Female-pattern baldness
Women lose hair on an inherited (genetic) basis, too, but female pattern hair loss tends to be more diffuse, with less likelihood of the crown and frontal hairline being lost. Although some women may notice hair thinning as early as their 20s, the pace of hair loss tends to be gradual, often taking years to become obvious to others. There seems to be a normal physiologic thinning that comes with age and occurs in many women in their early to mid-30s. More women have underlying causes of hair loss than men. These include treatable conditions like anemia and thyroid disease and polycystic ovary syndrome (PCOS). These conditions are diagnosed by blood tests along with a historical and physical evidence. Although a few studies have suggested that baldness may be inherited through the mother’s family genes, these theories require further testing. Current studies are inconclusive. Although not indicated for female pattern balding, spironolactone (Aldactone) has had some success in treating this condition.
While stories about hats choking off follicles or long hair pulling on the roots may be more folklore, repeat hair trauma like tightly woven hair pulled back and consistent friction can potentially worsen or cause localized hair loss in some individuals. Individuals who pull their hair tightly back in a rubber band can develop a localized hair loss at the front of the scalp.
Hair loss “myths” of special concern to women
- Longer hair does not necessarily put a strain on roots.
- Shampooing does not accelerate hair loss; it just removes those that were ready to fall out anyway.
- Coloring, perming, and conditioning the hair do not usually cause hair loss. Burns or severe processing may produce hair fragility and breakage. Styles that pull tight may cause some loss, but hair coloring and “chemicals” usually don’t.
What about pregnancy hair loss?
Pregnancy may cause many changes in the scalp hair. As the hormones fluctuate during pregnancy, a large number of women feel their hair thickens and becomes fuller. This may be related to change in the number of hairs cycling in the growth phase of hair growth, but the exact reason is unknown. Quite often, there may be a loss of hair (telogen effluvium) after delivery or a few months later which will eventually normalize.
What specific treatments are there for hair loss in women?
Female hair loss treatments include minoxidil (Rogaine), hair transplants, hair-powder fibers like Toppik, wigs, hair extensions, and weaves.
- Minoxidil (Rogaine) is available over the counter and available in 2%, 4%, and 5% concentrations. It may be something of a nuisance to apply twice daily, but it has been shown to help conserve hair and may even grow some. Minoxidil tends to grow very fine small hairs wherever it is applied. It is important to avoid running the liquid onto the face or neck where it can also grow hair. It is marketed for women at the 2% concentration but may be used in higher strengths as directed by a doctor.
- Surgical procedures like hair transplants can be useful for some women as well as men to “fill in” thinned-out areas.
What vitamins are good for hair loss? Are there home remedies for hair loss?
A good daily multivitamin containing zinc, vitamin B, folate, iron, and calcium is a reasonable choice, although there is no good evidence that vitamins have any meaningful benefit in alopecia. Newer studies suggest that vitamin D may be somewhat helpful and worth considering. Specific vitamin and mineral deficiencies like iron or vitamin B12 may be diagnosed by blood tests and treated.
Multiple vitamins, including biotin, have been promoted for hair growth, but solid scientific studies for many of these claims are lacking. While taking biotin and other supplements marketed for hair, skin, and nails probably won’t worsen anything, it may also not necessarily help the situation. Therefore, advertised hair-regrowth supplements should be approached with mild caution. There is only anecdotal evidence that oral or topical application garlic, onion juice, saw palmetto, coconut oil, evening primrose oil, apple cider vinegar, creatine, and pumpkin seed oil are of benefit for hair loss.
Can itchy scalp cause hair loss?
Itchy scalp may be a symptom of a scalp disease that could produce hair loss. Causes may include seborrheic dermatitis (dandruff) and psoriasis. Treatments may include medicated shampoos like ketoconazole (Nizoral), OTC dandruff shampoos, and topical steroid creams and lotions to help decrease itching.
What is the prognosis for hair loss?
The prognosis for androgenic non-scarring hair loss is guarded due to the fact that there is no cure for the problem. Medications must be taken indefinitely. Other types of hair loss have a good chance of spontaneously resolving.
How do people prevent hair loss?
Hair-loss prevention depends on the underlying cause. Good hair hygiene with regular shampooing is a basic step but is probably of little benefit. Good nutrition, especially adequate levels of iron and vitamin B, is helpful. Treatment of underlying medical conditions like thyroid disease, anemia, and hormonal imbalances may useful in prevention.
