Addressing the Root Causes of Female Hair Loss and Non-Pharmaceutical Interventions

July 2025 | Volume 24 | Issue 7 | 8763 | Copyright © July 2025


Published online June 18, 2025

doi:10.36849/JDD.8763

Adam Leavitt MD FAADa, Spencer D. Hawkins MD FAADb, Chesahna Kindred MD MBA FAADc, Cheri Frey MD FAADd, Madeliene Gainers MD FAADe, Steven K. Grekin DOf, Matt Leavitt DOg

aKCUMB Orlando Core Faculty, Orlando, Florida; Advanced Dermatology and Cosmetic Surgery, Orlando, FL
bHair Medicine Institute, Atlanta, GA
cKindred Hair & Skin Center, Marriottsville, Maryland; Howard University, Washington, DC
dHoward University, Washington, DC
eMadeliene Elaine Dermatology, Chevy Chase, MD
fProgram Director, Dermatology Residency, Beaumont Health Systems, Royal Oak, MI;
Advanced Dermatology and Cosmetic Surgery, Wyandotte, MI
gAdvanced Dermatology & Cosmetic Surgery; Orlando Dermatology Residency Program;, UCF and KCUMB, Orlando, FL

Abstract
Female hair loss affects over 50% of postmenopausal women, with up to 40% of healthy women experiencing frontal/parietal hair loss, often beginning around reproductive age. Androgenetic alopecia is the most prevalent form of hair loss. Other types include alopecia areata, telogen effluvium, and scarring alopecias, such as lichen planopilaris and central centrifugal cicatricial alopecia. Hair loss can severely impact a woman's psychological well-being, yet treatments approved by the US Food and Drug Administration (FDA) remain limited to topical minoxidil and oral Janus kinase inhibitors. This manuscript reviews the multifaceted causes of female hair loss, hormonal imbalances, inflammation, nutrient deficiencies, aging, and oxidative stress, and explores non-pharmaceutical interventions. Saw palmetto, horsetail, and pumpkin seed oil, all of which inhibit 5α-reductase, show promise in promoting hair density and reducing hair follicle miniaturization. Curcumin has demonstrated anti-inflammatory effects, contributing to improved hair and scalp health. Nutritional deficiencies, particularly in iron, vitamin D, and essential minerals, also play a significant role in hair loss, underscoring the importance of a balanced diet and conservative supplementation. Avoiding excessive supplementation, especially with biotin, is recommended due to potential diagnostic test interferences. With increasing demand for non-pharmaceutical options, identifying natural, safe, and effective treatments for female hair loss is imperative. Further studies are needed to validate the efficacy and safety of these interventions.

J Drugs Dermatol. 2025;24(7): doi:10.36849/JDD.8763

INTRODUCTION

Hair loss is a common problem that affects women. Greater than 50% of postmenopausal women, with up to 40% of healthy women, experience frontal/parietal hair loss, often beginning around reproductive age.1 The most common type of female hair loss is called androgenetic alopecia (AGA) or female pattern hair loss (FPHL). Other forms of alopecia affecting women include alopecia areata (AA), telogen effluvium (TE), lichen planopilaris (LPP), central centrifugal cicatricial alopecia (CCCA), frontal fibrosing alopecia (FFA), and traction alopecia. Female hair loss can have a psychosocial impact, contributing to a lower self-image, anxiety, and depression.2

Currently, there are a limited number of medications approved by the US Food and Drug Administration (FDA) to address female hair loss. FDA-approved treatments include topical minoxidil for FPHL and 3 oral Janus kinase inhibitors indicated for the treatment of AA.3 With the dearth of options, supplements and nonprescription therapies could play a beneficial role, filling a gap in the management of all females experiencing hair loss.

When discussing the pathophysiology of female hair loss disorders, it is helpful to consolidate etiologies into a few broad categories. These include hormone imbalance, systemic and localized inflammation, nutrient and vitamin deficiencies, aging and cellular senescence, and oxidative stress. Below, we discuss the origins of hair loss and review interventions that may serve as mediators impacting disease progression and reversal.

Hormone Imbalance and Sensitivities Hair loss in women is often influenced by hormonal factors, such as the production of dihydrotestosterone (DHT), polycystic
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