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Hair problem
The crown, or vertex, is the round spot at the top of the head, where the hair grows in a swirl. It is an area we almost never see head-on, so the thinning is usually noticed first by someone else, at the hairdresser or in a photograph. Here we explain how to recognise it, in men and in women, and what the clinic can offer.
Reviewed by Dr Michelle Campagnoli, clinical director
How to recognise it
The crown is hard to see in a front-facing mirror. These signs can help you tell whether the hair at the top of your head is getting thinner.
Tick what you recognise
Tick the signs you recognise in your case. This is not a diagnosis, it is only meant to give you an idea.
You recognise some of these signs. It may be thinning at the crown or it may have another cause. Only a medical assessment can say for sure.
Several signs match thinning at the crown. The earlier it is assessed, the more options you have to monitor the progression. Only a medical assessment can confirm it.
Book an assessment consultationSudden, heavy hair loss, well-defined round patches, a painful scalp, sores or heavy scaling should be seen without delay, because they usually have another cause.
Parting. In women, it gradually becomes wider near the top, and the scalp shows more along it.
Crown. The swirl area. This is where the hair may become finer, with a round area of lower density.
Temples. It is worth comparing them with the crown: if the sides are denser, the difference helps the doctor understand the pattern.
Why it happens
It is rarely just one thing. Choose a cause to see what makes it worse and what helps.
The follicles at the crown may inherit a greater sensitivity to certain hormones and gradually become smaller. The hair grows back finer and shorter. In men it is usually the start of baldness at the crown.
Waiting for it to pass on its own while the follicles keep shrinking.
Getting assessed early, because it is easier to monitor the progression than to recover what has been lost.
In women, the menopause, polycystic ovary syndrome or other hormonal changes can thin the hair at the top. The doctor may request blood tests when it is useful.
Putting it all down to age and not investigating a hormonal change.
Working out, with the doctor, whether there is a hormonal cause to treat.
Top knots, high tight ponytails and extensions pull on the hair at the top of the head every day and may weaken the roots over time.
Tying the hair always in the same place and pulled tight.
Alternating hairstyles, letting the hair down and using wide hair ties.
Iron, vitamin D or zinc deficiency and thyroid changes can add to the thinning and make it more visible. Only a blood test can confirm this.
Taking supplements on your own, without knowing what is missing.
Blood tests, when the doctor finds them useful.
Periods of great stress, illness, restrictive diets or poor sleep can make more hair fall out and accentuate a thinning that was already there.
Very restrictive diets and weeks without rest.
A diet with enough protein, regular sleep and breaks.
Crown or another cause
Not all thin hair at the crown is baldness or androgenetic alopecia. These signs help distinguish the typical pattern from other causes, which are treated differently.
What it looks like. A round area at the vertex where the hair is finer, slowly growing. In women, the parting at the top widens.
How it progresses. Gradually, over months or years, and it may continue if nothing is done.
What the clinic does. The doctor confirms the pattern, looks for associated causes and proposes a plan.
Follow-up. It is a condition that is monitored over time, with reviews and adjustments.
What it looks like. Sudden hair loss across the whole scalp, or a round, well-defined, smooth patch.
Warning. Pain, sores, marked flaking or intense itching call for assessment.
What the clinic does. The doctor looks for other causes, such as deficiencies, thyroid problems, traction, hair loss after illness or other alopecias.
Tell us at the consultation. When you noticed, whether there are cases in the family and what has changed: it helps in choosing.
Is the hair at the top of your head thinner? Book an assessment consultation, so the doctor can work out the pattern and what can be done.
Book an assessment consultationWhat the clinic can do
Thinning at the crown is usually a long-term condition, so the plan is designed for you and followed up over time. These are the treatments the doctor may propose after seeing your case.
Regeneration
Vitamins, amino acids, minerals and hyaluronic acid, to nourish the scalp and support finer hair.
Suitable when
the hair at the crown is finer and the doctor considers scalp nourishment appropriate.
Find out more→
Regeneration
Platelet-rich plasma, obtained from your own blood, to stimulate the follicle. The doctor first assesses whether it is appropriate.
Suitable when
there is thinning at the crown with follicles that are still active and the doctor considers stimulation appropriate.
Find out more→
Advanced regeneration
Regenerative solution to support follicle repair and improve hair thickness.
Suitable when
the doctor considers it useful to reinforce the plan with a regenerating active ingredient.
Find out more→What about oral therapy and other medical options? When there is a cause to treat or the thinning needs more than local care, the doctor explains the options and chooses them after the assessment and, if useful, blood tests. Results are gradual.
What the journey looks like
No treatment starts without an assessment consultation with the doctor. This is how it works.
The doctor asks since when you noticed the thinner crown, whether there are cases in the family and what medication you take, and examines the scalp and the hair density.
If useful, she requests tests for iron, vitamins, zinc, the thyroid and hormones, and explains what to expect and how long it may take.
She combines the treatments that make sense with care at home and treats the associated causes, always adapted to your case.
We look at the hair again after a few months and adjust the plan, comparing with the initial photographs.
Day to day
Since the crown cannot be seen head-on, it helps to have a simple method to monitor the progression and bring data to the consultation.
The golden rule
A photograph from above, in the same light and at the same distance, every 3 months, shows more than memory does. It is the best help for the consultation.
Two mirrors show the crown.
In practice: hold a hand mirror behind your head, with your back to the bathroom mirror.
The phone sees what the eye cannot.
In practice: ask someone to photograph the top of your head, with your hair dry and combed.
You can only compare what is comparable.
In practice: use the same spot, the same light and the same distance, and keep the photos in a folder.
The crown gets more sun than any other area.
In practice: wear a hat in the sun and wash with a mild shampoo.
Pulling the hair upwards weakens the roots.
In practice: avoid top knots and high, taut ponytails every day.
Coloured powders and disguising hairstyles delay the consultation.
In practice: book the assessment first and discuss disguising afterwards.
Taking several supplements on your own may not solve anything and can do harm.
In practice: speak to the doctor before taking supplements, especially iron.
Cutting calories worsens hair loss and the lack of nutrients.
In practice: eat enough and favour nutrient-rich foods.
Who will look after you
At Luxmed, the first step is always an assessment consultation with Dra. Michelle Campagnoli. She works out the pattern of the thinning, requests blood tests if useful and designs the plan with you.
Hair medicine
A simple trick to observe what you cannot see head-on.
Read the article →
Hair medicine
Same light, same distance, and a folder on your phone.
Read the article →
Hair medicine
What the doctor assesses and what the doctor may propose.
Read the article →Other hair problems
Book a consultation
Choose how you prefer to get in touch. We will arrange the assessment consultation with Dr Michelle Campagnoli.
New Life Miraflores, Algés · Office Center, R. Santa Teresa do Menino Jesus n.º 6, 9.º C, 1495-048
Your details are used only for this contact. Any treatment depends on a prior medical assessment.
In most cases there is a hereditary predisposition, sometimes helped along by hormones. Traction, deficiencies and stress also count. The doctor assesses which weighs most in your case.
No. In men it is usually the start of baldness at the crown, but there may be other causes. In women it is more often a thinning of the top, with a wider parting.
With two mirrors, a hand mirror behind your head and another in front, or with a photograph from above taken by someone else, with your hair dry and in the same light.
Yes. It is usually a diffuse thinning of the top, rather than a round patch, and the parting becomes wider. It is the assessment that distinguishes it from other causes.
It depends on the case and on how early you start. The aim is to monitor the progression and improve the density and thickness of the hair, which is easier with follicles that are still active. The doctor explains what is realistic.
They are gradual and usually become noticeable after a few months of regular treatment. The doctor explains what to expect in your case.
Depending on the case: NCTF hair treatment, hair PRP, hair exosomes and oral therapy or other medical options, chosen by the doctor after the assessment consultation.
They help look after the hair, but on their own they rarely halt the thinning. Supplements only make sense when a deficiency has been confirmed, so it is best to talk to the doctor.
When you notice a thinner crown, or someone tells you. Sudden hair loss, round patches or a painful scalp should be seen without delay.
It helps a lot. Bring photographs of the top of your head taken over time, in the same light, so the doctor can see how the hair has progressed.
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The assistant does not give diagnoses or replace a consultation. The plan and cost of any treatment are set at the medical assessment.