Hair loss in women

13 January, 2021 | Hair Loss | Author : Shveta Virmani

How we look, and how other people see us, is very important for most of us and hair is one of the most prominent features of our appearance. For women, hair is one of the most important features and hair loss is distressing for many of them.

Dermatologists share that there has been an increase in the number of women seeking treatment for hair loss problems. Hair loss affects self-esteem, confidence, and affects their emotional well-being. Recently women are experiencing a rise in hair loss due to various external factors such as pollution, stress, and hormonal problems as well. Many dermatologists believe the hair loss problems can be life-altering for most women and require proper attention and treatment.

What is hair loss in women?

A woman experiences unpredicted heavy loss of hair leading to hair fall which may be temporary or permanent. There are many reasons why women might experience hair loss like medical conditions, hormonal changes, hereditary, aging, or stress. Commonly, people shed from 40 to 90 strands per day. It is part of a natural cycle between hair fall and hair growth. When there is an imbalance, that is when more hair falls out and less hair grows, and sudden hair loss in women occurs. Hair loss is different from hair shedding and is medically called as alopecia.

Hair growth and hair fall has three phases:

The anagen phase i.e., the growing phase can last from two to six years or even more in some cases. About 80- 90% of the hair on the head is in this phase.
In the catagen phase i.e. transition phase the hair follicles shrink and take about two to three weeks.
The telogen phase is the resting phase and takes about 2-4 months, at the end of which the hair falls out.

How common is hair loss in women?

Though hair loss is very common in men, it is, however, estimated that more than 50% of women are experiencing visible hair loss. The most substantial type of hair loss in women is female-pattern hair loss (FPHL) which affects millions of women in the world.

People often believe that hair loss problems are associated with men only. This is because in men hair loss is noticeable as bald spots or receding hairline. However, hair loss is equally affecting women, but the only difference is it is more related to hair thinning. Hair thinning is a very common type of hair loss in women as they age. Women generally have a broadening of the parting hairline. In older women, the hair loss pattern is known as frontal fibrosing alopecia.

Who is affected more by hair loss in women?

Any woman can be affected by hair loss but it commonly takes place in women who:

Are older than 40.
Have a family history.
Are in Menopause - This type of hair loss increases when estrogen is lost during menopause. During menopause, hair becomes thinner because hair follicles shrink. Hair grows further slowly and falls out more easily in such cases.
Are losing a lot of weight, undergone surgeries, illness, or having a baby. This type of hair loss is called telogen effluvium. It happens to hair in the resting stage.
Are under cancer treatments like chemotherapy, radiation, and other medications.
Girls who use harsh chemical treatments on their hair during hair styling or coloring often face hair loss with time. Processing your hair, dandruff, scalp psoriasis, and having too-tight hairstyles is too often something overlooked. The obvious solution is to stop! You’re just pulling the roots and thus weakening them over time. The hair will just fall out and not grow back.
Have nutritional deficiencies or use certain medications. These can easily be cured by correcting your diet or stopping the use of unnecessary medications.

What causes hair loss in women?

Initially, your doctor or dermatologist will try to know the underlying cause of your hair loss. The most common cause of hair loss is hereditary female-pattern baldness. Due to a family history of baldness, you may have this type of hair loss. It may begin with maturity. Also, hair loss may occur with a simple pause in the hair growth cycle.

Many illnesses, surgeries, or disturbing events can activate hair loss. Studies show that about 40% of the women display signs of hair loss by the age of 50, and less than 45% of women reach 80 with a head full of hair. However, hair loss indications are usually seen in their late 30s or 40s itself.

Hormonal changes can cause temporary hair loss like those in pregnancy, childbirth, stopping the use of birth control pills, or menopause. Hair loss can also be due to medications used to treat diseases like arthritis, depression, heart issues, cancer, high blood pressure.

A physical or emotional imbalance like a loss in the family, huge weight loss, a very high fever may trigger visible hair loss. People with hair-pulling disorder are also more vulnerable to hair loss.

Medical conditions that may lead to hair loss include hypothyroidism, Hodgkin’s disease, celiac disease, Lichen planus, ringworm, scleroderma, hyperthyroidism, systemic lupus erythematosus, hypopituitarism, Hashimoto disease, Addison’s disease, trichorrhexis invaginata

You may also experience a series of other symptoms if your hair loss is caused by the below conditions.

Hypothyroidism may be the reason for fatigue, weight gain, muscle weakness, and joint swelling.
Celiac disease leads to mouth ulcers, headaches, skin rashes, and anemia.
Hodgkin’s disease may cause fever, night sweats, and swelling of the lymph nodes.
Ringworm may lead to crusty and sore red patches on the scalp.

Your doctor will take into consideration the other symptoms you are facing besides hair loss to help identify the cause. This may include a physical examination or blood tests or scalp biopsies.

What are the signs of hair loss in women?

Signs of hair loss in women may not be as prominent as in men like noticeable receding lines around temples, crowning, or bald spot appearance. Initial signs are associated with hair thinning, increased shredding. Everyone loses some amount of hair every day, after hair wash or combing of hair. Seeing more hair fall out every day is the first sign of hair loss problems that need attention. Women may experience this phase for over 4 to 6 months. If it is related to temporary hormonal imbalance or medication-related disorder, the hair loss slows down over the period of time and returns to normal in 6 months or 2 years.

Furthermore, widening of the parting line is a visible symptom of hair loss. Women suffering from acute hair loss may notice balding or patchy spots. Also, when a woman is suffering from age-related hair loss, the signs are different from female pattern baldness. The hairline sometimes becomes sparser and the forehead becomes wider.

The condition can be very stressful and one needs to take the required steps to minimize the hair loss and its impact on one’s self-esteem.

Also Read: Female Hair Transplant In India

How are hair loss problems evaluated?

The first step for preventing hair loss is a detailed diagnosis of hair loss. The hair specialist will discuss your general health, detail medical history, family history, and examine your scalp, hair for detection of underlying illnesses.

Examination:
This includes general observation of scalp, checking texture of hair, affected areas, and following factors related to hair loss:

Overall hair density
Miniaturized hairs
Hair density near parting line
Bare patches if any
Distribution of hair throughout scalp
Presence of inflammation or scales on scalp
Frontal hairline and receding pattern or irregular borders, etc.

Tests:
The hair specialist may carry out a negative hair pull test to measure the strength of hair. Pathological tests will include:

Presence of iron level or nutritional deficiency
Thyroid test for detecting Thyroid dysfunction related hair loss
Androgen index test
Autoimmune disorder test
Blood pressure monitoring and others

What are the treatment options available?

Based on the results the specialist will offer tailored treatment for hair loss solutions for women. The treatment options depend upon various factors and include:

Lifestyle changes: Many times nutritional deficiency is the reason behind hair fall. Adding iron-rich food (spinach, peas, lentils, sesame seeds, etc.), Vitamin C-rich foods (citrus fruits), food with omega-3, etc. can reduce the hair fall and promote regrowth of hair. Follow the healthy diet plan regularly for better and lasting results.

Choose the right type of shampoo, suitable for your hair type and wash your hair regularly (once or twice a week) to keep your hair and scalp clean. Cleaning and hydrating your scalp is another important step to tackle hair loss problems in a simple manner.

Stress and hair loss in women: For stress-related hair loss, speak with counselors for managing your stress levels and reducing the hair fall.

Lifestyle changes are recommended as part of any complete hair loss therapy not only to slow down hair loss but also to improve hair growth.
Simple non-medical treatment options: Herein, your hair specialist may suggest certain remedies to manage hair loss without getting any medical or surgical treatments. You can cut your hair short and may try a zig-zag pattern to cover the balding parting line or add a few extra short layers on top to hide the balding area and add volume. Avoid hairstyles like high ponytails, pulling your hair back in tight hairstyles, tight buns, etc. Avoid combing your hair when wet and rubbing too harshly. You will also be advised to use a friction-free towel and toothed comb for minimizing hair breakage. It is better to take advice from an expert hairstylist too for effectively hiding your hair loss. It is advisable to protect your hair from too much exposure to the sun and too many chemicals.
Hair products for mild or moderate hair loss: This includes a range of products for hair loss conditions such as hair mascara, or hair sprays giving camouflage effect, artificial hair fibers to cover balding areas and adding more thickness. Some women also prefer artificial wigs or extensions to cover the balding area.
Pharmacological treatments: If you are suffering from hair loss due to contraceptive pills with high androgen index, then you might want to switch to a low androgen index progestin birth control pill for reducing hair fall.

Minoxidil is the form of tablet or lotion and is one of the best solutions for women's hair loss. The tablet needs to be taken daily for at least 6 months to see noticeable results. It works better if taken on a regular basis.

Hormonal treatment works by controlling the reasons for sudden hair loss in women and side effects of androgen-based oral medication such as cyproterone, spironolactone, etc. Most antiandrogens are administered for up to 4 days for a month. The spironolactone can also be used in combination with minoxidil for significantly improving hair growth and density.

Autoimmune hair loss or Alopecia areata (reasons for rapid hair loss in women) can be prevented and managed by applying corticosteroids on bald patches or by taking steroid medications in the form of tablets or injections.

Other treatment options include low laser therapy, Hair Regrowth Treatment for women hair loss therapy for stimulating hair growth. These therapies have their limitations and are useful in mild to moderate hair loss conditions.
Surgical treatment: Hair transplantation is FDA approved, proven, and a lasting solution for hair loss problems. Follicular unit transplantation(FUT) and Follicular unit extraction (FUE) are primary methods for transplanting donor hair to bald patches of your scalp. Donor hairs are commonly collected from the back of the head. Both procedures are invasive procedures with good success rates. With advancements in technique and technology, the resulting hair looks natural and you can have fuller hair you always wanted.

Can Hair loss be reversed in women?

For reversing the effects of hair loss, it is essential to identify the underlying problems and take required treatment. For example, women suffering from hair loss due to iron deficiency can start taking iron supplements in the form of oral tablets and also by taking an iron-rich diet. Similarly, women with low vitamin levels need to take the required amount of vitamin supplements to slow down the process of hair loss and reverse the signs.

For patients suffering from hair loss due to medical conditions, it is important to understand that the hair loss condition is temporary and will improve over time. These women can consult a hair expert for taking additional supplements to minimize the signs. Women suffering from stress and anxiety need to speak to a counselor to learn to cope up with the stress. As discussed above, there are various ways to manage stressful situations. For women suffering from hair loss, post-pregnancy need not worry about the situation as hair fall is temporary and reversible.

The best way to reverse the hair loss is finding the right hair expert who will recommend the personalized treatment for you along with a nutritional supplement as a supportive measure.