Hair Loss in Women

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KEY POINTS

• There are several types of hair loss in women: female-pattern baldness, local hair loss, and general hair loss.
• Simple changes in health habits, such as eating a healthy diet or changing how you care for your hair, may help you to stop losing hair. Your healthcare provider may recommend medicine to slow your hair loss and stimulate hair growth.
• Avoid using nonprescription hair-growth products unless recommended by your provider. These products have not been proven to work and may harm your skin and hair.

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What is hair loss?

It is normal to lose some hair every day from your scalp. The lost hair is normally replaced with new hair. However, you may start having less hair because new hair does not grow back to replace lost hairs. In some case, you may also lose hair from other parts of the body. Hair loss may be temporary or permanent, depending on the cause.

What is the cause?

There are several types of hair loss in women:

• Female-pattern baldness runs in families. This type of hair loss usually causes the hair to thin in the front, on the crown, or on the sides. It seldom causes women to become completely bald.
• Local hair loss is usually patchy and confined to certain areas. It may result from:
  • Alopecia areata, a condition that causes hair loss in patches, usually on a small area of the scalp, and the cause is unknown
  • Ringworm, which is a fungal infection
  • Cancer treatment
  • Frequent use of a hot comb or hair dryer
  • Hairstyles that pull on the hair, such as tight pigtails or cornrows
  • Hot oil treatments and chemicals used in permanents, hair dyes, and straighteners
  • Repeated nervous hair pulling
  • Permanent skin damage, such as scarring from burns or serious skin diseases

Pregnancy can be another cause of temporary local hair loss. One to five months after your baby is born, you may lose more hair from your scalp than usual. The loss of hair happens because during pregnancy more hairs go into a resting phase than when you are not pregnant. The resting phase is part of the normal growth and loss cycle of scalp hair. Six to twelve months after delivery your hair will get thicker again. The hair loss will not be permanent or cause obvious bald patches.

• General hair loss is when all of your hairs enter a resting phase at the same time and then fall out. The resting phase is part of the normal growth and hair loss cycle of scalp hair. Causes of general hair loss include:
  • Stress, caused by events such as a divorce or death in the family, surgery, high fever, or chronic or severe illness
  • Drug treatment for a medical condition
  • High doses of vitamin A
  • Thyroid disease

Alopecia universalis is a rare and severe form of baldness in which you lose all body hair, including eyebrows, eyelashes, and hair in the genital area and armpits. The cause is not known.

How is it diagnosed?

Your healthcare provider will ask about your recent medical history and any history or patterns of hair loss in your family. Your provider will examine your scalp and skin. You may have blood tests or a skin scraping to check for infection.

How is it treated?

In some cases of temporary hair loss, simple changes in health habits, such as eating a healthy diet or changing how you care for your hair, may help you to stop losing hair.

Your healthcare provider may recommend medicine to slow your hair loss and stimulate hair growth. Minoxidil is a medicine you can put on bald spots daily. After several months of using this medicine daily, you may have some hair regrowth, although the hair may not look exactly like your original hair. You need to keep using the medicine every day to keep the new hair.

Men can take another medicine for baldness called finasteride (Propecia). This medicine can be taken ONLY by men. Pregnant women should not even touch the tablets because the medicine can be absorbed through the skin and cause birth defects.

If an illness is causing you to lose hair, your provider may be able to prescribe medicine to treat the illness. For example, your provider may prescribe an antifungal medicine if a fungus, such as ringworm, is causing your hair loss. Hair will usually grow back in the bald areas.

If you have alopecia areata, the hair usually grows back naturally in 6 to 12 months. Your provider may try to speed up regrowth by injecting your scalp with steroids or by having you put minoxidil on the bald area. Alopecia areata can come back months or years later.

Hair transplant surgery involves moving sections of skin with hair from one part of the scalp to another. The results may last a few years or they may last the rest of your life.

Female-pattern baldness will continue for the rest of your life. Baldness that is the result of skin damage from a disease or burn is also likely to be permanent. Other types of baldness may be temporary and last only a few weeks or months.

How can I take care of myself?

• If you have noticeable hair loss or a change in the condition of your scalp or other areas where hair normally grows, tell your healthcare provider. In the meantime, eat a healthy diet, get plenty of rest, exercise according to your healthcare provider’s recommendation, and learn ways to manage stress. This can help you recover faster if an underlying illness is the cause of baldness.
• Avoid irritating your scalp. For example, do not use barrettes, elastic hair bands, blow dryers, hot combs, hair dyes, or other chemicals on your hair.
• Use a natural bristle brush or a smooth hair pick to prevent a lot of pulling when you comb your hair.
• Avoid using nonprescription hair-growth products unless recommended by your provider. These products have not been proven to work and may harm your skin and hair.
• If you have lost a lot of hair from your scalp, you may choose to keep your hair short and hide thin spots with a layered cut. Or you may wear a wig or other type of hairpiece, hats, or head scarves.