Why Women Lose Their Hair
(And What To Do When Your Hair Is Thinning)November 5th, 2012
By Holly Klamer, MS, RD.
Edited by Brian Rigby, Clinical Nutrition Writer
Featuring Dr. Sara Gottfried, MD
As a society, we associate baldness as a man's condition, but according to the American Academy of Dermatology, about 30 million women have hair loss issues as well. It usually affects women in their 50s or 60s, but it can occur at any age. Hair loss in women is referred to as female pattern baldness, or female androgenetic alopecia (FAGA) if it is specifically from an increase in the hormone androgen.
Hair turnover is normal--women can lose up to 250 strands of hair after each wash. Normally, the hair grows back in the same thickness. Baldness or hair thinning can occur when strands of hair that grow in are thinner and weaker than the follicle they are replacing.
If you notice an increase in the amount of hair you are losing from brushing your hair or when you wake up, this may be a sign that abnormal hair loss is occurring.
Causes Of Hair Loss
The reasons for female baldness are not completely understood, but there are some conditions that it can be related too. Currently, there is no known method for prevention for hair loss, although there are some effective treatments, which are discussed in this article. Here are some of the causes linked to hair loss:
1. Hormonal Changes
As mentioned above, changes in the hormone androgen can affect hair loss. This hormone shift is especially prevalent during or after menopause. FAGA hair loss is hereditary, and it is the most common cause of hair loss in women. A change in testosterone or thyroid levels can also change hair growth.
Blood tests can determine if hormone levels are the reason for hair loss. A change in androgen can also impact hair growth on other parts of the body like the face or navel area. Polycystic ovarian syndrome may also be a reason for abnormal hair growth. Further testing from a health professional can clarify the hormonal causes of hair loss.
2. Skin Or Autoimmune Diseases
Some skin conditions, like dermatitis or psoriasis, can decrease hair growth. In order to determine if hair loss is from a skin or autoimmune disease, a doctor may perform a skin biopsy or blood work.
3. Nutrition And Hair Loss In Women
This is a big subject. There are a whole host of eating (and drinking) habits which can help create a fertile environment for hair loss. For example, vitamin B deficiencies, especially biotin, can cause hair loss. Low iron levels can also inhibit hair growth. Vegetarians are more susceptible for iron deficiency. In addition, too much vitamin A can also cause hair loss.
Blood work can help determine if nutritional deficiencies are the reason for abnormal hair loss. As the nutrient that is deficient is increased back to normal levels, regular hair growth should come back.
4. Can Stress Cause Hair Loss?
Major stress like dramatic weight loss, surgery, or an intense illness can cause hair loss. If hair is coming out in large clumps instead of gradually thinning, this is a sign that the hair loss is probably from stress. Women that are anorexic or on extremely low calorie diets may experience abnormal hair loss. In addition, stress raises cortisol levels, which can lead to irritability and a host of other conditions.
5. Can Pregnancy Cause Hair Loss?
Hair loss can be common about three months postpartum. This is caused by changes in estrogen levels after the baby is born. Hair growth will normalize about 6-12 months postpartum. Abnormal hair loss during pregnancy may be a result of a nutritional deficiency.
How To Know If You Are Losing More Hair Than Normal
Hair loss from FAGA will be gradual, and hair will be thinning around the crown of the head. Unlike male pattern baldness, female hair loss maintains the front hair line and usually has hair loss and thinning occurring from the top of the head. Hair loss from the center part line is also common. As new hair grows in, it is thinner and weaker. The hairs continue to become smaller and weaker and eventually they stop growing.
Treatment will depend on the reason for your hair loss, and can help hair loss most of the time. There are some medications approved by the FDA such as minoxidil and spironolactone. Minoxidil has been shown to be effective in reversing hair loss in about 20% of women, and it is also effective for stopping or slowing further hair loss. Spironolactone is designed for FAGA hair loss specifically.
Speak with a doctor before taking medication or if you have questions regarding medication. If hair loss is from hormonal changes, fixing your hormonal levels may help hair loss.
Other treatments will depend on the reason for your hair loss and results from skin and blood work. Hair loss can be permanent if not treated, although no other adverse health effects are usually present. Hair transplants can work, but they are often expensive and can increase the risk for skin infection.
Dr. Sara Gottfried's Observations On Hair Loss In Women
Hair loss is a scarlet letter of accelerated aging -- and taps into women's deepest fears and ambivalence of growing old and less relevant. And here's the worst part -- the solutions currently on offer are unpalatable and patronizing. Forty percent of my patients report hair loss, but they never report it neutrally -- they're furious.They feel conventional doctors offer no effective answers or treatments. Rogaine? Propecia? Please. We are obsessed with making symptoms rather than addressing the root cause. Hair to a woman is in a different category than the rest of the body. Hair is like breasts. Women have powerful emotional and psychological attachment to boobs and hair, and I totally get it. Nothing says aging like female hair loss.
As discussed earlier in this article, hormone imbalance is the top reason I've found for hair loss in the past 20 years of taking care of women. Here are the worst offenders: thyroid, cortisol, testosterone, and insulin.Here are some of the questions that I get from my patients at my clinic:
What do I do when I start to lose hair?
My answer here is that you improve what you manage. This is tangible - something you can manage (and would be well served to start) like your stocks or retirement portfolio.
1. Part your hair in the middle and take a photo with your smart phone. add to your dashboard.
2. Get your doctor to order the crucial tests, (which we go into in the call I just did with Jackie.) Stand your ground. Ask to be referred to an expert in hair loss, usually a dermatologist.
3. Start the lifestyle tweaks you can do before seeing that doc. Things like reducing coffee and alcohol are biggies, and I go into detail in the call with Jackie.)
4. Wash your hair less. Treat your cute hair follicles with a white glove. i wash my hair twice per week (and used to wash it daily which traumatizes your fragile follicles).
5. Manage your blood sugar - cut out the white stuff. Insulin resistance is a top reason for increased hair loss.
6. Check to see if your iron is low. Iron is like cortisol -- you want it not too high and not too low. Serum ferritin is the most sensitive indicator, and you need a ferritin level of 70-80 to keep your hair of your head. You need a minimum of 40 to grow new hair.
Does Being Overweight Lead To Hair Loss?
Yes. Insulin resistance leads to hair loss in women. Being insulin resistant, weight loss resistant- these are all things which help lead to hormonal and nutrient imbalance which fosters hair loss. If your weight loss plan does not address these hormonal imbalances, you will not get to the root cause of female hair loss. For example, Weight Watchers does not address hormonal imbalance as part of its Points System.
Related PEERtrainer Articles:
The Hormone That Helps Your Cells Burn Fat
What Is Weight Loss Resistance
Weight Watchers And Hormonal Imbalance
Are There Natural Remedies For Women Losing Their Hair?
Yes! The big thing you want to focus on is attacking and discovering the root causes of your hair loss or thinning hair, and not only treat the symptoms. If you come across a doctor who says there is nothing you can do and that this is just a "normal part of aging"- find another doctor and realize there is a lot you can do. Unfortunately my own clinic in Berkeley has a one year waiting list, but I am working with Jackie and PEERtrainer to make sure as much of what I have learned in the last 20 years is available to you all. If you have a question on this subject, Please ask it right here and Jackie and I will publish the answer on this page.
4. Camacho-Martinez FM (2009). Hair loss in women. Seminars in Cutaneous Medicine and Surgery volume 28;19-32.