Hormones and some other factors can result to hair loss in women. And while thinning hair and balding can be really embarrassing for women than they are for men, in most cases, they are treatable conditions. Here’s what women need to know about hair loss.
When you imagine baldness and hair loss, you may pull up visions of middle-aged men with shiny heads. And while approximately 85 percent of men have significantly thinning hair by 50, according the American Hair Loss Association (AHLA), 40 percent of persons affected by hair loss (also known as alopecia) are women. More than 50 percent of women will experience noticeable hair loss, according to the Cleveland Clinic.
Previously, balding and hair loss were dismissed as minor cosmetic problems not needing treatment. But today, there’s more compassion for the emotional consequences of hair loss, particularly for women. In fact, hair loss can seriously affect a woman’s self-esteem and body image, according to a clinical review published in the journal The BMJ. “Women are much more affected socially by hair loss than men,” says Amy McMichael, MD, a professor of dermatology at Wake Forest University School of Medicine in Winston Salem, North Carolina. “Women judge themselves harshly and have fewer coping mechanisms associated with their hair loss than men.”
Causes of Hair Loss in Women
Many factors can cause women to lose their hair, from hormones to stress to going on or off birth control. Here are some of the main causes of hair loss in women:
- Androgenetic Alopecia Androgenetic alopecia (AGA), or pattern baldness, can cause women to get thinning hair on the top of the head, says Rebecca Baxt, MD, a dermatologist in Paramus, New Jersey. “It’s hormonal. Sometimes it’s hereditary, sometimes it isn’t, and it’s extremely common,” she explains. Dr. Baxt sees AGA in patients of all ages starting in the late teen years, but notes that it can certainly get worse around menopause due to hormonal changes.
- Telogen Effluvium Another reason for hair loss is telogen effluvium, a condition in which women suddenly lose hair by the handful. Childbirth, surgery, disease, malnutrition, and other events and conditions that cause stress can cause telogen effluvium. Marital status may also play a role. A study published in the journal Plastic and Reconstructive Surgery found that women who had experienced the stress of losing a spouse, either to divorce or death, exhibited more hair loss than married women.
- Alopecia Areata Alopecia areata is an autoimmune condition that causes round patches of sudden hair loss as the immune system attacks the hair follicles. Certain thyroid disorders can put you at risk for alopecia areata.
- Birth Control Going on or off birth control, such as oral contraceptives, progestin implants, hormone injections, and the patch, can sometimes trigger hair loss in some women, Baxt says. The AHLA advises all women to use birth control pills with a “low androgen index,” and women with a family history of hair loss to use nonhormonal birth control.
- Chemotherapy By attacking growing hair follicles, chemotherapy can cause almost complete hair loss. Scalp cooling caps can help minimize hair loss during chemotherapy.
- Hairstyles Repeatedly wearing braids, cornrows, or other hairstyles that pull hair too tightly over a long period of time can cause hair thinning and hair loss. Overprocessing your hair with chemicals like bleach and heating tools like blow-dryers and flat irons can also damage your hair and cause breakage, but that’s different from hair falling out at the root, Baxt explains.
- Nutritional Deficiency Anemia, or low iron stores, as well as a protein deficiency can also lead to hair loss, Baxt says.
Hair loss can be devastating for women, so early intervention is key, advises Dr. McMichael. “As with most medical conditions, the key to controlling the hair loss cycle is to seek treatment early.”
Thankfully, there are many treatment options available for hair loss and thinning hair. Your doctor may prescribe one or more of the following hair-loss treatments:
- Testosterone-Blocking Drugs As women approach menopause, they have decreasing levels of estrogen compared with testosterone. Treatments geared toward blocking testosterone at the hair follicle, such as Aldactone (spironolactone) and Eulexin (flutamide), are helpful in treating hair loss, according to McMichael. Spironolactone is a blood pressure medication that’s sometimes used off-label to treat androgenetic alopecia, Baxt adds, which means the U.S. Food and Drug Administration (FDA) has not approved the drug for hair loss.
- Rogaine (Topical Minoxidil) The sole treatment for female pattern baldness to receive FDA approval, Rogaine is available over the counter and works by stimulating new hair growth.
- Treating Underlying Problems Treating an underlying condition that is causing the hair loss, such as a thyroid disorder or nutritional deficiency, can reverse hair loss problems.
- Topical or Injected Cortisone This can help reverse some hair loss, and it works really well for patients with alopecia areata, Baxt says.
- Hair Transplantation This involves surgically moving existing scalp hair to thin spots. “Surgical hair restoration is a very helpful treatment for women because women usually have less bald area to cover than men, so it is easier to make the density of hair look fuller,” says McMichael.
- Laser Phototherapy Also known as low-level laser therapy, this light treatment may help to regrow hair. But McMichael says this therapy needs to be refined because its effectiveness in most patients is not yet proven.
- Platelet-Rich Plasma Therapy Platelet-rich plasma (PRP) therapy is another “off-label” hair-loss treatment that has been growing in popularity over the last few years. During a PRP session, a technician draws a patient’s blood, then spins it to extract plasma. The plasma contains platelets, which promote hair growth, according to the Cleveland Clinic. The technician then injects the plasma into areas on the scalp affected by hair loss — usually about 15 to 20 injections per PRP session (patients typically require three monthly sessions plus a follow-up appointment, and then yearly maintenance sessions). “PRP does work for a majority of patients, but it’s expensive and you have to keep doing it,” Baxt says.
Hope for Women With Hair Loss
New research offers hope for women (and men) suffering from hair loss. In a study published in May 2018 in the journal PLoS Biology, researchers used an osteoporosis drug to prolong the growth phase of the hair cycle and potentially treat hair loss.
Other studies with mice have also been promising. In one series of experiments, researchers used an experimental compound to reverse hair loss in mice, according to a report published in July 2018 in the journal Scientific Reports. In a third study, published in July 2018 in the journal Cell Death and Disease, researchers discovered that turning off a mutant gene expression reversed hair loss in mice.