Hair Loss in Women
30% of all women will experience significant hair loss at some point in their life. In most cases, this hair loss is very upsetting, often much more so than for men, as hair plays a larger role in defining a woman’s self image. Dr. Shim Ching offers a variety of hair restoration options in Honolulu, Hawaii. He begins the treatment process by evaluating possible causes for the hair loss.
Most Common Causes for Female Hair Loss
There are many causes of hair loss in women including genetics and hormones. Aging can accelerate hair loss, accounting for the higher incidence of hair thinning in post-menopausal women. In some situations the hair loss is temporary, but when heredity is involved, the hair loss is almost always progressive and sometimes irreversible.
- Female Pattern Hair Loss – is genetically determined. It affects more than 30% of all women and accounts for more than 95% of all cases of hair loss in women (and more than 99% in men). No specific genetic path has been proven, but in most cases, the individual has one or more female relatives with hair thinning as well. Several patterns have been described with female pattern hair loss, but is most commonly characterized as diffuse thinning concentrated along the top of the scalp, sometimes sparing the very frontal hairline. The sides and back of the scalp can also be affected. The process usually begins in the late 30s to early 40s, but can appear at any time.
- Hormonal Changes – for most women menopause means physical and emotional changes. One area affected is the scalp, where the change in the ratio of estrogen to testosterone can result in an onset of female pattern thinning. Pregnancy is another example of fluctuating hormones leading to hair loss, which mostly starts several weeks to months after delivery, and which is contributed to by the physical stress it takes on the body. During pregnancy, due to increased metabolism and the higher levels of hormones, the body holds onto more of its hairs. After delivery, once the pregnancy is over, the body then typically sheds all of the hair it would have shed during the pregnancy. This results in a mild to moderate thinning that many women notice. Many other hormonal imbalances can be associated with hair loss, including hypothyroidism and polycystic ovaries.
- Stress – most people consider stress to be psychological, but a variety of things can inflict physical stress on our bodies. A very high fever, significant weight loss from dieting, pregnancy and surgery are some of the causes of stress-induced hair loss, and almost always are temporary. But emotional stress, such as grieving or depression, can also play a role in hair loss.
- Trauma – hair can be damaged by hair weaves and hair styles that pull on existing hairs. This type of hair loss is so common there’s even a name for it: traction alopecia. It one of the most common causes of hair thinning in African-American women, but traction alopecia can affect any woman.
- Medication and Medical Treatments – with chemotherapy an obvious example, there are numerous medications reported to be associated with hair loss. Some anti-inflammatories (e.g. Vioxx- now off the market), anti-hypertensives such as beta blockers, birth control, and hormone replacement therapy have been associated with hair loss.
When choosing an oral contraceptive or hormone replacement medication, it’s important to discuss your concerns and goals with your physician, as these medications can vary in the levels of different hormones they supply. Radiation therapy administered to the head can also result in hair loss.
- Local and Systemic Diseases – includes a wide variety of different medical conditions associated with hair loss. Anemia (low levels of iron or ferritin, the protein that carries iron in the blood), nutritional abnormalities, some autoimmune diseases such as lupus and rheumatoid arthritis infections, and hypothyroidism, to name the most common.
In many of these cases, the patient has an underlying genetic risk for hair loss, and the active process accelerates it. Attempts to determine the disease are undertaken to slow down or even stop the progression of the hair loss, but usually doesn’t result in any significant degree of hair regrowth.
- Nutritional Factors – certain diets, especially when they involve crash dieting, or some chronic conditions like alcoholism, may result in hair loss. For healthy hair growth, vitamins such as iron and zinc, and adequate levels of protein and amino acids are required.
For women who maintain a complete diet, this shouldn’t be an issue, but there’s little harm in taking iron and zinc supplements or other nutritional items that promote healthy hair growth.
Treatments for Female Pattern Hair Loss
First step: Minoxidil 2% applied preferably twice, or even once, a day to the areas of thinning. Assess response to this conservative treatment after 4 to 6 months.
Second step: For nearly all women, the gold standard for treatment is hair transplant surgery. This is the only intervention that can truly improve the density to areas experiencing hair loss. The success of this treatment is most dependent upon:
- Surgical Technique – where the emphasis is on efficiently using the limited supply of donor hair while minimizing damage to already existing hairs. Both are accomplished through microscopic dissection and hair planting techniques
- Patient Expectations – the importance of establishing realistic expectations for your hair loss treatment cannot be overemphasized.
- The Type of Hair Loss Pattern – in general, better results can be obtained when the hair loss is due to actual loss of hairs (with spaces between existing hairs) than when the hair loss is due to thinning of the individual hairs in the area.
- The Donor Density – where there’s a higher concentration or density of hairs, or hairs that are individually thicker, in the back and/or sides of the scalp (donor area), the improvement in density will be greater.
Women (and men) who suffer from thinning eyelashes can use LATISSE®, a prescription serum applied at home every night, to encourage natural eyelash re-growth.