Dealing With Hair Loss in Women
Hair is an important part of our identity. Because of its significance, hair loss can be very traumatic, for both men and women. Millions of women in the United States suffer from androgenic alopecia, or female pattern hair loss (baldness). But all is not hopeless for women who wish to confront their hair loss and take action to safely regain control of their appearance and self-esteem. Those who see their doctors are often able to treat hair loss early on, and find they have excellent outcomes.
The Typical Cycle of Hair Growth (and Loss)
Hair grows in phases from its follicle (the skin surrounding the hair root) at an average rate of about ½ inch per month. Approximately 90% of the hair on your scalp is growing at any one time and is in a phase that lasts 2-6 years. The other 10% is in a resting phase, which lasts 2-3 months. After the resting phase, the hair strand falls out and a new one begins to grow. As a result, you lose roughly 100 hairs on any given day.
Female Pattern Hair Loss
Androgenic alopecia (the most common cause of excessive hair loss in both women and men) occurs when hair falls out, but new hair does not grow in its place. The cause is not well understood, but it is associated with genetic predisposition (from either the maternal or paternal side), aging, and levels of androgens (sex hormones).
The pattern of hair loss in women is different from the typical receding hairline and crown loss seen in men. In women, there is usually thinning of hair over the entire head or slight hair loss at the crown or hairline. It rarely progresses to total or near baldness.
Other Causes of Hair Loss
Hair loss can occur for other reasons as well, including:
- Telogen effluvium (temporary shedding of hair)—This can occur a few months after a woman delivers a baby, which usually lasts about 1-6 months before completely resolving.
- Breaking of hair—Styling treatments (dyes, tints, bleaches, straighteners, and permanent waves) and twisting or pulling of hair can cause this.
- Alopecia areata—This is an autoimmune disorder in which affected hair follicles are mistakenly attacked by a person's own immune system, causing patchy areas of total hair loss.
- Thyroid disease—Both an overactive and underactive thyroid can cause hair loss; proper treatment can reverse it.
- The flu or severe infection—After a high fever, severe illness, or infection, some hair may fall out because illness can cause hairs to enter the resting phase.
- Tinea capitis—This is a treatable fungus infection on the scalp that can cause patchy hair loss.
- Major surgery—A major operation may temporarily increase hair shedding.
- Medications—Medicines used for the following may cause temporary hair loss: gout, arthritis, depression, heart problems, high blood pressure, or blood thinner; high doses of vitamin A may also cause hair shedding.
- Cancer treatments—Chemotherapy will cause hair cells to stop dividing, become thin, and break off; hair will re-grow after treatment ends.
- Inadequate protein in diet—Although rare in the US, growing hairs will shift into the resting phase when you don’t get enough protein from your diet; the condition can be reversed and prevented by eating adequate amounts of protein.
- Low serum iron—Iron deficiency occasionally produces hair loss; it can be corrected by taking iron pills.
Is It Possible to Prevent Female Pattern Hair Loss?
There is no known way to prevent female pattern hair loss. But call your healthcare provider if you think you may be balding. He may find a treatable medical cause for your hair loss and can work with you to treat the condition, as well as symptoms like itching or skin irritation. There’s no reason for you to feel anxious, embarrassed, or unattractive because of hair loss.
Treatment for Female Pattern Hair Loss
The hair loss of female pattern hair loss is permanent. However, it is of cosmetic importance only and does not indicate a medical disorder. So, if you are comfortable with your appearance, no treatment is required. If you want to treat the condition, keep in mind that your insurance will likely not cover medications or procedures for cosmetic purposes, but may if your hair loss is due to disease. The following options are available:
Minoxidil (Rogaine) is a medication which is available in the United States without a prescription. It is used topically on the scalp. The medication is usually applied to the scalp twice a day. It may take more than four months of use before you will see your hair regrow. Hair loss recurs if treatment is stopped.
Hair Replacement Surgery
Hair transplants, in which plugs of "donor" follicles from the patient's scalp, can be used to fill the hairline. The procedure usually requires multiple transplantation sessions. It can also cause minor scarring in the donor areas and carries a modest risk for skin infection. Results, however, are often excellent and permanent.
Nonsurgical Hair Additions
A nonsurgical hair addition is an external hair device (such as a weave, extension, hair piece, toupee, partial hair prosthesis, and hair weft) that is added to existing hair or the scalp to give the appearance of a fuller head of hair. They are safe. Many women opt for partial transplantation and a partial hair addition.
American Hair Loss Council
American Academy of Dermatology
Alopecia Areata Foundation
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Hair loss. American Academy of Dermatology website. Available at: http://www.aad.org/pamphlets/hairloss.html. Accessed September 16, 2003.
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Last reviewed March 2010 by Brian Randall, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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