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).
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.
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.
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.
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
—This may be caused by styling treatments (eg, dyes, tints, bleaches, straighteners) and twisting or pulling of hair.
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.
- Illness—Being very ill (eg, having a high fever) can lead to hair loss.
Major surgery—A major operation may temporarily increase hair shedding.
will cause hair cells to stop dividing, become thin, and break off. Hair will re-grow after treatment ends.
- Tinea capitis—This is a treatable fungus infection on the scalp that can cause patchy hair loss.
- Medicines—Taking certain medicines can lead to hair loss. Examples of these medicines include:
- Blood thinners
- High-dose vitamin A
- High blood pressure medicine
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 iron levels—Iron deficiency occasionally produces hair loss; it can be corrected by taking iron pills.
There is no known way to prevent female pattern hair loss. But call your doctor if you think you may be balding. She 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.
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 most likely not cover medicines or procedures for cosmetic purposes, but may if your hair loss is due to a disease.
Examples of treatment options include:
- Medicine—Minoxidil (Rogaine) is a medicine that is available in the United States without a prescription. It is used topically on the scalp. The medicine 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 involve taking plugs of "donor" follicles from the patient's scalp and using these to fill the hairline. The procedure usually requires multiple transplantation sessions. It can also cause minor scarring in the donor areas and carries a risk for skin infection. Results, however, are often very good and permanent.
- Nonsurgical hair additions—A nonsurgical hair addition is an external hair device (eg, weave, extension, hair piece) that is added to existing hair or the scalp to give the appearance of a fuller head of hair. They are safe. Many women may opt for partial transplantation and a partial hair addition.
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Trost LB, Bergfeld WF, Calogeras E. The diagnosis and treatment of iron deficiency and its potential relationship to hair loss.
J Am Acad Dermatol. 2006; 54:824.
Last reviewed May 2012 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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