The Complete Guide to Hair Loss for Women
Does your hair suddenly seems a lot thinner? Here’s everything you need to know about what could be causing it, plus doctor-recommended tips and treatments for regrowth.
BY IVANA RIHTER
I was in the shower when I first noticed the nest of hair in the drain. Then I saw the clumps entangled between my fingers and I knew something was wrong. It was all over my pillow. At first, I assured myself it was a fluke, a one-time scare that was caused by shampooing too much. But after weeks of losing what felt like half of my thick head of curly hair, I started to panic.
Hair loss is more common than you might think. According to the American Hair Loss Association, women make up to 40 percent of hair loss sufferers in the U.S. When I finally went to see a doctor, I found out that the cause of my thinning was due to a switch in birth control which threw my hormones off. At that point, it had been months of stress and worry and now, I realize I should have gone to see a medical professional much sooner. In my case and the cases of so many women, hair loss can actually act as a warning sign for underlying health issues. It is important to be attuned to what is happening with your hair because it can be indicative of your hormones, your thyroid, your metabolism, and your overall internal health.
“There are many different reasons for hair loss and hair loss may be a symptom of a greater problem,” New York-based dermatologist Michelle Henry tells Allure. “If someone has thyroid problems, it's really important to pinpoint this because this derangement in their metabolism can affect their overall health. If someone has iron deficiency anemia, one of their first manifestations may be hair loss.” The sooner these conditions are found, the better. Hair loss is nothing to hide or feel ashamed about, especially when it can give us clues about what is happening with our health and well being.
Some women may not even be aware of their hormonal or thyroid issues until they come to the dermatologist looking to be treated for hair loss. To get an in-depth understanding of the different types of hair loss and possible reasons behind it, we went to the experts.
What are the most common types of hair loss?
If you are noticing a sudden lack of hair on your head, that is saying something already. “It's pretty normal to lose between 50 to 100 or a little bit above 100 hairs a day,” says Henry. “Much more than that becomes concerning and that's really important to let your dermatologist know.” Just as you would pay attention to a suspicious mole or keep your eye on a rash, it is important to take note of what is happening with your hair. Henry recommends a hair count test where you count every single hair you lose per day to gauge if what you are experiencing is totally normal or veering into something concerning.
Despite what you may have been led to believe, not all hair loss looks the same. Identifying exactly what type you are experiencing can help you get to the bottom of the problem.
Receding hairline and thinning hair
The most common cause of hair loss, known as male-pattern baldness or female-pattern baldness, is actually hereditary and usually occurs gradually as you get older. You might notice a receding hairline, thinning hair, or bald spots. If you are noticing thinning at the temples and in the hairline, that is a sign the follicle is affected. In that case, it would be time to see a dermatologist who can screen for any underlying issues like iron deficiency or hormonal imbalances.
“If the hair loss is slow and gradual and there is a family history, one can assume that it might be female pattern hair loss,” says Henry. “If the hair loss begins a few months post-pregnancy, then it is fair to assume that this is a telogen effluvium due to pregnancy.” Unlike WebMD, an actualdermatologist can actually take a look at your scalp, administer blood tests, and talk to you about your symptoms.
Despite being panic-inducing, shedding is rather common after physical traumas, such as childbirth or surgery. Others might experience it after emotional traumas or periods of intense stress. Something as seemingly inconsequential as changing your birth control brand can also take a toll on your body and throw off your internal balance enough that hair loss follows.
If you've been going through a rough patch in life lately and shedding seems to be the culprit, there's actually some good news: all the hair you shed can come back. Focus on your mental health, take care of your body, and make a point of managing your stress levels and the period of shedding will likely go away on its own. “With women especially, stress and the stress hormone — cortisol — is a huge contributor, especially chronic stress as it can disrupt hormonal balances and lead to disruption of the hair growth cycle, as well as inflammation,” explains Sophia Kogan, co-founder and chief medical advisor of Nutrafol.
Breakage near the scalp
If you find your hair is breaking in the middle of the strand or a few inches away from the scalp, that is a sign of weakened keratin and breakage due to severe damage to the hair protein — not traditional hair loss. In this case, give your hair a rest and swear off heat, bleach, and dye until you see some grow-out on the broken pieces and an overall improvement in hair texture.
Bald patches or full-scalp baldness, including the loss of eyelashes and eyebrows
With conditions like alopecia areata, hair loss is caused when the immune system attacks the hair follicle. This type of hair loss is often sudden and you’ll notice one or more circular bald patches appear. It is common to have recurrences of the condition, and a small percentage of people who develop alopecia will experience eyelash and eyebrow hair loss on top of total scalp baldness, though they may not experience all these symptoms. This is a chronic condition and the sooner it is diagnosed, the sooner you can figure out the next steps.
What types of health conditions can lead to hair loss?
Hair loss itself is sometimes treated as a diagnosis, but it is more often, it is a symptom of something bigger. “Hair loss can be a sign of an underlying health issue and act as an early warning system,” says Richard Firshein, leading expert in integrative and precision-based medicine and founder of the Firshein Center. “The health of hair follicles is directly related to health and the functioning of our endocrine system.”
For conditions like polycystic ovary syndrome, which is often difficult to diagnose, hair thinning is often one of the first tell-tale signs along with acne and body hair caused by the increased levels of testosterone. “Patients with PCOS can have overall elevated testosterone leading to androgenetic alopecia,” explains Henry. Talking about it openly with your dermatologist, OB-GYN, or normal health provider can actually help get you to a diagnosis and treatment plan earlier. With many hormonal conditions, the sooner they are found the better for you.
“Both hypothyroidism or hyperthyroidism can cause hair loss,” says Henry. “So it's really important and it's a part of my hair loss blood panel to check the TSH, which is a screening test for both hyper or hypothyroidism.” Especially in the world of women’s health where so many are struggling with invisible illnesses, there is no reason you should have to. Hair loss can alert us to everything from hormonal imbalances to nutritional deficiencies. Henry also mentions that iron deficiency, vitamin D deficiency or vitamin B12 deficiency can also cause hair loss. The throughline is listening to one's body when something feels wrong. Take note of the hair loss and any other symptoms and ask your doctor or dermatologist for a comprehensive blood test and do not be afraid to advocate for yourself.
What are some effective types of treatment for thinning hair?
If you find yourself hyperventilating in the aisles of Whole Foods and buying $70 worth of biotin, don’t. Though its use as a hair and nail growth supplement is prevalent, research demonstrating the efficacy of biotin is limited and most has focused on nails. “We don't really have great data supporting its use,” says Henry. “The original studies on biotin and hair were actually quite small, because of this, I don't recommend very high doses of biotin. Further, high doses of biotin can interfere with some blood tests, especially in older patients and patients with a history of heart disease.”
Many women may have had these supplements recommended to them at some point, but unless there is a severe natural deficiency (which is very rare), it's typically preferable to incorporate proven lifestyle changes, like a nutrient-filled diet and decreased stress.
There are a few treatments, like platelet-rich plasma injections, that do work. “PRP contains a number of compounds that are unique to platelets that stimulate growth and reduce inflammation,” explains Firshein. “Platelets work similarly to how they do in other parts of the body by repairing damaged areas and helping them to regrow.”
If you are looking to improve the overall quality of your hair and get some thickness back, there are also botanical-based treatments like Nutrafol whose pills contain everything from curcumin from turmeric, ashwagandha (a stress adaptogen) and saw palmetto, a DHT rebalancer. Natural ingredients, such as vitamin B5 and rosemary oil, have also been proven to help thinning hair.
With cases that are stress-related or due to overprocessing hair, your hair will come back in no time and the best thing you can do is be patient — and maybe buy some flyaway spray to keep stragglers in check. In the case of hormone-related hair loss, go to a doctor and ask for blood work to get a full picture of what might be causing it. You may feel like you're overreacting, but there's no harm in getting reassurance that all your important internal systems are healthy and functioning properly. Too often, the reason women do not seek treatment is that they are not taken seriously or do not want to burden providers with their concerns. For the record: your concerns are valid and hair loss is connected to so many hormonal and autoimmune conditions that it is worth the checkup. On top of stressing about medical intervention, there's the added stigma around women’s hair loss that makes women feel embarrassed or nervous to talk about it openly.
“We're used to talking about hair loss in men, but in women, it has been a subject that is surrounded by shame,” says Kogan. “We know that we will age, get wrinkles, our bodies will change, but no one ever told us that our hair will change as well as we get older.” Hair loss is incredibly common and women should not have to suffer in silence or try to hide their hair loss for fear of being seen as “unattractive” or “old.” Aging is a natural and beautiful process whether it is going gray or thinning out, it is time we normalize beauty at every age.