Hair Loss in Women

How Hair Grows, and Doesn’t

On average about 50 to 100 hairs a day fall out of our heads naturally. Hairs fall out and new ones grow in. When that balance becomes tipped to more out than in, that’s considered hair loss – the medical term is “alopecia.” Female pattern hair loss (FPHL) is the most common cause of hair loss in women and mostly affects women in their 40s, 50s, and 60s. It usually looks like an overall thinning or receding at the temples. It does not result in complete baldness as it does in men. 

It is estimated that more than 50% of women will experience noticeable hair loss. Female-pattern hair loss affects about 30 million women in the United States.

Each strand of our hair occupies a tiny hole in the skin called a follicle. When the follicle begins to shrink, its hair becomes thinner and shorter. At some point no new hair will grow in that follicle even though it is still alive and might be able to grow new hair. If your part looks wider, your pony tail thinner, you see bald spots, and your brush is full of hair, you should consult a dermatologist. 

Are There Different Types of Hair Loss?

There are three: anagen effluvium, telogen effluvium and FPHL.

• Androgenetic alopecia/female pattern alopecia/female pattern hair loss (FPHL)/baldness: As I said, this is the most common. Hair thins over the top of the head and on the sides.

• Anagen effluvium: This is caused by medications such as chemotherapy, other chemicals, or radiation which damage a growing hair follicle.

• Telogen effluvium: This is caused by an increased number of hair follicles that are at the stage where hair falls out. Stressors such as surgery, high fever, chronic systemic illness, and hemorrhage can be the cause. Typically, it is reversable. 

Female pattern baldness may be related to:

• aging – in everyone, the rate of hair growth slows, hair strands become smaller and have less pigment.
• changes in the levels of androgens (hormones that can stimulate male features).
• family history of male or female pattern baldness.
• heavy loss of blood during menstrual periods when it causes anemia, which can affect hair health.
• estrogenic oral contraceptive, yes, the Pill can cause hair loss in some women.

• having a baby. Pregnancy keeps your hair in its growth phase longer than usual. A few months postpartum many women have hair loss as their hormone levels change. 
• undergoing chemotherapy or using other medications.
• hairstyles that pull on the hair such as tight long-term braiding, or the use of harsh chemicals.
• our friend menopause! Again, it’s caused by the drop in hormones.

Exams and Tests

Female pattern baldness is usually diagnosed by…

• ruling out other causes of hair loss, such as thyroid disease or iron deficiency.
• the appearance and pattern of hair loss.
• taking a medical history.
• hormone testing – signs of too much male hormone (androgen) could include:
• abnormal new hair growth, such as on the face or between the belly button and pubic area
• changes in menstrual periods and enlargement of the clitoris
• new acne

Treatment for Hair Loss

If the hair loss is severe, you may want to consult a dermatologist about medication. Minoxidil is the only medicine approved by the United States Food and Drug Administration (FDA) to treat female pattern baldness and it does not require a prescription.

Minoxidil is applied to the scalp in a 2% liquid or 5% foam solution that may help hair grow in about 1 in 4 or 5 women. It may slow or stop hair loss in most women. Use of the medicine must be continuous or hair loss will reoccur. 

Ask your provider about these other treatments if minoxidil is not effective: 

• spironolactone
• cimetidine 
• birth control pills 
• ketoconazole

Myths about Hair Loss! The Following are NOT True. 

• You’re losing hair because you shampoo it too much, or because you’ve colored it or had a perm.
• Dandruff causes permanent hair loss in women.
• Stress causes permanent hair loss in women.
• If you shave your head, your hair will grow back twice as thick.
• If you stand on your head you’ll increase circulation, stimulating hair growth.
• If you brush your hair 100 strokes a day that will make your hair healthier.
• Hats and wigs cause hair loss in women.
• Hair loss only affects intellectual women. (wow)
• You inherit hair loss from your mother

I hope this helps alleviate your worries and of course, when it doubt, do talk to your health care provider.