Hair Loss in Women: Causes & Treatment Options

As we age, hair loss can become more noticeable. In women, this type of hair thinning is known as female pattern hair loss or androgenetic alopecia, and it affects millions of women worldwide. Unlike male pattern baldness, which usually results in a receding hairline or bald patches, female pattern hair loss typically involves overall thinning, especially on the crown of the head, while the hairline remains intact.

Hair thinning in women tends to begin later than in men, often in their 50s or 60s. By age 70, around four in every ten women have noticeable hair loss. The gradual process does not usually cause symptoms like pain or itching. Each hair strand becomes thinner and shorter before falling out, and hair growth slows down over time. Genetics play a significant role in this form of hair loss, and if your mother or grandmother experienced hair thinning, you may also be more likely to develop it.

While female pattern hair loss is mainly hereditary, other factors, such as hormonal changes during menopause, can accelerate hair loss. Fortunately, treatments are available to help slow the progression and, in some cases, promote regrowth. Recognizing the signs early is essential for managing the condition effectively.

Can hair styling cause damage?

Yes, indeed, it can.

Hair styling can contribute to hair loss, especially if it involves excessive heat or constant pulling. Traction alopecia is hair loss caused by repeated tension on the hair follicles, often from tight hairstyles like ponytails, braids, or weaves. This hair loss is especially common along the front hairline, where hair is often pulled back. Over time, if the hair follicles are damaged, this can lead to permanent hair loss.

Certain hairstyling practices, such as hot combing, which is popular in the Afro-Caribbean community, can also contribute to hair loss by damaging the hair shaft. Frequent use of hair extensions, weaves, or even tightly wound buns can weaken the hair, causing it to break and fall out. Repeated heat styling from blow dryers, straighteners, or curling irons can also lead to hair shaft damage, weakening the hair's overall structure and leading to breakage.

To prevent traction alopecia and other styling-related hair damage, it’s essential to allow your hair to rest. Avoid tight hairstyles as much as possible, and consider giving your hair a break from heat styling. Switching to gentler haircare routines and using protective products can help maintain hair health. Taking these steps can help minimize long-term damage and prevent irreversible hair loss.

Is there a medical cause in women?

Medical conditions can cause hair loss. Autoimmune conditions such as lupus, Hashimoto’s hypothyroidism (underactive thyroid gland), Grave’s hyperthyroidism (overactive thyroid gland) and rheumatoid arthritis can all cause hair loss and all are more common in women.

Alopecia areata (patchy loss of hair) or alopecia universalis (total loss of hair) are autoimmune conditions where the body attacks its own hair follicles. These are both slightly more common in women.

Iron deficiency can cause hair loss, with or without anemia. Women with heavy or prolonged periods may be more susceptible to this. To rule it out as a cause, dermatologists recommend that your iron levels are very robust, not just "within the normal range".

Polycystic ovarian syndrome (PCOS) may cause hair loss, with a relative excess of androgen hormones. You will also experience absent or irregular periods, acne and excess hair around the chin, upper lip or chest.

Book an appointment with your doctor if any of this applies to you, if you are suddenly losing hair, if you have bald patches or it’s coming out in clumps, or if your scalp is itchy or burning. Book an appointment if hair loss is causing you considerable emotional distress and affecting your quality of life and self-confidence.

Hair loss can be distressing, but in many cases, it’s not permanent. However, specific symptoms should prompt a visit to the doctor, as they could indicate a more serious issue.

If you are suddenly losing hair, noticing bald patches, or experiencing hair loss in clumps, booking an appointment with your doctor is important. These signs could point to underlying conditions like alopecia areata, autoimmune diseases, or hormonal imbalances that require medical attention. Hair loss accompanied by itching, burning, or pain on the scalp may also indicate a condition that needs treatment, such as a scalp infection or skin disorder.

Women with PCOS or thyroid disorders who are losing hair should also consult their doctor to manage these conditions effectively. Sudden or excessive hair loss during pregnancy or after giving birth may be linked to hormonal changes, but it's worth discussing with your healthcare provider to rule out other causes.

Additionally, if hair loss is causing you emotional distress or affecting your self-confidence, seeking professional advice can provide support and treatment options. Hair loss treatments work best when started early, so prompt medical advice can significantly affect outcomes.

Diagnosis of Hair Loss

Diagnosing the cause of hair loss is crucial for determining the most appropriate treatment. When you visit a doctor for hair loss, they will likely begin with a medical history and physical examination of your scalp and hair. The doctor will ask about any family history of hair loss, your lifestyle, recent illnesses, and medications to identify potential triggers.

Blood Tests

Blood tests may be conducted to check for underlying issues such as thyroid disorders, iron deficiency, or hormonal imbalances. These tests can provide valuable insight into whether a medical condition is contributing to your hair loss.

Scalp Examination

A scalp examination will help the doctor assess the health of your hair follicles and look for signs of conditions like alopecia areata or scalp infections. They may also perform a pull test, gently pulling on small sections of hair to see how much comes out, which helps evaluate the degree of shedding.

Biopsy

In some cases, a scalp biopsy may be necessary. This involves removing a small section of the scalp to examine the hair follicles under a microscope. A biopsy can help rule out other potential causes, such as scalp infections or skin conditions like lichen planopilaris.

Once a diagnosis is made, your doctor can recommend the best course of treatment based on the underlying cause, whether medical, genetic, or lifestyle-related.

Several effective treatment options are available for women experiencing hair loss, ranging from over-the-counter solutions to more advanced medical procedures. The best treatment will depend on the cause of the hair loss and the severity of the condition.

Topical Treatments

One of the most commonly recommended over-the-counter treatments for hair loss is minoxidil. Available in 2% strength for females, minoxidil is applied directly to the scalp to stimulate hair growth. It works by increasing blood flow to the hair follicles, promoting more robust, thicker hair over time. Although it’s primarily used to treat androgenetic alopecia (female pattern hair loss), it can also be beneficial for other types of hair thinning. Results may take three to six months, and continued use is necessary to maintain hair regrowth.

Lifestyle Changes

Managing stress and adopting a nutrient-rich diet are critical factors in supporting healthy hair growth. Chronic stress can trigger hair loss, so incorporating relaxation techniques such as yoga, meditation, or exercise can be beneficial. Improving your diet by including foods rich in iron, zinc, and biotin can also help nourish your hair from the inside out. These nutrients support the hair growth cycle and strengthen hair follicles.

Hair Transplants and PRP Therapy

Hair transplants and Platelet-Rich Plasma (PRP) therapy are more advanced options for women with more significant or advanced hair loss. Hair transplants involve surgically removing healthy hair follicles from one part of the scalp and transplanting them to thinning areas. PRP therapy, on the other hand, uses injections of the patient’s platelets to promote hair growth. These treatments are more expensive and invasive but can offer long-term results for women with severe hair thinning.

While some hair loss may be inevitable due to genetics or aging, several lifestyle and hair care practices can help prevent excessive hair thinning.

Dietary Tips

Maintaining a balanced diet rich in iron, zinc, biotin, and omega-3 fatty acids is essential for healthy hair. Foods like leafy greens, nuts, eggs, and fish can provide the necessary nutrients for strong hair growth. Biotin supplements are often recommended for individuals with hair thinning, as this B vitamin is crucial in strengthening hair and promoting growth.

Hair Care

Caring for thinning hair involves gentle treatment to avoid further damage. Washing hair with mild shampoos and conditioners free of harsh chemicals can help maintain scalp health. Avoiding heat styling tools like blow dryers and straighteners is also essential, as these can weaken the hair shaft and lead to breakage. Minimizing chemical treatments, such as coloring and perming, can also reduce damage to already fragile hair.

Stress Management

Stress can significantly impact hair health, as high-stress levels are linked to conditions like telogen effluvium, where hair prematurely enters the resting phase of its growth cycle and sheds. Incorporating stress-reduction techniques such as meditation, deep breathing exercises, or even regular physical activity can lower stress levels and prevent stress-related hair loss. Ensuring good sleep hygiene and prioritizing relaxation can further promote healthy hair growth.