Receding Hairline – Can It Be Stopped?

Written by Rali Bozhinova, Superintendent Trichologist, The Belgravia Centre

We often get asked about receding hairline at the clinic. You might think that only men experience receding hairline but the reality is that many hair loss conditions can change the appearance of your hairline. Men and women of any age and ethnicity may notice changes around their fringe and we are here to explain why this may be.

Male Pattern Hair Loss

Male pattern hair loss is the most common reason for someone to experience receding hairline. This is a genetic type of hair loss although it is not always obvious in the immediate family. It is so common that sometimes it becomes unnoticeable. During consultations, our hair loss specialists ask patients if they have hair loss in their families. Often the first answer is ‘no’ followed by ‘my father has always had receding hairline but it’s normal for him because he’s older so this doesn’t count’. Unfortunately, it does count, and this pattern of hair loss is often inherited.

Male pattern hair loss can start at any age after puberty. This is because during puberty your hormones change and your male sex hormones, also called androgens, kick in. This is the time when you may also notice some acne, oily skin, a thicker beard, and the first signs of hair loss. Interestingly, the same hormones are responsible for your thicker darker hair growth on your face and chest, and also for your thinner and sometimes lighter hair growth on your scalp. More specifically, the hormone responsible for male pattern hair loss is dihydrotestosterone (DHT).

DHT forms from testosterone in the presence of 5-alpha reductase enzyme which is found in specific tissues in your body, one of which is your scalp. DHT is the most potent androgen, it attaches to androgen receptors in the genetically-predisposed hair follicles, and it gradually makes them lose their hair. It is unlikely for you to notice hair loss overnight but over a long period of time, the affected follicles will miniaturise and become smaller in size. If these follicles used to hold 4 hair strands, they may now hold only one, reducing your hair density. You may notice your hair looking thinner and thinner over time and eventually, it may be lost. Signs of male pattern hair loss include:

 

 

 

• Receding hairline
• Thinning of the crown and top
• Thicker hair at the back
• The affected hair feels thinner, more brittle
• The affected hair may grow slower compared to the rest of the hair

Treatments for male pattern hair loss include 5-alpha reductase inhibitor such as finasteride and a hair growth stimulant such as minoxidil. Finasteride and minoxidil are the only two medically proven treatments for this condition and they tend to work very well in men. If you have noticed receding hairline or other signs of male pattern hair loss, contact us for a free consultation with one of our hair loss specialists who will discuss your medical history, lifestyle, examine your hair, and help you find a tailored treatment plan specific to your situation.

Female Pattern Hair Loss

Similarly to male pattern hair loss, female pattern hair loss tends to have a genetic predisposition. Women can also experience receding hairline although this tends to be less severe compared to men. Many women may notice their temples growing thinner hair and their scalp being more visible through their hair at the front.

Female pattern hair loss is also linked to the DHT hormone but the condition can be more complex compared to men. Women tend to go through many hormonal changes in their lifetime, not just puberty. Pregnancies, menopause, irregular menstrual cycle, high free androgen index, polycystic ovarian syndrome and other hormonal imbalances in women are common triggers for further hair loss which can exacerbate the appearance of female pattern hair loss.  The exact role of androgens is not fully understood – female pattern hair loss is common in those with elevated androgens but many women don’t have any hormonal imbalance and still develop female pattern hair loss. There have also been cases reported of female pattern hair loss in women without any functioning androgen receptors. The most likely explanation for this is that it is not just the DHT alone that is causing the hair loss, but the ratio between male and female sex hormones in the hair follicles, combined with other factors such as genetic predisposition and lifestyle factors such as stress, dietary deficiencies and other medical conditions. Signs of female pattern hair loss include:

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• Thinner temples
• Thinner hair on the top of the head
• Thicker hair at the back of the head
• Wider hair parting on top
• Less volume and flat-looking hair on top

Minoxidil is the only medically proven treatment for women with female pattern hair loss. However, it is equally important that women address any other medical concerns with their doctor so that other contributing factors are not left untreated. If you have noticed receding hairline or other signs of female pattern hair loss, contact us for a free consultation with one of our hair loss specialists who will discuss your medical history, lifestyle, examine your hair, and help you find a tailored treatment plan specific to your situation.

Traction Alopecia

Traction alopecia is fairly common and it often affects the hairline. It can develop gradually over a long period of time and it can make the hairline lose its hair in a band-like pattern. Other patterns of traction alopecia are possible, too, as the pattern would depend on the hair styling practices. Traction alopecia is hair loss caused by continuous repetitive physical trauma to the hair, usually due to the tension applied to the hair roots when the hair is styled. Common practices that can cause traction alopecia over time include:

• Tight ponytails and buns
• Tight rollers
• Tight hair clips
• Tight wigs or headscarves that are constantly rubbing against the hairline
• Tight braids and cornrows
• Hair extensions, extension braids, weaves
• Glued-on hair pieces and wigs
• Pulling of the hair during blow-drying and brushing

These are common reasons for traction alopecia. When combined with further trauma to the hair such as bleaching, relaxing, perming, and using hair straighteners, you may notice severe hair breakage and hair loss, and you may also struggle to grow your hair in length. Signs of traction alopecia include:

 

 

 

• Hair loss and breakage around the hairline, often in a band-like pattern
• It may affect the hairline above your ears and above your neck
• You may have hair loss in the places where your extensions are attached
• Your hair may be growing thinner and shorted from the affected areas
• You may notice some areas looking perfectly smooth without any hair

If you have noticed any signs of traction alopecia, it is always best to think about your hair care routine and reduce the amount of trauma applied to the hair. We all like to style our hair but you can find a balance between beautiful hair styles and healthy growing hair. Your hair bun could be looser, your extensions could be lighter and only for special occasions, your braids don’t need to give you headaches and can be made looser. Additionally, if your hair has been bleached or relaxed, it would be more vulnerable to breakage and you should be exceptionally careful in this case not to cause further trauma.

If changing your hair care routine does not help, you can contact a dermatologist for further advice. Please bear in mind that The Belgravia Centre does not treat traction alopecia.

Frontal Fibrosing Alopecia

Frontal fibrosing cicatricial alopecia is a type of scarring hair loss that can cause permanent hair loss around the hairline in a band-like pattern. Some speculate that Queen Elizabeth I might have had frontal fibrosing alopecia due to her high forehead but there is no evidence for this. Frontal fibrosing alopecia is more common in post-menopausal women however, there have been many reports of women with frontal fibrosing alopecia before menopause, as well as men. This type of hair loss is of autoimmune nature. If you have frontal fibrosing alopecia, your lymphocytes, which are types of white blood cells and part of your immune system, attack cells in the hair follicles. This causes inflammation and eventual destruction of the hair follicles which are then replaced by scar tissue. The condition is not very well understood and we still don’t know why some people develop frontal fibrosing alopecia but it is thought that genetic predisposition, your own immune system, and possibly your hormones play a significant role. Signs of frontal fibrosing alopecia include:

 

 

 

• Hair loss around the hairline in a band-like pattern
• Hair loss on the eyebrows
• The affected area may appear pale and smooth to touch
• The hairline may feel tingling or itchy, although many people don’t feel anything
• You may see some inflammation and scaling around the roots of each hair strand

If you have noticed any signs of frontal fibrosing alopecia, it is important that you contact a dermatologist for treatment. The treatment may not regrow the hair, but it can help stop the progression of the condition. A biopsy may be performed to confirm the diagnosis. Treatments may include topical steroids or steroid injections, immunosuppressive or immunomodulatory drugs, some antibiotics, and some anti-androgen drugs. Please bear in mind that The Belgravia Centre does not treat frontal fibrosing alopecia and you should contact a dermatologist for further advice.   

Booking A Consultation

If you are concerned that you have a receding hairline, it is always best to address this early and consult with a specialist who can advise you on suitable treatments for your specific case. Treating a hair loss condition early usually leads to better outcomes.

If you have noticed signs of traction alopecia or frontal fibrosing alopecia, contact your dermatologist for further advice on a suitable treatment plan. If you are worried about male or female pattern hair loss, you can arrange a free consultation in our Central London clinic with a hair loss expert or complete our Online Consultation Form from anywhere in the world and we will talk to you on Zoom. Take a look through our hair regrowth photo gallery – which is the largest gallery of its kind in the world and contains over 1,000 sets of hair growth photos and verified reviews from patients of The Belgravia Centre.

The Belgravia Centre’s Pharmacy offers special formulations of minoxidil at various strengths and formulas, and with added ingredients to maximise effectiveness; finasteride can be used in oral or topical form, depending on your medical history, preference and lifestyle. Additional natural and technological solutions may be offered as part of the treatment such as Hair Vitalics, a one-a-day food supplement that combines important vitamins, minerals, amino acids, and plant extracts to support healthy hair growth; and HairMax LaserBand, an FDA-cleared low-level laser therapy device which uses photobiostimulation technology to stimulate the follicles at a cellular level. Your hair loss specialist will guide you through the treatment process and will monitor your progress regularly to help you achieve optimal results from your treatment plan. Our qualified hair loss specialists have extensive experience in treating hair loss conditions, and they are available 7 days a week to support our patients with their high level of expertise.