Odds are, if we asked you to think about hair loss, would the first thing that would come to your mind be an image of a man with a bald spot or a completely bald head?
From medications, expensive toupees, and even hair follicle transplants, it is not uncommon to hear about the great lengths that many men will go to reduce the look of their hair loss. But, just because male pattern baldness is the most talked-about form of hair loss in Western society, it is not the only type of hair loss worthy of discussion.
As it turns out, hair loss can also impact women — and it’s about time that shed some more light on this increasingly common condition.
Recent research has shown that up to 50% of women can expect to experience some level of hair loss during their lifetime¹.Hair loss (also known as androgenic alopecia) can be caused by a variety of factors. It is more than just a couple of extra strands coming out after vigorous brushing.
The American Academy of Dermatology states that the average person has upwards of 100,000 individual strands of hair on their scalp alone — meaning losing anywhere between 50-100 strands of hair a day is nothing to be worried about². With this in mind, this amount of regular hair loss is all part of a normal and natural cycle of hair, and is not likely to lead to the development of bald spots on the scalp or on other areas of the body. But, if a woman notices significant changes in the rate that their hair is growing or they notice profound thinning or balding, they may be experiencing a different and more profound form of hair loss.
Why aren’t we talking about female hair loss if it is becoming more prevalent? Most causes of female hair loss are not associated with life-threatening consequences. This doesn’t mean that this condition should be ignored or not taken seriously.
Hair loss can have a profound impact on a woman’s self-confidence and personal image. Getting access to the support and treatments they need to slow the progression of hair loss is often a top priority for women experiencing this condition. With up to half of all women can expect to experience hair loss (and some may require medical attention to better treat their symptoms), it is time to bring the conversation about female hair loss to attention.
There are many different reasons why a woman can experience hair loss. First, we should understand the natural cycle of hair growth. As a multi-year process from start to finish, all hair on our body is subject to this growth cycle¹:
Anagen growth phase — Taking anywhere from two to eight years to complete, this is the first stage of hair growth. On average, shorter hairs like eyelashes and eyebrows have a shorter anagen phase, while longer hair like what we grow on our scalps can remain in the anagen growth phase for many years. During the anagen growth stage, the cells at the root of the hair are rapidly dividing, leading to the development and growth of the actual strand of hair. In most cases, up to 90% of the head on your scalp is in the anagen growth phase at any given time³.
Catagen transition phase — During this phase, significant changes begin to occur in the hair root. Known as the transition phase, the hair follicle starts to shrink over a period of two-three weeks. As a result of this, hair growth slows down, and the individual hair strand will disconnect itself from the hair follicle base. On average, about 5% of the hair on your scalp is in the catagen transition phase³.
Telogen resting phase — As the final stage, the no longer growing hair strand is expelled from the hair follicle and will fall off the head during brushing, showering, or just on its own. Once the hair follicle is empty, it remains dormant for a few months before a new hair strand begins to grow. After the new hair is set in the follicle, the cycle begins all over again.
When this cycle is able to progress at its standard rate, only small amounts of hair will be shed from day to day. But, in the case of women with alopecia androgens or other hair loss conditions, this cycle becomes disrupted, resulting in significant hair shedding and potential balding.
When it comes to pinpointing the exact cause of female hair loss, there isn’t a one-size-fits-all option. For most women, hair loss is actually the result of a multitude of factors — often factors which may not be able to control. It is best to ask for advice from your family doctor if suffering from extensive hair loss.
Some common examples of causes of female hair loss include⁴:
Genetics and family history — As the most common cause of female hair loss around the world, hereditary factors play a significant role in a women’s risk of developing androgenic alopecia. Early signs of this type of hair loss in women include thinning of the hair and widening of the part of their hair.
Hormonal changes — Our hormones impact the health and function of every organ and system in our bodies. Hormonal imbalances have been proven to be a cause of female hair loss.
Medication side effects — For some women living with other chronic health conditions, an unpleasant side effect of some treatments can include the development of androgenic alopecia. Depending on the condition that is being treated and the available treatment options, it may be possible to discontinue the medication that is causing the hair loss to reduce the risk of experiencing long-term effects.
High levels of stress — During times of stress (either from personal or professional sources), it is possible for women to experience a period of time while they lose a significant amount of their hair. Utilizing stress management techniques can help to slow or stop this type of hair loss.
Radiation or chemotherapy — Used for the treatment of a variety of cancers, radiation and chemotherapy are known for causing significant hair loss. These treatments are designed to target and kill cancerous cells. It is very common for women undergoing these treatments to lose their hair (though it commonly grows back after they are finished).
Hairstyles and aesthetic treatments — Often overlooked, wearing tight hairstyles that pull on the scalp or undergoing multiple chemical bleaching or aesthetic hair treatments can result in significant hair loss over time. Taking steps to avoid pulling on the scalp can help to reduce the extent of hair loss caused by restrictive hairstyles.
Unlike male pattern baldness that typically develops starting at the crown of the head, women with androgenic alopecia experience thor hair loss in different areas of their scalp and body.
Some common signs of female hair loss can include⁵:
Gradual thinning at the top of the head
Circular or patchy bald spots
Sudden loosening of hair
Slower hair growth
Full-body hair loss
Depending on the underlying cause of the hair loss, other systemic symptoms may accompany female hair loss. Women should speak with their primary care provider as soon as they begin to notice changes in their hair, so they can work with you to create a personalized treatment plan to tackle your symptoms as early as possible. In most cases, early identification of female androgenic alopecia decreases the risk of experiencing profound hair loss over time.
For most women, it is common to only realize they are experiencing hair loss when they notice changes to the appearance and texture of the hair on the scalp. As the most densely packed and visible location of hair on the human body, even minor changes to our head hair can be quite noticeable. However, our head hair is not the only hair we have on our body — hair loss in other areas can indicate other forms of alopecia.
Alopecia areata is a dermatological condition that causes hair loss all over the body, in any place where hair naturally grows⁶. While women with this condition do often lose hair on their scalp, it is also common for them to experience a loss of their eyebrows, eyelashes, nose hairs, and pubic hair. Additionally, if a woman’s hair loss extends to every part of her body, the condition is diagnosed as alopecia unvisersalis⁷.
While this condition may even sound favorable for some women who prefer to remove their body hair, it is important to note that hair (especially fine hairs on our face and near our eyes) does play an essential role in adding an additional layer of protection. So, if you are noticing changes in the amount of hair you have on your body, it is worth getting it checked out by your primary care provider.
Now that we understand the most common causes, symptoms, and types of hair loss, we can now explore some of the secondary hair loss that comes as a result of other, more complex health issues. Because hair covers a large surface area of our bodies, sudden and significant hair loss can be a good indicator that something else may be going on.
Examples of other underlying medical conditions that can cause female hair loss include:
Polycystic ovary syndrome (PCOS) — Hair loss (particularly on the crown of the head) is a common symptom reported in women with PCOS as a result of hormonal inbalances⁸. To tackle this form of hair loss, taking steps to reduce the severity of all PCOS symptoms has been proven to reduce the extent of hair loss caused by this condition.
Telogen effluvium — This is a phenomenon that can occur as a result of a variety of stressful events, including surgery, pregnancy, and profound weight loss, which causes a woman to suddenly shed large chunks of hair⁹. It is understood that this hair loss occurs as a result of a faster than normal transition from the catagen to the telogen phase of the hair cycle. In most cases, this hair grows back normally after the stressful period has resolved.
Lupus — As an auto-immune disorder, lupus can cause a wide variety of systemic symptoms, one of which is hair loss¹⁰. If you experience flare-ups of scaly rashes and sores and have been noticing hair loss, getting connected to a rheumatologist will help to better manage your symptoms and can help to prevent additional hair loss.
Nutrient and energy deficiencies — What we eat plays a significant role in our overall health. If your diet is not providing your body with enough energy, iron, or other essential nutrients such as zinc, vitamin D and B12, it is very common for hair to become brittle and weak, causing breakages and hair loss. To combat this, eating a balanced diet containing nutrient-dense vegetables, fruits, nuts, while also ensuring enough protein from poultry, fish, eggs, tofu, and other plant-based options to ensure that you are giving your body enough nutrients and energy to grow beautiful hair¹¹.
Depending on the cause and severity of a woman’s hair loss, the treatment options available to them will differ greatly.
While some sources of hair loss from stress, pregnancy, or other short-term conditions will likely resolve themselves over time, other forms of alopecia androgens may be more difficult to resolve.
Working with your primary care provider to create a personalized treatment plan is one of the best ways to ensure that you are getting the care you require to have the best possible outcomes. Examples of female hair loss treatment options can include everything from dietary adjustments and taking oral iron supplements to taking prescription medications like Minoxidil (also known as Rogaine) and HairMax Lasercomb low light laser therapy to encourage hair regrowth in areas with balding¹²,¹³.
No matter the causes or extent of your hair loss, it is important to know that you are not alone in experiencing these symptoms. With more and more women living with hair loss and pattern baldness symptoms world every year, medical professionals and researchers are working to improve the awareness and education about this common condition.
With this in mind, educating yourself about the early symptoms of female hair loss is an essential step in advocating for your needs with your doctor or health professional, as well as ensuring that you can get access to the best possible care to address your concerns.
Hair loss: overview from The American Academy of Dermatology Association
Hair loss: who gets and causes from The American Academy of Dermatology Association
Hair loss types: alopecia areata overview from The American Academy of Dermatology Association
Alopecia universalis from The National Center for Advancing Translational Sciences
A Patient’s Guide: Management of Hair Loss in Polycystic Ovary Syndrome from Contemporary OB/GYN
Hair loss in women: causes, treatment, and prevention from The Cleveland Clinic
The author, Claire Bonneau, is a medical writer and certified trauma operating room nurse.
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