Female Hair Loss

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.

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.