Hair Loss in Women
The incidence of female hair loss is increasing and can effect women of all ages, starting as early as their 20s. There are many contributing factors that influence hair growth and hair loss in women, thus making the diagnosis and management more complicated than that for male patients. Hair loss in women may present in many different forms: a gradual thinning of the sides and top of the scalp, progressive widening of hair partings, excessive shedding from the entire scalp, receding of the frontal hairline, bald patches or breakage of fragile hair.
What causes Hair Loss in Women?
Even though hereditary hair loss accounts for the majority of hair loss in females, a wide range of factors can influence the process. These include stress, medications, general health status, nutritional deficiencies, iron deficiency, genetics, hormonal imbalances, thyroid disease, PCOS (polycystic ovarian syndrome), auto-immune conditions, contraception and other less common factors.
This makes a thorough consultation, a clinical and microscopic examination and further laboratory investigations essential in the workup and diagnosis of the underlying cause of women’s hair loss.
What are the options to treat Female Hair Loss?
Hair and skin are complex and sensitive tissues that respond to the internal environment of the body and can reflect changes and imbalances that are happening. There is always a reason for hair thinning, once this has been determined treatment options can include:
- Topical or Oral Medications
- Growth Factor Injections
- Dermapen Microneedling Follicle Stimulation
- Autologous Growth Factors (Platelet Derived)
- Hair Transplant
What are the common causes of Hair Loss in Women?
Androgenetic Alopecia (Female Pattern Hair Loss)
This is the most common type of hair loss experienced in female patients. It has a strong hereditary component and the incidence increases with age. It presents as a slow, progressive thinning of the hair affecting predominantly the frontal areas, sparing the back aspect of the scalp. Despite the term ‘patterned hair loss’ this condition can manifest as a diffuse thinning of hair.
The exact aetiology of FPHL is yet to be determined, although it does have an association with certain underlying medical conditions and is effected by hormonal balance.
Telogen Effluvium (Hair Shedding)
Excessive sudden hair shedding can reflect that the body, or mind, has gone through a period of stress. This stress can be experienced in many forms such as a result of nutritional changes, nutrient deficiencies, hormonal fluctuations, change of medications, infection, surgery or psychological stress. The process typically begins around 6-12 weeks following the stressful event.
This happens due to a rapid change in the growth cycle of hair, where they go from the anagen (growth) phase to the shedding (telogen/exogen) phase. This phenomenon is known as telogen effluvium. A common example of this would be post-COVID hair loss that was experienced by many people. The positive part about having this condition is that it infrequently leads to permanent hair loss, and if the stress or triggering event is removed it is possible to regain your hair over time.
Traction Alopecia
Traction alopecia is caused by repetitive and persistent trauma to the hair follicles as a result of tight hairstyles, braids and extensions. This type of hair loss is most commonly experienced in the frontal and temporal scalp and most frequently affects females of African descent with afro-textured hair.
The tension placed on the hairs causes damage that is reversible if it is treated early, but with continued traction it does result in permanent loss of hair follicles.
Alopecia Areata
This is a chronic immune-mediated condition whereby the body targets it’s own hair follicles, damaging them and causing hair loss. Alopecia areata presents with initially small, round patches of smooth skin in between normal appearing areas of hair on the scalp which can progress to involve the entire scalp. Hair loss can also occur on other areas such as within the eyebrows, beard and on the body.
The mainstay of treatment for alopecia areata is to suppress the immune response through medical therapy.