Hair Today, Gone Tomorrow
You’ve seen the evidence on your pillow. You’ve found it on your clothes and in the shower. And although you may feel nervous, embarrassed or even scared, it’s important to know that the problem you’re dealing with is one that most women will face at some point in their lives.
We’re talking about hair loss.
Is hair loss normal?
To a degree, yes.
At any given time, approximately 90% of the hair follicles on your head are in the growth phase, while the remaining 10% are in a resting phase. Resting phases can last for a few years at a time. When the follicle is in resting phase, the hair falls out. Different follicles take breaks at different times, which is why we don’t notice patchy spots more often. Sometimes hair follicles will stop entering growth phase altogether as they age. This is why thinning hair and/or significant hair loss is positively associated with advanced age.
Many things, including fluctuating hormones, stress or medications can impact the hair follicles. Medications that can affect hair loss include some blood thinners, medications for gout, high blood pressure or some heart conditions, as well as birth control pills. Many women report periods of significant hair loss after childbirth. A period of intense hair loss can show up months after a serious illness or injury in both men and women.
Am I losing too much?
Hair loss is a difficult condition for many women to deal with. Societal norms and beauty standards can create feelings of anxiety and depression in women who begin to experience hair loss or baldness. However, it is important to remember that some hair loss is common, it is completely normal to lose approximately 100 hairs a day (based on a typical scalp which contains 100,000 hair follicles). And though the problem is much more commonly associated with men, a 2007 study determined that “fewer than 45% of women go through life with a full head of hair.”
All About Alopecia
There are many reasons why women may find themselves losing more hair than is ‘normal’. Alopecia is the medical term for hair loss, or ‘baldness’. There are two main types of alopecia.
- Alopecia Areata is an auto-immune condition in which a person’s immune system attacks the hair follicles, resulting in significant and rapid loss of hair in patchy spots. You are more likely to experience Alopecia Areata if someone else in your family has the condition, or if you suffer from other autoimmune diseases or even allergies. The condition usually shows up in younger people initially. It cannot be cured, but it can be treated. Many people who experience hair loss as a result of Alopecia Areata will have a regrowth of the hair that has been lost.
- Androgenetic Alopecia (also called Female Pattern Hair Loss – FPHL) is the most common type of hair loss that women experience. Androgenetic Alopecia occurs in reaction to changing levels of androgens, which are male hormones that aren’t typically present in large amounts in females. Many factors can affect androgen levels in females, thus affecting hair growth and retention. Pregnancy, childbirth, the presence of ovarian cysts, menopause and even certain types of birth control pills can all affect androgen levels. Unlike Male Pattern Hair Loss, women who suffer from FPHL do not typically experience bald areas, rather they are more likely to experience thinning, most frequently over the top and the front of the scalp. This type of hair loss is most common in post-menopausal women.
Hormones Gone Haywire
Hormones affect everything from our appetite to our sex drive. It’s no surprise they also major players when it comes to keeping a healthy head of hair.
- Estrogen is the bread and butter of female hormones and when it’s balanced and working as it should, we’re happy to have it. The presence of estrogen in our bodies elongates the growth phase of hair follicles, ensuring that more hair is growing than not at any given time. However, many things can disrupt normal estrogen levels for women. Obesity, stress, toxic overload of xenoestrogens from the foods we eat and the plastics they are packaged in, pregnancy, childbirth, and perimenopause can cause estrogen to fluctuate which in turn can lead to thinning hair.
- DHT, or Dihydrotestosterone, is a form of testosterone created in the body through metabolic processes that involve androgens mixing with an enzyme known as Type II 5-alpha-reductase. More so than the levels of testosterone present, it is the amount of DHT binding to the receptors in the hair follicles that seems to create a hair loss problem. DHT can cause hair follicles to shrink, reducing their ability to produce healthy hair. The hormonal processes of testosterone converting to DHT occurs in both women and men, and generally women have nowhere near the levels of testosterone that men have, which in theory would make them less susceptible to DHT related hair loss issues, but current research suggests that even very low levels of testosterone can trigger DHT hair loss complications.
- Insulin is not just for regulating blood sugar levels, it also is a major hormonal player in all major body systems including the circulatory system, the digestive system, and even the integumentary system (hair and nails). Insulin resistance develops when the body produces too much insulin and cannot effectively eliminate the excess. When there is too much insulin in the bloodstream for too long it increases the production of cortisol, which leads to oxidative stress and an excess of free radicals. Oxidative stress speeds the aging process from the inside and greatly increases levels of inflammation, which in turn affect the health and functionality of hair follicles.
- Thyroid hormones can fluctuate wildly in some women as a direct result of lifestyle choices, diet and heredity. When thyroid function is unpredictable or suboptimal, energy for non-critical body processes (such as hair growth and retention of healthy hair follicles) are diverted to more important and pressing biological needs.
More Hair, Please
According to the American Hair Loss Association via the Washington Post, American hair loss sufferers spend more than 3.5 billion dollars a year on treatments for hair loss. While that figure might seem staggering, it is even more alarming when you take into account that currently there is only one FDA approved treatment for female hair loss and only two treatments that have been clinically proven to successfully treat hair loss in men. Minoxidil is currently the most prescribed drug therapy used on both men and women as a way to regrow hair. The drug was initially used as a medication to treat high blood pressure, and was only incidentally found to have an effect on hair growth when applied topically. Subsequent studies have found evidence that Minoxidil can slow the rate of hair loss and even regrow some hair. However, it has no effect on the underlying hormonal or systemic reasons for the initial hair loss, leading many researchers to see it as a less than ideal treatment.
Change your diet, change your scalp?
With the less than stellar research and development of treatments to effectively treat female hair loss, many women turn to the alternative health community for support and answers. And while there has been no significant research on the effects of natural or homeopathic remedies for hair loss, many nutritionists have plenty of ideas that women can try.
Protein – It is widely understood that protein is vital to hair growth and strength. Many nutritionists will advise that patients increase their protein intake from clean sources as a means to support hair health.
Fiber – Increasing the amount of fiber in your diet can lower estrogen levels through the process of ‘elimination’ – fiber increases our ability to ‘dump’ waste and excess estrogens head out with the garbage, so to speak.
Omega–3’s – Omega-3 fatty acids are also important as they can lower inflammation and support healthier scalp function in the process. Nuts, eggs, seeds and fish are all good sources of omega-3’s.
Variety – Nutritionists say that many people fall into a rut when eating. It is important to get a wide variety of foods into your diet to avoid nutritional gaps. Ensuring that you get six to ten servings of vegetables, two to four servings of fruit, along with healthy grains, legumes and lean protein sources is your best diet plan for overall health of all major body systems.
Multivitamin – Iron, zinc and biotin are sometimes recommended to women experiencing hair loss, but there has been no scientific evidence of their efficacy. Vitamin C & zinc have shown promise in repairing cellular damage from the inside, which can affect the health of hair follicles. B vitamins has long been thought to affect hair thickness and shine and Vitamin E can protect against free radical damage. Remember – If you choose to incorporate these compounds into your regimen, be sure to do your research and speak with your doctor to determine possible contraindications given your specific medical history.
All Knotted Up
Whatever the reason for hair loss, many women suffer more from the associated emotional repercussion than the actual physical condition. Women have reported professional discrimination, romantic concerns and self-esteem issues as a result of experiencing hair loss. Self-image and self-esteem suffer critically according to women. Some studies suggest that women who experience alopecia are at a higher risk of depression and anxiety as a result. Some studies even suggest that the loss of hair is more distressing to women than the loss of a breast to cancer. So far, the research into the psychological impacts of hair loss for women is woefully underrepresented. The best advice coming from the research available is to join a support group of women experiencing hair loss for to help bolster emotional health, foster community and share coping mechanisms. Additionally, there are many cosmetic options such as wigs and a wide variety of beauty products such as sprays and gels that women can use to camouflage thinning areas while regrowth occurs.
The Mane Idea
Women who find themselves facing hair loss often feel embarrassed, scared or depressed. Taking the time to get answers from trusted medical professionals about the reasons behind the loss are important, and there are different treatment options depending on the underlying cause of the loss.
It’s also important to get the support of family and friends and to double down on self-care efforts such as adequate sleep, stress reduction, as well as a varied and healthy diet. This multi-system approach is your best bet to not only a healthy head of hair, but also a healthy sense of self-confidence and self-esteem if and when hair loss strikes.
Dinh, Q. Q., & Sinclair, R. (2007). Female pattern hair loss: Current treatment concepts. Clinical Interventions in Aging, 2(2), 189–199.
American Hair Loss Association – Women’s Hair Loss / Treatment. (n.d.). Retrieved April 06, 2016, from http://www.americanhairloss.org/women_hair_loss/treatment.asp
Reviewed by: Paul J. McAndrews, MD
Hunt, N., McHale, S. (2005a). Clinical review: The psychological impact of alopecia. British Medical Journal, 331, 951–953.
van Zuuren EJ, Fedorowicz Z, Carter B, Andriolo RB, Schoones J. Interventions for female pattern hair loss. Cochrane Database of Systematic Reviews 2012, Issue 5. Art. No.: CD007628. DOI: 10.1002/14651858.CD007628.pub3.