Female Hair Loss: Overview
Hair disorder, especially when severe, often profoundly affects the lives of those afflicted. Severe hair loss evokes not only cosmetic concerns but may also evoke feelings of vulnerability (nakedness), loss of self-esteem and alterations in self-image.
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Each hair follicle produces hair in phases. There is a growing (anagen) phase, which lasts from 2 to 6 years, a resting (catagen) phase which lasts for about 3 months, and finally the shedding of the hair (telogen) phase which allows the follicle to begin pushing a new hair to the surface.
Most modern medical research leans toward the position that a male hormone called dihydrotestosterone (DHT), which is converted from testosterone, binds to sites on hair follicles and is a primary instigator of hair loss. DHT appears to make the follicles go into their "resting" phase faster which in turn starts to cause the hairs produced by those follicles to become thinner and thinner with each growth cycle.
Although hair loss is a concern for many men, hair loss in women is also a problem.
Incidence; Causes and Development
Female pattern baldness usually begins about age 30, becomes noticeable around age 40, and may be even more noticeable after menopause. It is thought that about 15% of American women have such hair loss; around 30% of affected Caucasian females are affected before menopause.
As in males, hair follicles simply shut down. Women rarely lose their hair due to a genetic predisposition; instead it is usually caused by hormonal imbalance and other cyclical shifts such as during/after pregnancy, postmenopausal trauma or birth control side-effects. Other causes include nervous tension, side-effects of certain medications, harsh commercial shampoos, perms, hair color, bleach, blow-drying, and improper combing/brushing.
One plausible theory to explain some of the difference between men and women is based on the angle of follicles and resultant sebum build-up. The angle at which hairs come out of a female scalp allow the sebum (oil produced by the scalp) to "run off" whereas the angle of hairs on a male scalp (straight up) can lead to oil blockage.
Common causes of hair loss or hair thinning in women:
- thyroid or liver disease
- hepatic or renal failure
- anesthesia
- childbirth
- starting or stopping birth control pills
- very high fever
- severe stress
- anemia (sometimes seen in runners)
- hypothyroidism or hyperthyroidism
- essential fatty acid deficiency
- zinc deficiency
- any condition that upsets the ovarian, adrenal, or pituitary axis
- protein deficiency (common with vegetarian diets)
- anorexia or bulimia
- too much vitamin A
- local viral, fungal, or protozoan infection
- drug toxicity
- antimitotics – such as those used for chemotherapy
- bromocriptine – used to inhibit lactation
- beta blockers
- ACE inhibitors
- amphetamines
- anticholesterol agents
Signs and Symptoms
It is usually an overall thinning rather than a bald area on top of the head, though women may have a receding hairline, too.
Treatment and Prevention
Most doctors agree that if you have a oily scalp with thinning hair, frequent shampooing is advised. Shampooing can reduce surface sebum, which contains high levels of testosterone and DHT that may reenter the skin and affect the hair follicle.
Specific foods or vitamins don't regrow hair, although good nutrition is essential for healthy hair.
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Female Hair Loss:Signs, symptoms & indicators of Female Hair Loss:
Symptoms - Hair
Risk factors for Female Hair Loss:
Autoimmune
Lupus, SLE (Systemic Lupus Erythematosus)
Alopecia occurs in 50% of patients. Typically manifested as reversible hair thinning during periods of disease activity, it is demonstrated by the ease with which hair can be plucked from the scalp and the development of "lupus hairs" (i.e. short strands at the scalp line). Following an acute attack of SLE, usually with fever, patients may experience much generalized hair loss. This results from a period of arrested hair growth during the acute episode.
Diet
Effects of a Low Carbohydrate Diet
Hair loss is a common side-effect of low-carb diets. A study funded by Dr. Atkins himself found that about 10% suffered from hair loss. The precise cause is unknown at the time of writing: it may be due to basic malnutrition, or, as one of our doctors notes, "I've seen this over and over again in my practice. Basically, this diet can cause your cortisol levels to go sky high, which will lead to hair loss. Ideally, you should change your diet to help solve this problem."
Drug Side-Effect
Environment / Toxicity
Glandular
Hypothyroidism
In rare cases, diffuse hair loss may be the only symptom of hypothyroidism, but in many people with hypothyroidism the hair is not affected. Once thyroid hormone is administered, regrowth of hair occurs in approximately 2 months.
Hypothalamus / Pituitary / Pineal Dysfunction
Any condition that upsets the ovary, adrenal or pituitary gland may result in hair loss.
Hormones
Infections
Yeast / Candida Infection
Candida can cause hair shedding in male or female patients. The exact mechanism is unclear because there are so many possible pathways. The three most likely pathways are thyroid dysfunction, allergies and enzyme suppression.
Nutrients
Vitamin A Toxicity
Vitamin A toxicity symptoms include skin that has a rough and dry appearance, hair loss and brittle nails.
Zinc Requirement
Mineral metabolism of 19 patients with hair loss was examined. Twelve of those patients had problems with their zinc metabolism. Specific nutritional and mineral therapy resulted in improved hair growth after 2-3 months of treatment. [Blaurock-Busch, E. Wichtige Nahrstoffe fur Gesunde Haut und Haare, Kosmetik Internat. 3/87]
Manganese Requirement
Mineral metabolism of 19 patients with hair loss was examined. The analysis showed manganese deficiency in all 19. Specific nutritional and mineral therapy resulted in improved hair growth after 2-3 months of treatment. [Blaurock-Busch, E. Wichtige Nahrstoffe fur Gesunde Haut und Haare, Kosmetik Internat. 3/87]
Calcium Requirement
Mineral metabolism of 19 patients with hair loss was examined. Eighteen of those patients showed considerable problems with calcium absorption. Specific nutritional and mineral therapy resulted in improved hair growth after 2-3 months of treatment. [Blaurock-Busch, E. Wichtige Nahrstoffe fur Gesunde Haut und Haare, Kosmetik Internat. 3/87]
EFA (Essential Fatty Acid) Requirement
Essential fatty acid deficiency can results in dry, brittle hair and hair thinning or loss.
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Recommendations for Female Hair Loss:
Diet
Animal/Saturated Fats Avoidance
Researchers in one study noted that Japanese hair was thick and healthy, with a small gland and little scalp oil, until large amounts of animal fat crept into their diet after World War II.
Drug
Laboratory Testing
Test for Hormones
There have been several reports that supplemental DHEA has accelerated hair loss in susceptible men and women. Hormone level testing is advised prior to hormone use.
Test Iron Stores (Ferritin)
Iron deficiency can cause hair loss in women. Laboratory evidence of such a deficiency may show up on a complete blood count, serum iron or serum ferritin.
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Last updated: Jun 15, 2023