It’s a common belief that hair loss is a men’s issue, but while it does occur more frequently in males, it also affects plenty of women.
According to the American Hair Loss Association, while 85 percent of men will experience visible hair loss by the age of 50, so will 40 percent of women. It’s normal to shed about 100 hairs per day ― anything more than that could be cause for concern.
Hair loss results from many different factors, including genetics, stress, hormonal fluctuations, other medical conditions and in some cases even diet. And though it is generally viewed as a normal part of the aging process for men, for women it can be so much more than that.
Women who experienced female pattern hair loss displayed symptoms of depression, while men were more likely to show signs of anxiety, according to a 2013 report published in the International Journal of Women’s Health.
“There’s such a glory around having beautiful hair that often women will not seek treatment in a timely fashion, which makes hair loss harder to treat,” Dr. Lara Devgan, the New York-based chief medical officer of RealSelf, told HuffPost.
To make matters worse, she also said that people may be doing things to their hair that contribute to hair loss without even knowing it.
With August being National Hair Loss Awareness Month, we wanted to learn more about female hair loss ― what causes it and whether it can be prevented ― so we asked Devgan and Dr. Sophia Kogan, a New York-based dermatologist and chief medical officer of Nutrafol, for insight.
First of all, when we talk about hair loss, what do we mean?
“Hair loss is multifactorial and poorly understood,” Devgan said.
The most common type of hair loss in women is female pattern hair loss (FPHL), also known as androgenetic alopecia, according to a report published in BioMed Research International.
“The condition is characterized by progressive replacement of terminal hair follicles over the frontal and vertex regions by miniaturized follicles, that leads progressively to a visible reduction in hair density,” the report said.
FPHL is more common among post-menopausal women than younger ones, HealthLine said. And it isn’t the only type of hair loss; others include telogen effluvium, which is typically caused by stress and doesn’t necessarily cause permanent damage, and alopecia areata, an autoimmune disease in which the body attacks its own hair follicles. There is also focal alopecia, which can result in patches of hair loss, according to Devgan.
She also said hair loss can occur in different ways for different people. For instance, some individuals may experience thinning all over the scalp, while others may only see thinning in certain areas.
Oh, and for the record, hair loss is not just genetic, though genetics can play a role. As Kogan said, “We’re all genetically predisposed to one thing or another.”
“A lot of people say hair loss is genetic, but I often say the gene pool is the gun and the environment pulls the trigger,” she said. “If you have a genetic predisposition [for] hair loss or anything else, whether or not you get the manifestation of it is really a combination of genetics and what we call epigenetics, or environmental factors that play a role.”
Stress and hormone imbalances can play a part in hair loss.
Stress is hard to escape. People are constantly trying to balance work and life, all while staying constantly connected to the world through computers and smartphones.
Our bodies develop coping mechanisms in response to stress and, Kogan said, we often can’t distinguish the difference between matters that are truly serious and those that aren’t. If our bodies are constantly trying to cope with stress, we experience elevated levels of cortisol (the stress hormone), which can throw off our other hormone levels, she added. (Fluctuating hormone levels are also largely to blame for post-pregnancy hair loss.)
“Women are much more sensitive to hormonal imbalances than men because we have so many fluctuations happening all the time,” she said. “So when you have cortisol elevation, that could throw a lot of other hormones off in the body, including the hormones that are important for hair growth, like estrogen, progesterone and thyroid hormones.”
Additionally, Kogan said, our hair requires a lot of energy to continuously grow through its cycles. And when we’re stressed out, the body’s first response is to minimize energy on things it doesn’t need, like hair.
You may also be doing things that can lead to hair loss without even knowing it.
Going overboard with heat styling probably isn’t doing your hair any favors in the long run. Neither is pulling your hair into an Ariana Grande-style ponytail on a daily basis.
“There’s this pressure, with social media and everything else, to have a perfect hair day every day,” Kogan said. “It puts a lot of pressure on women to look a certain way and as a result, you’re consistently adding more damage to the hair and scalp as a result.”
One blowout here and there isn’t going to be detrimental, she added, but blowdrying your hair on high heat regularly can compromise its health and that of your scalp.
“If you are blow drying your hair, try to minimize the heat settings,” she said. “Maybe it will take longer, but it will be milder and gentler on the hair.”
Devgan said that always parting your hair the same way, constantly pulling your hair back or wearing extensions are also styling behaviors that can contribute to hair loss, specifically traction alopecia, “which means that you’re putting too much pull on the hair follicle and it’s causing the shaft of the hair to fall out.”
“Sometimes if you do that enough, you can get permanent loss or damage,” she said, adding that excessive processing and coloring can also lead to breakage and thinning of the hair.
As for those who swear by silk pillowcases for keeping their hair soft and healthy, Devgan said that while there isn’t enough good data that proves the effectiveness of that, “I don’t think it will do you any harm.”
When should you see a doctor?
Devgan and Kogan agreed that prevention is key for those who want to protect and maintain as much of their hair as possible as they age.
“The sooner you seek intervention, the better, most of the time,” Devgan said. “Hair loss can be a very sensitive topic and it can be embarrassing or stigmatized or difficult to talk about, but if you are noticing hair loss and you speak to a doctor sooner rather than later, you have a higher likelihood of preserving the integrity of your hair.”
If you think you’re experiencing more hair loss than normal, Devgan suggested going to your general medical doctor to find out if your body is responding to any other health issues.
“You want to make sure an unrelated medical condition, a medication you might be taking or another change in your overall medical health is not contributing to your hair loss,” Devgan said.
Kogan said that about 50 percent of hair follicles need to be affected before hair loss is recognizable to the naked eye. So, even if you’re only thinking about potential for hair loss, it’s never to early to have that conversation with a doctor.
“As hair loss progresses, the follicles get thinner and smaller, and produce smaller, tinier hairs, until they’re finally replaced by connective tissue, at which point they’re no longer viable,” Kogan said. “What you want to make sure is that even if you’re concerned about it or thinking about it ― your family history, things like that ― you do go to the doctor. Prevention is a lot easier than restoration.”
What about treatment options ― what’s available?
You may have heard about hair transplants, or the more dated hair plug, but those costly treatments aren’t the only way to keep your hair looking full and healthy. Devgan and Kogan suggested starting with a well-balanced diet with plenty of good fats and protein, as a general rule of thumb.
“There’s not a magic food that’s going to give you hair again, but having a reasonable balanced diet where you’re making sure you’re getting enough protein, particularly if you’re vegetarian or vegan, and making sure you’re getting enough variety in leafy greens, legumes, vegetables [is key], Devgan said.
She said supplements such as Viviscal are on the market that contain biotin and/or folate (a form of B9), both of which are necessary vitamins for healthy hair growth.
There are topical treatments as well, like Rogaine (the brand name for Minoxidil), which are meant to treat thinning hair.
There’s also platelet-rich plasma (PRP) therapy for hair, which uses a derivative of the body’s own blood, which is high in growth factors that help “ramp up the production and activity of stem cells,” Devgan said.
“When PRP is injected into the scalp in a series of four to six sessions over the course of six months, we see a nice improvement in hair growth and I think this is something people haven’t necessarily heard about,” she said.
At the end of the day, the best thing you can do if you’re worried about hair loss is speak to your doctor, who can help you figure out the best route forward.