Hair Loss in Women

What is hair loss in women?

Hair loss in women is just that — when females experience unexpected, heavy loss of hair. Generally, humans shed between 50 and 100 single hairs per day. Hair shedding is part of a natural balance — some hairs fall out while others grow in. An interruption in this balance — when hair falls out and less hair grows in — causes hair loss. The medical term for hair loss is “alopecia.”

Hair grows on almost all of your skin surfaces — not the palms of your hands, soles of your feet, lips or eyelids. Light, fine, short hair is called vellus hair. Terminal hair is thicker, darker and longer.

What are the cycles of hair growth?

Hair goes through three cycles:

• The anagen phase (growing phase) can last from two years to eight years. This phase generally refers to about 85% to 90% of the hair on your head.
• The catagen phase (transition phase) is the time that hair follicles shrink and takes about two to three weeks.
• The telogen phase (resting phase) takes about two to four months. At the end of this phase, the hair falls out.

Your shorter hairs — like eyelashes, arm and leg hair, and eyebrows — have a short anagen phase (about one month). Your scalp hair can last up to six years or even longer.

What are the types of hair loss in women?

There are three types of hair loss in women:

• Androgenetic alopecia/female pattern alopecia/female pattern hair loss (FPHL)/baldness: This is the most common type. Hair thins over the top of your head and on the sides.
• Anagen effluvium: Medications cause this type because they compromise a growing hair follicle. An example is chemotherapy.
• Telogen effluvium: An increased number of hair follicles reaching the telogen phase causes this type. This is the stage where hair falls out.

How common is hair loss in women?

Many people think that hair loss only affects males. But studies show that more than 50% of females will experience noticeable hair loss. The most significant cause of hair loss in women is female-pattern hair loss (FPHL). This affects about 30 million people in the United States.

What are the signs of hair loss in women?

The signs of hair loss in women may include:

• Seeing more hair fall out daily.
• Having noticeable patches of thinner or missing hair, including a part on the top of your head that gets wider.
• Seeing scalp skin through your hair.
• Tying up smaller ponytails.
• Feeling hair break off.

What causes hair loss in women?

There are several possible causes of hair loss in women, including:

• Damaged hair follicles.
• Changes to your eating habits (rapid weight loss).
• Stress.
• Chemical hair treatments.
• Treatments like chemotherapy or radiation therapy.
• An underlying health condition like an abnormal thyroid, anemia, vitamin deficiency, etc.
• Hormonal changes (pregnancy, menopause).
• Certain medications and supplements (blood pressure medicines, gout medicines and high doses of vitamin A).
• Genetic predisposition (it runs in your biological family history).

What is the relationship between hair loss in women and menopause?

Your body experiences changes during menopause. This can affect your hair and cause:

• Hair growing where it didn’t before.
• The hair you have thinning out.

These changes happen due to varying levels of hormones during menopause. In addition, your hair follicles shrink. This makes your hair grow finer (thinner).

What are the risk factors for hair loss in women?

Hair loss in women can affect any female at any age. However, it’s usually more common if it runs in your biological family history and/or after:

• Age 40.
• Pregnancy.
• Chemotherapy or radiation treatment.
• Menopause.

How will a healthcare provider diagnose hair loss in women?

A healthcare provider will do a thorough examination and take a detailed history to understand changes in your hair growth. Your provider will also ask about what medications or supplements you currently take. Tests may follow the exam. 

What tests diagnose hair loss in women?

The tests to diagnose hair loss in women may include:

• Gently pulling on your hair to see how many hairs come out.
• Scalp examination under a microscope.
• Blood tests. These check for vitamin and mineral levels (like vitamin D, vitamin B, zinc and iron) and hormone levels (like thyroid).
• Scalp biopsy to remove and examine a very small piece of scalp skin.

What questions might your healthcare provider ask to diagnose hair loss?

To diagnose hair loss, your healthcare provider might ask questions about your hair habits, like:

• What kinds of hair products do you use?
• What kinds of hairstyles do you wear?
• Do you have a habit of pulling your hair out (trichotillomania)?

They might ask questions about your history, including:

• Has anyone in your immediate family experienced hair loss?
• Is there anything stressful going on in your life?
• What medications and supplements do you take every day?
• Has hair loss ever happened to you before?
• What foods are in your diet?

Also, they might ask questions about your observations, like:

• How long have you been losing hair?
• Have you been shedding more?
• Have you noticed hair loss in places other than your scalp, like your eyebrows, leg and arm hair?
• Does anything worsen your hair loss?
• Does anything improve your hair loss?
• Have you noticed hair loss occasionally or has it been going on continuously?
• Have you noticed if your hair growth has changed?
• Has your hair been breaking more often?

How is hair loss in women treated?

Treatment for hair loss depends on the cause. It may include:

• Reducing your stress, like talking with a mental health professional.
• Not using hair products (like chemical treatments) that damage your hair.
• Taking vitamins or supplements for a vitamin deficiency. 
• Changing your hairstyling routine to avoid damaging your hair follicles.
• Taking medications.
• Managing any underlying health conditions.

In addition, a healthcare provider might recommend forms of light therapy like using the HairMax Lasercomb®. This low-light laser is approved by the U.S. FDA to treat FPHL. Another FDA-approved laser product is the Theradome LH80 PRO® helmet and low-light laser helmets and caps.

If you have hair loss due to stress or hormone changes like pregnancy, you may not need treatment. The hair loss will stop after a period of time.

Other forms of hair loss treatment may include:

• Microneedling of the scalp with and without the application of minoxidil.
• Injections of protein-rich plasma (PRP) to encourage hair growth.
• Hair transplant surgery. 

It’s important to talk to your healthcare provider before starting any form of treatment for hair loss. Some types of treatment aren’t safe to use if you’re pregnant, planning on becoming pregnant or going through menopause.

What medicines treat hair loss in women?

A healthcare provider might recommend using minoxidil (Rogaine®). This is approved for treating FPHL. You can purchase the 2% or 5% solution over the counter (OTC). However, you have to follow directions exactly and use the product indefinitely. Don’t use this product if you’re pregnant, if you plan to get pregnant or if you’re breastfeeding.

Other medications that treat hair loss in women may include:

• Spironolactone and other anti-androgens.
• Finasteride and other alpha-reductase enzyme inhibitors.
• Estrogens.
• Prostaglandin analogs.
• Steroids.

Are there side effects of minoxidil?

Minoxidil may irritate your scalp and cause dryness, scaling, itching and/or redness. See your dermatologist if this happens.

With minoxidil, you might also see hair growing in places other than your scalp (cheeks and forehead, for example). Wash your face after you apply minoxidil and make sure you avoid other areas when you apply it.

Who treats hair loss in women?

A dermatologist usually treats hair loss in women.

Can hair loss in women be prevented?

You can’t prevent all cases of hair loss in women. You can prevent hair loss caused by chemical hair treatments by not using them. You might be able to prevent some hair loss by eating nutritious foods that provide necessary nutrients (like vitamins, minerals and protein) or adding vitamins to your daily routine.

What is the prognosis for hair loss in women?

The type and severity of hair loss you experience may determine the outcome (prognosis). Some types of hair loss are permanent, especially if you have damage to your hair follicles. But not all cases are. For example, anagen and telogen shedding may stop with time. Managing any underlying health conditions improves hair loss. And early treatment of alopecia may reduce the speed of thinning and promote regrowth. A healthcare provider can tell you more about what to expect in your situation.

What are some tips for dealing with hair loss?

There are some things you can do to manage your hair loss and feel more comfortable, including:

• Changing your hair color. Adding dye can increase strand volume, making your hair seem fuller.
• Massaging your head. When you wash your hair, use your fingers to massage your head to stimulate blood flow to your scalp and hair follicles.
• Changing your hairstyle. Cutting your hair shorter or changing your look with layers or new styling techniques can boost your confidence and potentially hide any hair loss.
• Using different types of shampoo and hair products. Look for a shampoo that adds volume without using sulfate detergents.

When should I see a healthcare provider?

See a dermatologist as soon as possible when you notice hair loss. The sooner you get treatment, the more effective it’ll be.

What questions should I ask my healthcare provider?

You may want to ask your provider:

• What’s the cause of my hair loss?
• How many strands of hair am I losing per day?
• What type of hair loss do I have?
• Will my hair loss be permanent?
• What’s the best treatment for me?