imagine my freak out when last year my dermatologist told me I had the early stages of female pattern baldness.

“Can you check my scalp out?” I asked as my doctor waved the Woods lamp over every nook and cranny.  “I feel like it’s been getting sunburned lately”.   “No problem, but you know you need to protect your scalp with sunscreen because you’ve got early stage female pattern baldness” he said nonchalantly.

“That’s impossible” I snipped, as though he declared I had an STD.  Sure, my part was getting a little wider, my pony tail thinner and my scalp a little more sensitive to the sun.  I convinced myself this was all in my imagination, but hearing the official words  “female pattern baldness” from my doctor landed like a thud of hopelessness.

“Yep, the early forties is when it begins to show up in women” he said.  “The problem is, most women don’t do anything about it until the scalp is clearly visible or the part is noticeably wide.  At that point it’s too late, they’ll never regrow what they lost, they can only keep what they have.”

How is it that after dealing with cancer and losing my breasts, a little hair loss suddenly made me feel diminished and ashamed?   And why isn’t this a bigger part of the anti-aging conversation?   After all, women don’t want to cut their hair short like our mothers or grandmothers did after a certain age, unless we want to.  I want my locks to be as lush and vibrant as I am.

Dr. Vivian Miller touches on this in her piece  The Gender Hair gap and suggests that having lustrous hair is hardwired into women as a key to survival.  Yay.  Women with thick hair signals fertility, vitality and youth as does everything else that seems to go south after 40, but female hair loss seems to be the last frontier.  When men lose their hair, we’re used to seeing it and lets face it most of them look smoldering when they go full scalp commando, at least in a bank robber meets assassin kind of way. Women, not so much.

Female hair loss is also sneaky and subtle.  It starts off with a thinning around the crown and then spreads in a tree like pattern per the Ludwig scale below (I am considered stage 1-2, see the picture above).   While few women get the very advanced stages, anything beyond 1-4 can be traumatic.

The Ludwig Scale of Hair Loss

My derm went on to tell me that my options are limited aside from Rogain 5% and that my goal now should be to hold on to the hair I have, rather than thinking I can regrow the mane made I once had.  However, he did give me a glimmer of hope about some clinical trials around the iGrow hair laser and wrote me a referral to Dr. Philip Bruder who specializes in hair loss.

Oh my God, was this contraption in my future?

igrow woman


A month later I’m in Dr. Bruder’s office, a nice, but no-nonsense man who closely resembles Beeker from the Muppets and from the ambient office music, had a clear penchant for Led Zeppelin.  I’ll listen to Black Dog all day long if he can restore my beautiful mane .

He tells me that he suspects I have the type of female pattern baldness that comes with genetics, age and hormones given I went into early menopause due to the cancer treatment.  But, he throws me the bone of offering to do a scalp biopsy and full blood work up to rule out other causes if I want.

Yes, I want.   Take that piece of my scalp Mister and fix me already!

15 minutes later, I’m numbed up and two hole punched pieces of my scalp are removed and stitched up.  He stitches me up leaving me with what looks like the tentacles of a lady bug for a week.  Now, on to the most comprehensive blood work panel I’ve ever had.  Fortunately, this was covered by insurance.

Two weeks later, the verdict, female androgenic alopecia, a fancy term for what Dr. Bruder suspected which is hair loss caused by genetics and age.

So what now?   Dr. Bruder continued to recommend Rogain 5%.  He said there are some promising lasers on the horizon, but as of yet nothing has had the evidence to suggest the cost and effort are worth it (so long iGrow, until you have more clinicals).  So for now, my bag of tricks in the hair loss department looks like this:

  • Rogain 5% Extra Strength.  This is the stuff the guys use, but you cannot use it if you could be come pregnant.  On the upside, it really does work and gives your hair a bit of a dry shampoo texture.  On the downside, it’s  pain in the neck because you have to use it morning and night for the rest of your life.  Also, the gooey texture makes my hair sometimes feel greasy and it makes my scalp flake.  A high price to pay, but I have to say it WORKS.  Your hair will fall out even more in the first few months (those are the weak follicles being pushed out by stronger ones).
  • Viviscal.  Models pop it like Pez and my hairdresser swears by it.  I’ve been taking it for about a month and do think my hair feels stronger, but I’ll report back in another three months.  I’ve also used biotin, but Dr. Bruder told me that only works if you have a biotin deficiency and even then, it only makes the hair that’s there grow faster and longer.  Biotin does not thicken or replace the hair you’ve lost.
  • Topikk.  I don’t used this all the  time, but on those occasion where my hair feels especially thin and scalpy, I’ll sprinkle this keratin powder formula on my blinding white scalp spots and watch it magically disappear.
This is going to be a long journey, so I’ll be revisiting this topic often with my eyes wide open.  If you’ve been dealing with thinning hair, would love to hear your experience and any lessons learned along the way.
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  • Reply
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    August 20, 2012 at 10:21 AM

    […] hair.  It’s easy to neglect that slightly widening part, or that visible scalp (click here for my own personal journey).  But what women don’t realize is that female pattern baldness exists and needs to be treated […]

  • Reply
    April 2, 2013 at 11:32 AM

    I haven’t explored any solutions yet and merely have all over thinning with no pattern, but I’m extremely interested in your findings. I’ve been going shorter and shorter with my hair (used to be under butt length) so it doesn’t end up looking scraggly.

    • Reply
      April 3, 2013 at 7:29 AM

      I’m shorter now too, but but my hair is still below my shoulders. I just don’t look that good with a pixie, otherwise I would chop it. I’ll definitely share what I find out as I learn more.

  • Reply
    Stephanie (
    April 2, 2013 at 11:38 AM

    Goodness, like you haven’t been through enough already! BUT, with your sense of humor and gorgeous face (seriously, you pulled off the GI Jane look incredibly!), you will jump over this hurdle, too!

    • Reply
      April 3, 2013 at 7:31 AM

      The interesting thing is that my thinning isn’t visible to other people (unless I point it out), but most think I have a full head of hair. I thought I was imagining it until my derm pointed it out, but he said most women don’t take any action until it is really visible, at which point it’s hard to address. And thanks for the compliment, helps that the picture was taken 8 years ago:)

  • Reply
    April 2, 2013 at 1:49 PM

    Any other surprises that come with aging? I still retain the mane but I have a number of girlfriends battling with the same problems as you. Nothing that you would actually notice upon meetin them, but they know. What I found out is that having a trichologist’s number next to every other doctor is now a must. Does insurance cover any of this?

    • Reply
      April 3, 2013 at 8:09 AM

      I haven’t tried a trichologist yet. I started with a derm that specializes in hair loss to see if there was something deeper going on, but alas, no:( My next stop in my adventure will be to a trichologist, I think I’ll try Philip Kinglsey. To be continued….

  • Reply
    April 2, 2013 at 6:37 PM

    I love that you have such a ‘take no prisoners’ attitude to ageing. So many women just lay back and let their bodies trample all over them, as though they have no say in the situation. Not you.

    • Reply
      April 3, 2013 at 8:10 AM

      Thanks Rebecca. I just hate that inside I feel 30, but my outsides don’t always reflect that:)

  • Reply
    July 11, 2013 at 1:02 PM

    Anything new on this front? What did you decide on the Viviscal??

    • Reply
      July 11, 2013 at 8:27 PM

      Yes, I’ve been using Viviscal Professional and LOVE IT. That and Rogaine have been a huge help.

  • Reply
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