Luxuriant, thick, and silky hair is a sign of youth, health, fertility, and beauty. Most women hold their identity in their hair’s appearance and become frantic and lose confidence when their hair thins or falls out. While I cannot cover every cause of hair loss in one article, I’d like to discuss a few of the most common causes and what you can do to improve the health of your hair.
Some Facts About Hair
- You are born with all the hair follicles that you will ever have. Even if you were born with no hair, those 5 million or so hair follicles were present at the time of your birth.
- You have about 100,000 hair follicles on your scalp.
- Hair grows about ½” a month – it is one of the fastest-growing things on your body, which is why it is affected by outside influences (diet, chemotherapy, stress).
- It is normal to lose about 100 hairs a day – hair grows in different phases and when some hairs are actively growing, others are resting, and others fall out. Shampooing may make it seem as though you lose more hair as the hair that was sitting there ready to fall out is easily shed with shampooing.
When I see someone in my office that complains about hair loss, the first important question I ask is: Are you noticing excessive hairs falling out or a gradual thinning of hair over time? This helps me differentiate between the two most common causes of non-scarring hair loss, also known as “alopecia”.
Telogen effluvium. This type of hair loss is when the hair sheds more than the average 100 hairs a day. This excessive shedding typically occurs about three months after experiencing significant stress or hormonal disturbance, including:
- Significant weight loss
- Childbirth or stopping birth control pills
- Surgery, illness, high fever
- Emotional stress (death in the family, divorce, or move)
The good news is that this type of hair loss is usual temporary and usually resolves on its own in six to nine months. But, if the trigger persists, the hair shedding can be chronic so it is really important to try to determine the cause and address it. You can’t always control the situation, but you certainly can control your response to the situation so choose a response that won’t negatively impact your health. Exercise, meditate, breathe deeply, and choose real food packed with nature’s nutrients to give your hair roots the building blocks it needs to grow healthy hair. If you suspect that a treatment or drug is causing your hair loss, talk with your doctor. Don’t ever stop a medication on your own as serious side effects may occur.
Female pattern hair loss (FPHL). A woman who inherits the genes for hereditary hair loss may notice gradual thinning. I have struggled with this personally since I was 19 years old. Many women in my family are bald, and as a child, I remember my dog running around the house with my grandmother’s wig in his mouth. As soon as I felt my first scalp sunburn at 19, I knew my hair was thinning and that I needed to do something about it! Every treatment I mention here I have or am currently doing firsthand. We cannot change our genetics, but we do have the ability to control how our genes are expressed in the environment (epigenetics).
Without treatment, female pattern hair loss can progress from a widening part to overall thinning. Usually, the caliber of the hair becomes thinner at the top of the head along the part line, especially compared to hairs in the back of the head. You have the same number of follicles, but the hairs become much thinner and finer. Some people notice their scalp burning in the sun. Others notice their ponytail is thinner. It is a slow and progressive condition and women continue to lose hair. It also seems to worsen with age due to hormonal influences. Treatment can prevent hair loss from worsening and help some hair regrow. Treatment delivers the best results when started at the first sign of hair loss, and it must be continued forever. Just make it part of your regimen.
Minoxidil (brand name Rogaine). We aren’t quite sure how it works – possibly by increasing blood flow and nutrient delivery to hairs to help them thicken. But, it does work. Products containing either 2% or 5% minoxidil have been approved to treat FPHL. The 2% formulation should be used twice daily and the 5% formulation is once daily. If you overuse it, you will start noticing increased hair growth on your face. To avoid this, apply only to your scalp and wash your face afterward. Be patient because it will take three to six months to work. Best results are achieved at nine to 12 months and maintenance is necessary.
A common side effect of minoxidil is an irritated, scaly, itchy scalp. I usually see this happening from the propylene glycol in the solution and do not see it from the 5% once-daily foam formulation. Some women prefer the solution and others prefer foam, depending on their hair type and style. Women who are breastfeeding, pregnant or plan to become pregnant must avoid minoxidil. Most women experience thickening of their hair during pregnancy so this should be reassuring. After breastfeeding, you can restart minoxidil.
Lasers for at-home use. The FDA has approved laser combs, helmets and other devices that are available without a prescription to treat hair loss at home. These devices emit a low level of laser light that may help stimulate new hair growth. A few studies show that this can be effective for treating FPHL. I use it in addition to other treatments.
Platelet-rich plasma therapy. This therapy uses your own blood, which is placed into a machine that separates the blood into its different components. The platelets, which are a type of blood cell, are treated and injected into your scalp. It is believed the platelets help stimulate your cells to grow hair. If you choose to have this treatment, you will need multiple treatments that average about $800 each, so go to a board-certified dermatologist that specializes in this treatment and don’t take risks.
Supplements. Many supplements, including biotin and folic acid, are said to help grow and thicken hair. In studying these different supplements, the findings have been mixed. Consuming a healthy, colorful, plant-based diet with protein and iron to supply the building blocks necessary to grow new hair is essential. My favorite supplement for hair is Nutrafol. I personally notice an increased growth rate of my hair when using it and my patients have also seen significant benefits.
Hair-loss shampoos: These shampoos tend to do one of the following:
- Help your hair hold moisture, which makes hair look fuller and thicker
- Lessen breakage, which can reduce thinning
While hair-loss shampoos may do the above, they cannot regrow hair or prevent hair loss from worsening. I would recommend spending your money on reparative shampoos or conditioners rather than those that falsely promise hair growth.
Avoid These Things to Maintain Healthy Hair:
- The sun (which is one reason why you should wear a hat when you go outside).
- Chemicals (such as chlorine) in pools – coat your hair with a protectant, wear a cap, and wash hair immediately after exiting the pool.
- Products and treatments that make hair curly or straight or change its color.
- Things you use to style your hair, such as curling irons, flat irons and hair dryers (so don’t use them too much, especially if your hair seems to be getting drier or breaks easily).
Since the hair is no longer alive once it leaves the root, split ends cannot be repaired. All you can do is cut them off.
There are hundreds of causes of hair loss so if you experience pain, redness, scarring, or anything that doesn’t respond to basic guidance mentioned in this article, please seek help from a board-certified dermatologist through www.aad.org. The sooner treatment begins, the better the prognosis. If you are concerned by the amount of hair falling out, you don’t need to suffer in silence. You can turn to a dermatologist for help. These doctors specialize in diagnosing and treating the skin, hair and nails.