There is a common misconception that hair loss more commonly affects men. On the contrary, the American Hair Loss Association reports that 40 percent of Americans dealing with hair loss are women. Impacting women at all stages of life for a variety of reasons, hair loss and thinning may be temporary or permanent depending on the situation. In honor of National Hair Loss Awareness Month this August, here are the eight most common causes of hair loss in women and how to treat and, in some cases, prevent them.
While the myth that your hair is determined by your mother’s father isn’t entirely true, it’s also not completely false. “You cannot look to just one relative to predict hair growth,” says Benjamin Paul, MD, a New York City-based double board certified facial plastic surgeon. “Though your mom’s dad (maternal grandfather) is an important player, he is not the only player impacting the growth and longevity of your hair.”
Even so, your hairline is very much influenced by family history. “If many of your relatives have shown a similar pattern of hair loss to your pattern of loss, you know who to thank for the genetics involved,” he adds.
While male pattern baldness is more common, women can experience female pattern hair loss (especially after menopause), which is hereditary. In both cases, the condition is known as androgenetic alopecia. The difference is how the baldness presents — men are more likely to experience receding hairlines and balding at the top of the head, whereas women typically see thinning around the crown.
“Female pattern hair loss is best characterized using the Ludwig classification,” explains Gary Linkov, MD, a double board certified facial plastic surgeon in New York City. “The scale ranges from stages I to III. Stage I begins with thinning on the top of the head. In stage II the scalp starts to show. All of the hair at the crown of the head may be lost when the hair loss progresses to stage III.” Treatment options range from oral and topical medication (think: Propecia and Rogaine) to wigs and hair transplants, depending on the severity of the condition.
Hormonal changes and imbalances can lead to a variety of conditions, hair loss among them. “The most common type of hair loss in women is female pattern hair loss, which is analogous to male pattern hair loss and involves testosterone,” Dr. Linkov explains. For men and women alike, the hormone dihydrotestosterone (DHT) is responsible for hair loss. “Testosterone gets converted to DHT, which is largely responsible for hair miniaturization,” he says. “The pattern of hair loss, however, is different between men and women.”
Androgenic alopecia is considered the most serious form of hair loss because it is usually permanent (due to the hair follicles being miniaturized). The severity of the impact can be mitigated, however, with treatment. Women who start to notice thinning along the scalp should consult with a board certified provider.
Hormonal changes due to pregnancy, birth control, stress, and more can also lead to temporary hair loss, which we explore below.
3. Hair Styling
‘Beauty is pain’ has its limits. Unfortunately, tying your ponytail or bun too tight, heat styling, and using harsh chemicals can take its toll on your hair. Tight hairstyles, especially cornrows and braids, can actually cause traction alopecia, which can result in a thinning hairline and gradual hair loss. Taut ponytails and braids can have a similar effect, as chronicled in a season 17 Keeping Up With The Kardashians episode, in which Kourtney’s sky-high ponytail led to patchiness that was treated with PRP injections. While the occasional braid, bun, or pony shouldn’t cause much harm, regular styling could lead to more permanent hair loss.
Similarly, excessive heat styling wreaks havoc on the hair. A side effect of thermal damage is brittle, weak hair shafts, which can result in breakage. Giving your hair a break from your hair straightener, curler, and dryer will benefit your strands’ long term health. If heat styling is a must, be sure to use a heat-protectant product to mitigate damage.
Hair treatments, like perms, color, and chemical straightening, can also weaken the hair when performed regularly. They have the potential to dry out both the hair and scalp, which may lead to hair loss.
4. Pregnancy & Childbirth
Many women report enjoying luscious locks during pregnancy, but hormonal changes mean that hair is often shed in the weeks and months after giving birth. Postpartum hair loss is common for new moms (read our guide to managing it HERE), but it is rarely long-lasting. Most women see total hair restoration within a year and find that shedding is at its worst around four months postpartum. As a result, many doctors do not recommend treatment.
Nutritional deficiencies are also another common contributor to hair loss among women. Meeting the required dietary allowances (RDA) for vitamins and minerals — particularly iron, zinc, vitamin B, and protein — are critical for hair and overall health.
Unhealthy eating habits, eating disorders, or certain diets can all play a part in nutritional deficiencies. Those on a vegan diet, for example, may find it difficult to consume adequate protein and vitamin B. If you think you may have hair loss related to diet, work with a board certified doctor or nutritionist to ensure proper diagnosis and treatment. Vitamins and supplements may help provide balance.
As we’ve all heard in the laundry list of side effects at the end of pharmaceutical commercials, many medications can cause hair shedding. According to Dr. Paul, birth control is a common culprit. “A bad reaction to medication may induce telogen effluvium or shock loss,” he shares. “There is an extensive list of potential medicines that may cause this and not all medicines on the list will cause hair loss.”
If you experience hair loss after starting a new medication, consult with your provider on other potential treatment options. “It is best to review all your medicines — current and new — with your doctor at each visit,” Dr. Paul says. “If you are on a medicine that may cause shedding, you can discuss changing medicines or treatment strategies with your doctor.”
Stress, be it psychological (e.g. the loss of a loved one or a challenging work situation) or physical (e.g. weight loss, surgery, etc.), can cause hair loss and thinning ranging from acute to severe. This kind of hair loss is known as acute telogen effluvium. “The first step is to try and eliminate or lessen the stressor,” Dr. Paul says of treating the condition. While undoing the effects of stress takes time, most patients do see a return to normal growth. “The next step is to try and stop shedding and support regrowth,” he explains. “For many, the cycle of shedding, resting, and regrowth can take as long as a year. Many, but not all, see a near full return of the hair that was lost.”
Dr. Linkov notes that recent studies in mice have shown signaling from the sympathetic nervous system, when subjected to stress, led to the depletion of a stem cell population in the hair follicle. “This discovery sheds light on why stress turns hair prematurely grey and contributes to hair loss,” he says. In the future, such research could improve treatment and prevention options.
8. Medical Conditions
There are a number of medical conditions and treatments (think: chemotherapy) that are known to cause hair loss. Autoimmune disorders like hyperthyroidism, lupus, rheumatoid arthritis, and sickle cell anemia, may cause shedding.
Alopecia is another example of an autoimmune disease that results in hair loss. In this case, the immune system misidentifies the hair follicles and attacks them. Depending on the person, hair loss from alopecia can be temporary or permanent.
Scalp psoriasis, a variation of the common skin condition, causes red, scaly patches to form around the scalp. The condition itself doesn’t cause hair loss, associated itching and scratching can. Assuming it is controlled quickly, hair usually grows back.
Many women experience hair loss at some point in their life, but, for many, the condition is temporary. Consulting with a board certified provider will help to get to the root of why the shedding or thinning is occurring, so proper treatment options can be recommended.
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