My hair is so thin I can see my scalp: why is this happening and how can I solve it?

This situation is one of the first signs of female pattern baldness. Contrary to popular belief, this isn’t simply an inevitable consequence of ageing, but rather a medical condition that can be effectively treated, particularly when caught early. In this comprehensive guide, we’ll explore why your hair might be so thin you can see your scalp and, most importantly, examine practical solutions to address this concern effectively.

Why can I see my scalp through my hair?

The hair miniaturisation process

If your scalp is becoming increasingly visible, this is primarily due to the gradual miniaturisation of your hair. The issue isn’t necessarily that you’re losing loads of hair, but rather that your hair is gradually becoming finer.

Normally, each hair goes through a growth cycle (anagen phase) lasting several years, followed by a short transition phase and then a resting phase before falling out. In women with female pattern baldness, this cycle becomes disrupted: the growth phase shortens dramatically and the follicles produce increasingly finer and shorter hairs.

GOOD TO KNOW

Women with lighter-coloured hair notice scalp visibility earlier. The greater the contrast between your skin tone and hair colour, the more visible your scalp will be, even in the early stages of hair thinning. Fair-haired women typically notice their thinning hair earlier than brunettes, even with the same degree of hair loss. The result? Even if you still have roughly the same number of hairs, their diameter decreases significantly, so they cover the scalp less effectively. It’s rather like gradually replacing a thick, cosy blanket with an increasingly sheer veil.

Typical location in women

Unlike men, who tend to lose their hair mainly at the temples and crown, female hair thinning manifests quite differently. In women, thinning generally occurs on the top of the head, with a gradual widening of the centre parting. The good news is that the front hairline is usually preserved.

Why is my hair so thin I can see my scalp?

Genetic and hormonal factors

Heredity plays a crucial role in female pattern baldness. If your mother, grandmother or aunts have experienced this problem, you’re significantly more likely to develop it too.

Hormones, particularly dihydrotestosterone (DHT), are also deeply involved in this process. In genetically predisposed individuals, this hormone affects the hair follicles, causing them to gradually miniaturise. Periods of hormonal upheaval such as the menopause often exacerbate the problem, as the decrease in oestrogen reduces its protective effect on the hair.

Other aggravating factors

Several factors can accelerate or worsen hair thinning:

• Chronic stress plays a significant role
• An unbalanced diet lacking essential nutrients
• Certain medications with hair loss as a side effect
• Nutritional deficiencies, particularly iron, vitamin B or zinc
• Thyroid disorders affecting hormone balance
• A sedentary lifestyle with poor circulation

How can I tell if I really have female pattern baldness?

If you’re concerned about your hair being so thin you can see your scalp, look for these characteristic signs:

• A gradually widening parting, especially at the top of the head
• Decreased overall volume of your hair
• Hair that is visibly thinner than before
• Scalp more visible in certain lighting conditions or when your hair is wet

This change is usually slow and gradual, occurring over several months or years, rather than suddenly.

GOOD TO KNOW

The impact of the seasons on your hair. Did you know that we naturally lose more hair in autumn? A dermatological study has revealed that hair loss increases by 30% between September and November. So don’t be alarmed if your scalp seems more visible during this period – it’s a normal cyclical phenomenon that doesn’t necessarily mean your hair thinning is worsening. If in doubt, do consult Dr Cinik’s medical team. Diagnosis is usually based on a clinical examination, sometimes supplemented by a trichoscopy (examination of the scalp with a dermatoscope) and blood tests to rule out other causes such as thyroid problems or deficiencies.

Solutions to quickly conceal my visible scalp

Whilst waiting for underlying treatments to take effect, there are several brilliant techniques you can use to immediately conceal your scalp.

Styling techniques and cosmetic products

Changing the way you style your hair can make a remarkable difference:

• A side parting often creates more volume than a centre parting
• Strategic cuts such as bobs, gentle layers or fringes can help to mask thinning hair
• Shorter styles sometimes work better than very long hair, which tends to flatten
• Blow-drying with your head tilted downwards helps create volume at the roots

Les produits cosmétiques peuvent être de précieux alliés. Privilégiez les shampooings volumateurs sans silicone qui n’alourdissent pas les cheveux. Les mousses et sprays volumateurs, appliqués sur cheveux humides avant le brushing, donnent instantanément plus de corps à la chevelure. Les poudres texturisantes, appliquées aux racines, créent un effet lifting immédiat.

Direct camouflage solutions

For immediate results, coloured powders and sprays adhere to existing hair and instantly mask the scalp. Brands such as Toppik® and Nanogen® offer keratin-based hair fibres that cling electrostatically to the hair to create the illusion of density. These are widely available in Boots and Superdrug throughout the UK.

There are also specific make-up products for the scalp, similar to foundation, which reduce the contrast between the skin and the hair – quite brilliant for quick fixes before important events.

Effective medical treatments

To treat the cause rather than just the symptoms, several medical solutions have proven remarkably effective.

Minoxidil

Minoxidil remains the gold standard first-line treatment and the only one specifically approved for female pattern baldness on the NHS. It works in several ways: it dilates blood vessels, prolongs the hair growth phase and stimulates dormant follicles.

Available as a 2% or 5% solution or as a 5% foam, it is applied once or twice a day to the dry scalp. Results are usually visible after 4 to 6 months of regular use. It’s important to note that a temporary increase in hair loss may occur in the first few weeks – this is perfectly normal and even a good sign! Possible side effects include local irritation or, more rarely, increased facial hair growth.

This treatment must be continued long term to maintain the results obtained. Discontinuing minoxidil generally results in a gradual return to the initial condition within 3 to 6 months.

GOOD TO KNOW

The ideal time to apply minoxidil. Contrary to popular belief, applying minoxidil in the evening is more effective than in the morning. During sleep, the skin temperature and blood flow to the scalp increase, optimising the absorption and action of the product. If you only use minoxidil once a day, it’s best to apply it at night.

Anti-androgens

For more resistant cases, your GP or dermatologist may prescribe anti-androgens. Spironolactone is mainly used in women with other signs of hyperandrogenism such as acne or excessive hair growth. The usual dosage ranges from 25 to 100 mg per day.

Cyproterone acetate, often found in certain oral contraceptives such as Dianette® in the UK, can also help women suffering from symptoms of hyperandrogenism.

These treatments require a medical prescription and regular monitoring. They are strictly contraindicated during pregnancy due to their teratogenic potential on male foetuses.

Advanced medical procedures

If topical and oral treatments aren’t sufficient, several more advanced interventions may be worth considering.

Revitalising injections

Mesotherapy consists of superficial injections of nutrient cocktails (vitamins, minerals, amino acids, sometimes minoxidil) directly into the scalp to stimulate the follicles. Generally, 4 to 8 sessions spaced a few weeks apart are necessary to see results.

PRP (Platelet-Rich Plasma) uses your own blood, from which growth factor-rich platelets are extracted before being reinjected into the scalp. According to studies, approximately 57% of women see an improvement after several sessions. This technique has the advantage of being natural, as it uses your own cells to stimulate hair regeneration.

DHI hair transplant

For more advanced cases, DHI (Direct Hair Implantation) offers a permanent solution. This advanced technique involves removing follicles from the occipital area (back of the head) and implanting them in the thinning areas. DHI has several advantages for women. It is less traumatic for the tissue and sometimes allows long hair to be kept during the procedure.

Combined approach for optimal results

The best results are usually achieved by combining several therapeutic approaches:

• Combining topical minoxidil with cosmetic camouflage provides both immediate results and long-term benefits
• Minoxidil and anti-androgens together act simultaneously on hair growth stimulation and hormonal factors
• Microneedling with minoxidil has shown superior results to minoxidil alone, as the mechanical action enhances absorption
• Medical treatment with PRP sessions can significantly boost follicular stimulation

Daily habits that make a difference

Your daily hair care routine plays an essential role in the health of your hair:

• Use gentle, sulphate-free shampoos that respect the balance of your scalp
• Minimise heat styling (high-temperature hair dryers, straighteners, curling irons)
• Avoid hairstyles that pull on the roots which can cause traction alopecia
• Be gentle with wet hair when it’s at its most vulnerable
• Massage your scalp daily to improve local blood circulation

Tight ponytails, African braids, heavy extensions or pulled-back buns create chronic tension that can permanently damage hair follicles, particularly in the already weakened temporal and frontal areas. This is especially problematic when combined with female pattern baldness.

Sources :

Müller Ramos, P., Fernandes Melo, D., Radwanski, H., Cortez de Almeida, R. F., & Amante Miot, H. (2023). Female-pattern hair loss: therapeutic update. Anais Brasileiros de Dermatologia, 98(4), 506-519. https://doi.org/10.1016/j.abd.2022.09.006

Kaneko, A., & Kaneko, T. (2018). A new classification of early female pattern hair loss. International Journal of Trichology, 10(2), 61-67. https://doi.org/10.4103/ijt.ijt_80_17

Tsutsui, G. M., Ramos, P. M., & Miot, H. A. (2022). Prevalence of female pattern hair loss in a multiracial population. Journal of the American Academy of Dermatology, 86(4), 862-894. https://doi.org/10.1016/j.jaad.2021.03.106

Sinclair, R. D. (2018). Female pattern hair loss: a pilot study investigating combination therapy with low-dose oral minoxidil and spironolactone. International Journal of Dermatology, 57(1), 104-109. https://doi.org/10.1111/ijd.13838

Ramos, P. M., Sinclair, R. D., Kasprzak, M., & Miot, H. A. (2020). Minoxidil 1 mg oral versus minoxidil 5% topical solution for the treatment of female-pattern hair loss: A randomized clinical trial. Journal of the American Academy of Dermatology, 82(1), 252-253. https://doi.org/10.1016/j.jaad.2019.08.060

Dubin, D. P., Lin, M. J., Leight, H. M., Farberg, A. S., Torbeck, R. L., Burton, W. B., & Khorasani, H. (2020). The effect of platelet-rich plasma on female androgenetic alopecia: A randomized controlled trial. Journal