Why Women Lose Their Hair and How to Treat It

How do you feel about your hair?

If you’re like most women, you probably wish it were different somehow: flatter or curlier, thicker or finer, shorter or longer. We tend to be a bit too critical of ourselves, and to find what’s wrong with our “crowning glory,” rather than what’s right about it.

Some women don’t have that luxury, however. They can’t complain about the texture or color of their hair, because they’re too focused on something else—the fact that they don’t have as much of it as they’d like.

When we think of hair loss, we typically think of men. They are the ones that suffer from it most often, and many wear a bald head really well. One has only to look at some of today’s popular action stars to realize that no hair is good hair in the male world.

It’s less so in the female world. Fortunately, some strong women are working to change that. Still, a woman who starts losing her hair tends to go through some difficult times, emotionally, say nothing of the challenges she faces when trying to adjust her look.

Lots of Women Suffer Some Form of Hair Loss

According to the North American Hair Research Society, female pattern hair loss occurs in about 50 percent of women by the age of 50. That means that about half of us will experience at least some hair loss by that time.

A 2007 study reports similar statistics:

• 12 percent of women will develop female pattern hair loss by the age of 29
• 25 percent will develop it by the age of 49
• 41 percent will by the age of 69
• over 50 percent have some hair loss by 79 years
• only 43 percent of women aged 80 or over show no evidence of female pattern hair loss

Shocking, right? Most women don’t think of losing their hair, ever. And though most women experience thinning and don’t go totally bald, it can still come as a surprise, and many don’t know how to deal with it.

“We want to live our own life and not let [hair loss] keep us from doing things,” said Thea Chassin, founder of Bald Girls Do Lunch. “Women stop swimming, women stop playing tennis, women stop going on a bike. Why? Because they haven’t figured out how to do it and be comfortable.”

What Causes Female Pattern Hair Loss?

Part of the problem is that it can be challenging to figure out what’s causing the hair loss. There are a number of possibilities, including:

• Female pattern hair loss (androgenetic alopecia): This is the most common cause of women’s hair loss, and affects about one-third of women who are genetically predisposed to it. In other words, it’s inherited from your parents’ genes. It’s most commonly seen after menopause, though it can begin as early as puberty in some women, and creates gradual thinning. It’s related to the hormone dihydrotestosterone (DHT), which also causes hair loss in men, but both genders have this hormone. DHT shrinks hair follicles and makes it difficult for healthy hair to survive. Though women may not have as much DHT as men do, the level they do have can trigger hair loss. Falling levels of estrogen, which occur at menopause, may also allow the DHT to have more impact.
• Alopecia areata: This is thought to be an autoimmune condition that can create patches of hair loss. It causes the immune cells to attack the hair follicles, and can lead to total hair loss, or baldness. It also affects the nails, creating dents (pitting), white spots or lines, and splitting.
• Polycystic ovary syndrome: This condition, which causes female hormones to become unbalanced, can also lead to hair loss. The ovaries overproduce testosterone, which can create a bald patch on the top of the head, as well as excess facial and body hair.
• Hypothyroidism: Women with this condition have a thyroid that doesn’t produce enough hormones. Without appropriate treatment, it may lead to hair loss.
• Iron deficiency and anemia: Women who have heavy periods or who don’t get enough iron in their diets may have an iron deficiency, which can cause some hair loss.
• Medications: Certain medications, including antidepressants, beta-blockers (for high blood pressure), and nonsteroidal anti-inflammatory drugs (like ibuprofen and aspirin) may lead to hair loss in some susceptible women.
• Lupus: Lupus is an autoimmune disease in which the immune system attacks the body’s own tissues, sometimes including the hair follicles. The results can be similar to alopecia areata.
• Scalp skin conditions: If you have psoriasis, dandruff, or other skin conditions that affect your scalp, they can make it more difficult for hair to grow.
• Pregnancy: Because of the hormonal changes, pregnancy can cause hair loss, particularly after the baby is born. This type is usually temporary.

There are other potential causes too, including medical illnesses, chemotherapy, surgery or trauma, and physical and emotional stress. This is why it can be difficult for doctors to make a diagnosis, but it’s important to get as close as you can so you can find the treatment that’s most likely to work for you.

Symptoms of Hair Loss in Women

How can you tell if you’re losing your hair? While we all lose a little bit each day—100-150 hairs is normal, the experts say. When you start to lose it for good, you’ll notice some changes. For one, the hair that grows in will be shorter in places, creating a “peach fuzz” sort of effect. You may also see hairs growing from the scalp at different lengths.

Next, the hair loss tends to occur over the mid-frontal scalp first, widening your central part. The front hairline will likely remain. You may also notice more hair in the sink as your shedding levels increase. If your ponytail looks thinner or your hair seems to lack the body it used to have, these changes could also indicate hair loss.

Be aware that the loss isn’t necessarily gradual. It tends to occur most often in fits and bursts, so you’ll see more hair loss for a few months, and then things will tend to stabilize for a while. If you have one of the more permanent types of hair loss, however—that are caused by hormones or your immune system rather than stress—you can expect that the hair loss will come back again, and will continue to rob you of your hair over the next several years.

How to Treat Female Pattern Hair Loss

Treatment of hair loss depends on the cause. If you have the most common cause—female pattern hair loss caused by DHT—common treatments include the following:

• Minoxidil (Rogaine): You’ve likely heard of the topical medication Rogaine for men. It works for women, too, though don’t expect it to bring back a full head of hair. It will restore only some of it, but that may be enough to help improve your confidence. Do be patient—studies show it can take many months of treatment to notice an effect.
• Spironolactone (Aldactone): This is a medication that reduces the amount of fluid in your body without affecting your potassium levels like many diuretics do. The medication also works as an antiandrogen, which means it helps tame the action of DHT, preventing it from killing off more of your hair follicles.
• Climetidine (Tagamet): This drug is mainly used to treat gastrointestinal ulcers, but it also has shown promising results in studies of women with female pattern hair loss.
• Hormone replacement: Though this treatment is commonly prescribed after menopause to help reduce troublesome symptoms like hot flashes, it can also help restore hair. In fact, it’s believed to be the most common internal treatment for hormone-triggered hair loss.
• Nizoral/Ketoconazole: This topical medication is an antifungal treatment that doctors use to treat fungal infections, but it also reduces the production of testosterone and other male hormones, so it can help treat hair loss. You’ll most often find it in hair-loss treatment shampoos.
• Hair transplant: Women who have thinning at the front of the scalp but otherwise still have strong, healthy hair may be good candidates for a hair transplant. Realize that the procedures can be time-consuming and expensive, and that it typically takes 1-3 sessions done six months apart to create optimal results. There are also potential side effects, including swelling, post-operative bleeding, and infections.

If your doctor says that your hair loss is caused by something other than hormones, your treatment may be different. Nutrient deficiencies can be treated with diet and supplements, for example, and autoimmune diseases will require different medications.

You can also talk to your hairdresser about some options that will help you feel more confident with your look. Shorter styles created a more lifted appearance, as do layers at the crown. Take care with the hair you do have by using wide-toothed combs that reduce breakage, washing and styling your hair less frequently, coloring hair to make it look like it has more volume, and styling with curls to give more bounce. Ask your stylist about products that will help boost fullness, without weighing your hair down or causing more damage.

Sources

Anna Medaris Miller, “Hair Loss: Not Just a Man’s Issue,” US News, March 2, 2015, http://health.usnews.com/health-news/patient-advice/articles/2015/03/02/hair-loss-not-just-a-mans-issue.

Elise A. Olsen, “Female Pattern Hair Loss,” North American Hair Research Society, June 23, 2017, http://nahrs.org.tempdomain.com/PatientInformation(FAQs)/FemalePatternHairLoss(FAQ).aspx.

O’tar T. Norwood, “Incidence of Female Androgenetic Alopecia (Female Pattern Alopecia), Dermatologic Surgery, January 2001; 27(1):53-54, http://onlinelibrary.wiley.com/doi/10.1111/j.1524-4725.2001.00124.x/full.

Quan Q. Dinh and Rodney Sinclair, “Female pattern hair loss: Current treatment concepts,” Clin Interv Aging, June 2007; 2(2):189-199, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2684510/.

Winnie Yu and Prevention, “9 Causes of Hair Loss in Women,” ABC News, April 10, 2011, http://abcnews.go.com/Health/WomensHealth/reasons-losing-hair/story?id=13320129.

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