Dealing With Hair Loss as a Woman

When you think of baldness and hair loss, you may conjure up visions of middle-aged men with shiny heads. But women are not immune. According to the American Hair Loss Association (AHLA), as many as 40 percent of those affected by balding are women. And the American Academy of Dermatology notes that hair loss in general affects more than half of American women by age 50.

In the past, balding and hair loss were dismissed as minor cosmetic problems not requiring treatment. But today, researchers are increasingly recognizing that hair thinning in women is a serious problem that can cause embarrassment and low self-esteem and affect quality of life, if left untreated.

“Women are much more affected socially by hair loss than men,” says Amy McMichael, MD, associate professor of dermatology at Wake Forest University School of Medicine, in Winston Salem, NC. “Women judge themselves harshly and have fewer coping mechanisms associated with their hair loss than men.”

Hair Thinning: Factors That Affect Women

From hormones to ceramic flat irons used to straighten hair, abnormal hair loss, also called alopecia, has multiple causes that can affect women, including:

Hormones: Androgenetic alopecia, or pattern baldness, is believed to be triggered by dihydrotestosterone (DHT). Derived from the male hormone testosterone, DHT attacks hair follicles by reducing their size. Although women have far less testosterone than men, menopause can trigger hormonal changes that may cause hair loss. Oral contraceptives can also trigger hair loss in some women.
Androgen index: Progestin implants, hormone injections, and the patch can all contribute to hair loss in women. The AHLA advises all women to use birth control pills with a “low-androgen index,” and women with a family history of hair loss to use non-hormonal birth control.
Stress: Childbirth, surgery, disease, malnutrition, and other forms of stress can cause telogen effluvium, a condition in which women lose hair by the handful. Marital status may also play a role. Researchers from the American Society of Plastic Surgeons found that women who had experienced the stress of losing a spouse, either to divorce or death, exhibited more hair loss than married women.
Autoimmune disorders: Sometimes the body makes antibodies to its own hair. In alopecia areata, white blood cells assault hair follicles and make hair fall out in patches.
Chemotherapy: By attacking growing hair follicles, chemotherapy can cause almost complete hair loss.
Hairstyles: Braids, cornrows, or other hairstyles that pull hair too tightly can cause hair thinning and hair loss. Other hair-loss culprits include chemicals used to process hair and flat irons.
Hair thinning can be devastating for both men and women, so early intervention is advised, says Dr. McMichael: “As with most medical conditions, the key to controlling the hair loss cycle is to seek treatment early."

Hair Loss Treatments

Fortunately, there are several treatment options available for hair loss and thinning hair. Your doctor may prescribe one or more of the following hair loss treatments:

Testosterone-blocking drugs: As women approach menopause, they have decreasing levels of estrogen compared to testosterone. Treatments geared toward blocking testosterone at the hair follicle, such as Eulexin (flutamide) and Aldactone (spironolactone), are helpful in treating hair loss, according to McMichael.
Rogaine (topical minoxidil): The sole treatment for female pattern baldness to receive FDA approval, Rogaine is available over-the-counter in 2 percent and 5 percent solutions and works by stimulating new hair growth.
Treating underlying problems: Curing an underlying condition that is causing the hair loss, such as an inflammatory disorder, can reverse hair loss problems.
Topical or injected cortisone: This can help reverse some hair loss.
Hair transplantation: This involves surgically moving existing scalp hair to thin spots. “Surgical hair restoration is a very helpful treatment for women because women usually have less bald area to cover than men, so it is easier to make the density of hair look fuller,” says McMichael.
Laser phototherapy: Also known as low-level laser therapy, this new light treatment may help to regrow hair. But McMichael says this therapy needs to be refined because its effectiveness in most patients is not yet proven.
Hope for Thinning Hair

Research continues to dispel the notion that some types of hair loss are permanent. Experts at the University of Pennsylvania School of Medicine, for example, recently found that people who struggle with hair loss don’t have dead follicle stem cells, as previously feared — just malfunctioning follicle stem cells, which may be fixable. And another study found that mice with deep skin wounds could regrow hair, sparking hope for a cure for baldness in humans.