Today we’re talking about something that seems to be an increasing trend: hair loss in women. After the birth of my son almost two years ago, I noticed that my hair was shedding in abnormal amounts. With my medical background and knowledge, I knew that this shedding was likely caused by hormones and I shouldn’t worry. Honestly though, it was terrifying to see so much hair in the shower drain. Read on to determine if your hair loss is simply shedding, or if it’s something that requires medical attention.
Everybody loses hair on an ongoing basis. Hair sheds as part of the natural turnover process and is constantly regenerating. The average human will shed between 50 to 100 hairs during the course of a day. When the shedding hair becomes more than average and you begin to notice areas of baldness, many people begin to worry and this is when people begin to seek help. A dermatologist can examine your scalp and hair loss patterns to help identify the underlying cause of the hair loss. In some cases hair loss can be indicative of an underlying medical condition so it is important to seek out a medical opinion.
How much is ‘normal’
I think it is important to understand what a normal amount of hair loss looks like. This can be really hard to measure because at times – after washing, brushing, etc – it seems like A LOT of hair is falling out. However, it’s the cumulative effect over a day that we will monitor.
When it’s too much, you will notice
- Clumps of hair on pillowcase in the morning
- Areas of baldness and excessive thinning – check for a change in your part size, hair loss is usually more obvious here
- An accumulation of more hair in your brush or shower drain than usual
When the amount of hair you are shedding goes beyond the average, it is termed excessive shedding. If the hair does not re-grow, it’s termed hair loss. Once you begin to notice a pattern of excessive shedding or loss, it is time to seek out the advice of a dermatologist.
Understanding the Cause
There are a number of reasons for excessive hair shedding and hair loss in women, and understanding the reason for excessive shedding will ultimately help determine the treatment options.
Our genes play a role in the most common type of hair loss. If your father or mother experienced hair loss – sorry but you probably will too. The good news is that there are options available to help prevent and treat this type of hair loss. If hair loss is a common pattern in your family, treatment can begin when hair loss is at its earliest stages and is often more effective.
Stress & Hormonal Factors
When we talk specifically about hair loss in women, the term Telogen effluvium comes to mind. This term is used to describe the thinning or shedding of hair resulting from the early entry of hair in the telogen phase (which is the resting phase of the hair follicle). Stress is one of the main causes of this – both emotional and physiological stress – and some medications can also cause it. Most common causes include:
- Loss of 20 or more pounds
- High fever
- Operation or medical procedure
- Nutritional changes – eating disorders
- Stress (job change, caring for loved one who is sick, divorce, etc)
This type of shedding will typically begin a few months after the stressful event and will peak around 4 months. Within 6 to 9 months your hair should regain its original fullness and strength – although it’s worth noting that if the stressful condition causing excessive hair shedding remains, it could result in long-term excessive shedding.
There are a number of medical conditions that can result in the body shedding hair at an excessive speed. These conditions require attention from a medical doctor and often with management the hair shedding or loss can be reversed.
– Hypothyroidism occurs when the body produces too little thyroid hormone which will cause a variety of symptoms – including hair breakage. A blood test will confirm thyroid levels and there are medications that can help control the hormones.
– Alopecia Areata is an autoimmune disease which causes bald spots on the scalp (in some case the entire scalp).
– Anemia – iron deficiency anemia can cause hair loss. When you are anemic, your body will send oxygen to support vital functions which means your hair will be getting less oxygen.
I think it is worth talking about lifestyle because many people don’t realize the damage they are causing their hair with certain products and hair styles. I’ve seen many cases where a person has damaged their hair through styling which resulted in bald patches and very thin hair. The AAD has some great tips on styling hair without damage. Personally, when I want my hair pulled back, I opt for a simple braid with a loose band to hold it in.
Treating Hair Loss
If you think that your hair shedding is becoming excessive or if you have noticed hair loss, it is time to consult with a dermatologist. There are a few basic tests that can be performed to help identify the cause of the problem.
- Blood tests – helps to identify underlying medical conditions
- Pull test – we will actually pull a small amount of hair and examine both how easily the hair sheds as well as the root that was pulled out.
- Scalp biopsy – if we suspect an infection or certain condition we will scrape a small amount of skin from the scalp to examine.
- Examination – a light microscopy is used to examine the base of the hair to help identify any issues with the hair shaft.
Some types of hair loss will require treatment by your primary care physician (for example, if you have hypothyroidism, you doctor will need to monitor your hormone levels and provide medication). However, if hair loss is hereditary or the result of a skin condition, a dermatologist can offer treatment plans. Treatments for hair loss in women will differ from treatments for men with hair loss. Treatments will help to produce some amount of hair growth but they are often most helpful in slowing down hair loss (which is why early action of any symptoms is important).
Minoxidil (Rogaine) is the only topical medication approved by the FDA for treating hair loss in women. When applied topically, this solution can help to stimulate hair growth. Available over the counter in strengths of 2% and 5%, this solution does take some time to work. In general, I recommend women use 5% rogaine one time a day. Results are usually noticeable in three to four month and treatment will need to continue once hair growth begins.
Hair transplantation is expensive but is growing quickly in popularity. This involves taking hair follicles from one area of the scalp and transplanting to the affected area. For women, this surgery is not always beneficial and should only be considered if hair loss falls into certain categories. For example, transplanting hair to an area with scarring will not be effective.
If you determine that you are experiencing hair shedding and not true loss, I have some tips for managing the shed:
- Gentle styling – use a detangle spray to help with knots and a wide tooth comb to separate hair. Don’t pull and tug with a brush.
- Avoid heat – the irons, driers, etc. Occasional use is ok but if used daily you will damage your hair over time. Non-Surgical Nose Job
- Loose hairstyles – avoid tight ponytails and braids unless absolutely necessary.
- Products – Volumizing shampoos can be helpful to improve the thickness of remaining hairs. I personally use Art Naturals Organic Moroccan Argan Oil and other patients swear by the Viviscal line which includes a hair growth serum.
- Cover it up – Try moving your part around to help cover any thin areas. A hat or scarf can be a fun accessory too! Hair microfibers can also help when hair loss is more severe (try TOPPIK Hair Building Fibers.
Hair loss can be a very stressful experience for women. I cannot emphasize enough the importance of seeing your dermatologist, if you feel that you have unusual/excessive hair loss. Early intervention is key!!
Do you have any hair loss tips or stories? Share in the comments or email them to me at firstname.lastname@example.org
Don’t miss this post where I share a DIY recipe for a hair oil that I used when I began to notice my hair shedding after the birth of my son: Can You Find Beauty In The Kitchen
Join the Vibrant Dermatology Beauty Club for skin tips via email, giveaways, and more!