Elderly ladies (70+) sometimes develop a fibrosing alopecia where the hair follicles disappear and the skin has a "scarred" look about it. Hair loss in these areas is permanent, and any hair loss treatment is aimed at attempting to limit the spread of the condition. Fibrosing alopecia is not caused or influenced by perming or tints, but the hair should treated as though it were damaged or degraded.

Severe or prolonged emotional or physical stress can trigger genetic thinning. Stress increases cortisone levels, and these can have the same adverse effects on the hair as androgens.

As with genetic baldness in men, women must have inherited the tendency to develop this type of thinning. The relative infrequency with which genetic thinning occurs in women suggests the trait must be inherited by the daughter from bothparents in order for her to exhibit it.

There are a variety of reasons for women’s hair loss. Androgenetic alopecia is the most common cause of hair loss in both men and women and a majority of people in the world will experience androgen mediated alopecia at some point in their lives. Androgenetic alopecia is a condition that has a wide variety of names including male pattern baldness, female pattern hair loss, and androgenic alopecia. All these names refer to the same condition involving the loss of hair in response to androgen hormones.

In the past, androgenetic alopecia was thought to be the primary cause of men’s and women’s hair loss. Although the reasons behind female balding are still largely misunderstood, there is evidence that it’s attributed to many factors, such as DHT (common in men as well), other types of enzymes, as well as hormone receptors and blockers. Since there may be other factors causing female hair loss besides androgen hormones, the more generic term androgenetic alopecia is sometimes not used to categorize women’s hair loss. Instead it can be referred to as female pattern thinning, which is a broader term that encompasses many possible causes, some of which are likely to be directly linked to an excess of testosterone, and some of which are not.

Causes of female pattern thinning: Hormones, DHT, Blood Flow, Nutrition, Stress, Sebaceous Oil Build-up.

Hormones

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DHT
Heredity is assumed to be the primary cause, although the male hormone testosterone plays an important role, seemingly independent of genetic predisposition. Cells in genetically programmed hair follicles contain the enzyme 5 alpha reductase. This is found in higher quantities in the scalp follicles of affected men. 5 alpha reductase converts the hormone testosterone into the more potent 5-alpha dihydrotestosterone (DHT). The DHT hormone then binds to androgenic receptors in the hair follicle and the specific bond triggers cellular processes, which reduce the anagen (growing) phase of the hair cycle. For this reason, the hair passes earlier into the telogen (resting) phase and falls out. Over succeeding cycles, terminal hair gradually converts into thinner and shorter vellus hair and the hair follicle becomes minute.

In those with androgenetic alopecia, the overall levels of testosterone may be normal however the activity of 5-alpha reductase is greater than normal which results in increased amounts of DHT in the hair follicle. The density of the adrogenic receptors in the hair follicles varies according to location (more adrogenic receptors at the back and top of the head, fewer on the sides) and this is genetically determined.

Blood Flow
Blood delivers the elements that are essential for life. A constricted blood supply prevents nutrients from coming into the papilla area where vitamins, minerals, and amino acids are necessary for proper cellular reproduction.

Stress
This is another contributor and causes of hair loss. While under stress, the pituitary gland can produce hormones and enzymes that can constrict the vascular system, thus hindering the oxygen, nutrients, and blood flow to the hair. It is important to bring stress levels under control to stop it as a cause of hair loss.

Sebaceous Oil Build-up
Sebaceous glands secrete an oily substance called sebum into the hair follicle. Sebum lubricates the hair for smooth growth, and also protects and waterproofs hair and keeps it from becoming dry, brittle and cracked. When poor quality, thin hairs are produced, oil fills up in the follicle, hardens, and can hinder proper hair growth.