Does FPHL cause hair loss on the sides?

Does female thinning cause hair loss on the sides or just the middle?

I’ve selected this question below for this week’s question of the week. It allows us to review some concepts regarding the diagnosis of female pattern hair loss.

Question

I’m confused as to whether female pattern hair loss causes hair loss on the sides. All the pictures I see online show that it causes thinning in the middle of the scalp. What is the correct answer?

Answer

Female pattern hair loss can cause hair loss at the sides and the back of the scalp as well. We call this a diffuse unpatterened hair loss or DUPA. A key differences (among a few) between male and female pattern hair loss is just how much more common diffuse thinning or DUPA occurs in females. It’s rare in males but not all that uncommon in females.

A good history and proper examination can confirm if the diffuse hair loss is from androgenetic hair loss or from other causes of diffuse hair loss like telogen effluvium.

Many females with diffuse thinning note that the hair loss started centrally in the mid-scalp but came to progressively involve the sides and back as time went by.

Here are the typical patterns that women can develop: