Hair Loss in Women

Hair loss is common in both men and women but for women, it is more psychological in women than for men.  Hair is defined on Wikipedia as a “protein filament that grows from follicles found in dermis, or skin.”  There are many common causes of hair loss in women but if incorrectly diagnosed, the temporary hair loss can turn into long-lasting hair loss.

Misdiagnosing the potential reason for the recent hair loss can be more frustrating in women than men and become more long-lasting.  Common reasons for hair loss among women range from stress to medicinal reactions to pregnancy. But in most cases, hair will grow back. In unfortunate cases for some women, hair loss can become a lifelong struggle.  For women, there is such high expectation to be perfect in every aspect, including how full one’s hair is.  Whereas men who are bald’ or are currently balding’ is more acceptable.  And yet, there are so many different kinds of treatments for hair loss on the market.  Then the question is “which one will actually work and how much is too much?”

There are many types of hair loss among women.  Excessive abnormal hair loss is commonly known as alopecia.  There are also many kinds of alopecia.  All hair loss have a common symptom in both men and women which is that something is wrong or changed in your body.  A typical scalp can home about 100,000 hairs.  Each follicle produces a single hair that can grow around about half an inch per month.  That hair can remain there anywhere between 2 to 6 years, then will stop until the next cycle starts up which usually starts in 4 weeks.  Then that single hair may fall out, making room for the new.  Normally people shed anywhere between 50-100 strands every day.  In most cases, hair loss can be a short-term symptom ranging from stress, pregnancy, disease, or medication reaction where hair growth and shedding phases can be altered.   In these situations, hair will grow back once the cause is over, so to speak, and normal growth patterns and shedding return.  We are told to speak with our doctors when we experience hair loss but there are so many factors tied to hair loss that it becomes a trial and error for us and our doctors.

Doctors use the Ludwig and Savin scale to measure hair loss. Both scales are closely similar in nature but the Savin scale measures overall thinning as well as density.   Savin scale measures normal hair density to a bald crown. The scale helps document female pattern baldness.  Even though it is more commonly known among men,  it affects about 30 million American women.

“Two types of hair loss in women are associated with dihydrotestosterone (DHT) a derivative of the male hormone, testosterone. The majority of women with androgenetic also called androgenic alopecia have diffuse thinning on all areas of the scalp. Men rarely have diffuse thinning but instead, have more distinct patterns of baldness. Some women have a combination of two pattern types. Androgenic alopecia in women is due to the action of a male hormone that is typically present in only small amounts called androgens. Androgenic alopecia can be caused by a variety of factors caused by the actions of hormones, including some ovarian cysts, taking high androgen index birth control pills, pregnancy and menopause. Just as in men, the hormone DHT appears to be at least partially to blame for miniaturization of hair follicles in women suffering from female pattern baldness.  Heredity also plays a major factor in the disease.”(WebMD)

One of the most common hair loss conditions happens more in athletic women is known as traction alopecia.  It is caused by localized trauma to hair follicles from tight hairstyles that pull at the hair for a long period of time.  Hairstyles like braiding, cornrows, tight ponytails and extensions are common causes of traction alopecia.  If corrected early, the hair with regrow.  But then we are left with how are we suppose to keep our hair out of our eyes while we are playing sports.  It is an extreme struggle between trying to maintain hair and be athletic.

Another factor in hair loss in women is when your body goes through something traumatic.  Extreme stress is a leading factor along with malnutrition.  What you eat can affect hair growth and shedding patterns.  But childbirth, severe infections, and major surgeries are also considered as traumatic to the body that can impact your hair.  Growing phase called anagen, and the transitional phase (catagen) can actually shift into rest phase, also known as telogen phase, during these stressful events your body is going through.  The shedding phase can happen anytime within 6 weeks to 3 months after the event, which is called telogen effluvium. Unfortunately for some women, telogen effluvium is a chronic disorder.  These women can experience this process for months, even years without even knowing what the triggering factor is or where the stressor comes from so they are mystified on what it is they are to avoid to help stop this process.

When stress is not a factor we turn to chemical factors, like chemotherapy for example.  When hair follicle impairs its’ own cellular level mitotic or metabolic activity, we have an occurrence of Anagen effluvium.  Chemotherapy targets rapidly dividing cancer cells.   And hair follicles in the growing phase (anagen) are part of the rapidly dividing cells which chemotherapy affects greatly.  Once chemo begins, it affects 90 percent or more of the hairs in anagen phase causing them to fall out.  During this process, the anagen effluvium is a tapered fracture of the hair shafts.   The hair shaft narrows as the matrix is damaged.  The shaft becomes fractured at the site of narrowing which causes the loss of hair.  Having to go through chemotherapy is difficult in itself.  But then hair loss is added to the stress.  I see women using wigs while they go through this process.  They are literally fighting for their lives and yet they are compelled to try to keep up their appearances.

When stress and chemotherapy are not the factors for hair loss, a person’s own immune system can attack the roots of hair follicles and cause an inflammatory reaction which is better known as alopecia areata.  These symptoms can develop suddenly and include patchy shedding of hair. Fortunately, about 70% of patients recover their hair within two years even if they do not receive treatment.

Society has impacted women and how we present ourselves.  There are so many factors that can lead to hair loss, from stress to your own immune system. The emotional toll hair loss causes can take its toll on a woman, from low self-esteem to the feeling of not feeling attractive to embarrassment, loss of confidence and shyness to depression.  Age also plays a factor in hair loss for both men and women but that can also lead to depression.  No one wants to get old or face the fact that they are getting “old.”  Hair loss changes a person’s appearance and can cause one to even appear old.  But this also leads to being unsatisfied with one’s appearance.

In a 1992 study in the Journal of the American Academy of Dermatology that compared the psychological impact of hair loss between men and women found that women had a more negative self-image and were less adaptable to hair loss.  Women suffered more emotionally than the men in the study.  Women were generally more concerned and worried about the way they look than the men.  Women tend to feel insecure about their appearance and how the world and people around them will accept them.  Women use hair to express themselves individually. Losing their hair limits them to express themselves and feel awkward in their appearance.

But women also judge each other as well as themselves.  The world we live in now is actively social and social media makes it easier to be social but can also set oneself up for social teasing and humiliation when living with hair loss.  Dealing with hair loss in a very social world also causes emotions of envy and jealousy.  We all want to have a full head of hair forever but it is inevitable that we all will go through some sort of hair loss. We see someone on TV and automatically want to know what they use to keep that full body of hair, quickly googling the top brand names to use.

Treatment for hair loss comes in all sorts of ways, from oral to what kind of shampoo to use.  There are vitamins one can buy,  cream treatments to put in one’s hair and even hair transplant surgery one can buy.  The treatment itself can get complex if the root of the problem isn’t taken care of or solved, then one is not actually treating actual hair loss. Instead just simply masking the hair loss.  Speaking with your doctor about the issue will give you a better idea of how to handle hair loss.

You can also find some remedies here from Reader’s Digest

The way each of us as deal with this inevitable situation and how we respond to each other will take time to become a positive outlook.  It is easier to say that we should be proud of the way we look no matter what but we tend to worry what the next person thinks of us.  Hair loss can be a serious underlining condition and should not be something we make fun of each other about.  Hopefully, science will find a way to lessen our experiences with hair loss but until then, we rely on our doctors, our genes, diets, hats and wigs, shampoos and vitamin supplements.


Special Thanks:


World Hair Institute

American Hair Loss

reviewed by Paul McAndrews, MD



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