Hair Loss in Women

What is abnormal hair loss?

It is normal to lose about 100 to 125 hairs a day from your scalp. However, hair loss may be a problem when you lose more than 125 hairs a day from your head, or when new hair does not grow back to replace lost hairs. You may also lose hair from other parts of the body. The loss of hair may be temporary or permanent, depending on the cause.

How does it occur?

There are several types of hair loss in women:

• female-pattern baldness
• local hair loss
• general hair loss.

Like the common male-pattern baldness, female-pattern baldness runs in families. This hereditary baldness 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 in which hair is lost suddenly from a particular area, usually a small area of the scalp (the cause is unknown)
• ringworm, a fungus infection
• cancer therapy
• 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 and hair dyes
• nervous, repeated hair pulling
• permanent skin damage from burns or serious skin diseases.

Pregnancy can be another cause of local, temporary 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 become thicker again. The hair loss will not be permanent or cause obvious bald patches.

General hair loss occurs when all of your hairs enter a resting phase at the same time and then fall out. This may be caused by stressful situations or conditions, such as major surgery, high fever, or severe or chronic illness. Other causes of general hair loss are:

• drug treatment for cancer
• some prescription drugs
• high doses of vitamin A
• thyroid disease.

Alopecia universalis is a rare and severe form of baldness that results in permanent loss of 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 fungus.

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.

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

Sometimes baldness can be treated with medicine. Your healthcare provider may recommend minoxidil (Rogaine) 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 minoxidil daily, you may have some hair regrowth, although the hair may not look exactly like your original hair. This treatment must be continued daily 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. The medicine can cause birth defects (abnormal growth of the genitals) in baby boys before they are born.

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 solution directly on the bald area. This problem can recur.

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 be permanent.

How long will the effects last?

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, tell your healthcare provider. In the meantime, eat a healthy diet, get plenty of rest, and try to reduce stress. This can help you recover faster if an underlying illness is the cause of hair loss.

Avoid irritating the area that has lost hair. For example, do not use barrettes, elastic hair bands, blow dryers, hot combs, or hair dyes or other chemicals. Use a natural bristle brush. When you have lost a lot of hair from your scalp, you may choose to change how you look by keeping your hair short and concealing thin spots with a layered cut. Or you may wear a wig or other type of hairpiece, hats, or head scarves.

Avoid using nonprescription hair-growth products other than minoxidil. These products are generally not effective and may in fact harm the skin and hair.

How can I help prevent hair loss?

There is nothing you can do to prevent most types of hair loss.