Every woman would have experienced hair loss at some point in their lives. Sometimes, this hair loss could mean a serious underlying condition. Identifying the cause of your hair loss could help determine the right treatment options.
Here, we discuss the hair growth phase and the major causes of hair loss in women. You may identify with some of those. If you also are experiencing some of the symptoms we have highlighted, you might need to visit a doctor.
Table Of Contents
Hair Loss In Women: How Common Is It?
Hair loss is a common issue in women. Research shows that nearly 12% of women in their 20s to 50% of women over their 80s usually deal with androgenic alopecia (1). Postpartum hair loss occurs a few weeks after delivering the baby. Emotional distress causes the most severe type of hair loss in women. To better understand how hair loss occurs, we need to look at the hair growth cycle.
The Hair Growth Cycle
The hair growth cycle has three phases – anagen, catagen, and telogen. Anagen is the growth phase, catagen is the regression phase, and telogen is the resting phase. In the anagen phase, the hair follicles stimulate full hair shaft growth from the root to the tip. In the catagen and telogen phases, the follicles reset and prepare to form new hair shafts, allowing the old hair to fall out.
- Phase 1: Anagen
The hair grows out from the follicles. The shaft is continuously constructed to increase your hair length. Anagen can last for 2 to 6 years.
- Phase 2: Catagen
Your hair prepares to go into resting. Catagen can last for about 2 weeks.
- Phase 3: Telogen
The hair stops growing and eventually falls out to let new hair replace it. Telogen lasts for about 5 to 6 weeks.
Hair loss occurs when your hair falls out without completing this three-stage cycle.
A couple of other phases in this cycle are neogen and exogen. Neogen is the regeneration stage of a hair follicle, where a new follicle grows in the place of an old one. Exogen is the releasing of the old anagen.
The hair growth cycle tells us that it is normal to lose about 100 strands a day. However, heavier hair fall could be caused by various factors. Hair loss can happen in women in different forms. We will look at them below.
Types Of Hair Loss In Women
- Postpartum Hair Loss: Postpartum hair loss occurs a few weeks after childbirth. It occurs due to low hormone levels. During pregnancy, there is an increase in progesterone and estrogen levels. This increase puts hair in a prolonged anagen phase (2), (3). These levels return to normal after the removal of the placenta, causing hair loss. Postpartum hair loss can also be caused due to nutrient deficiencies, post-surgery stress, and hypothyroidism (2), (4).
- Stress-Related Hair Loss: Stress affects the hair follicle development and can impact the hair growth cycle (5). Stress-related hair loss, when left untreated, can lead to serious hair disorders like alopecia, telogen effluvium, and baldness (5).
- Drug-Induced Hair Loss: Hair loss can also be caused by drug intake. Certain drugs can induce either anagen or telogen effluvium (6). These can lead to patterned or diffused hair loss and can be acute or chronic.
- Anagen Effluvium: Anagen effluvium occurs a few days or weeks after taking the drug.
- Telogen Effluvium: Telogen effluvium occurs typically two to four months after you start taking the drug.
- Alopecia Areata: Alopecia is an autoimmune condition that results in patchy hair loss on the scalp and other parts of the body, including eyebrows, eyelashes, and the face (7). It causes your hair to fall out in patches and may lead to complete scalp hair loss or full-body hair loss. Two types of alopecia affect women the most.
- Androgenic Alopecia: Hair loss occurs in patterns. Female pattern hair loss is one such type.
- Alopecia Areata: Hair loss occurs in patches.
- Trichotillomania: A compulsive disorder where the patient pulls out their own hair (8). The constant pulling of hair can lead to severe hair loss.
- Diffuse Thinning: Hair begins thinning all over the scalp.
- Nutrient Deficiencies: Deficiencies in vitamins and minerals, including iron, vitamin D, selenium, and calcium, can lead to hair loss (9).
In the following section, we will explore the causes of hair loss in women in detail.
Causes Of Hair Loss In Women
1. Hereditary Factors
You will likely have a hair loss problem if your parents do. Alopecia is normally caused due to genetics. While this is more evident in men, women too are likely to develop genetically inherited alopecia.
2. Hormonal Changes
Hormonal changes in the body increase the sensitivity of hair follicles, weaken the hair roots, and cause excess hair fall. Issues like menopause, ovarian cysts, hypothyroidism, and hyperthyroidism change the body’s hormonal balance and may lead to hair loss.
During and after pregnancy, most women experience frequent dehydration, fatigue, and hormonal imbalances. These issues increase sensitivity in the hair follicles and create unfavorable scalp conditions, leading to chronic hair loss.
4. Physical And Mental Stress
Drastic and excessive weight loss, persistent illness, and excessive physical labor may exhaust and dehydrate the body. This can cause the hair follicles to become malnourished and weak, leading to hair loss.
5. Scalp Infections
Fungal, bacterial, and viral infections like seborrheic dermatitis and psoriasis on the scalp can weaken hair roots and damage hair follicles. These infections can eventually lead to hair thinning and breakage.
6. Autoimmune Disorders
Autoimmune disorders like alopecia areata are characterized by hair loss that happens when the immune system attacks the hair follicles (10). While there are treatments to reduce this type of hair loss, there is no definite cure.
7. Medication And Treatments
Certain medical conditions call for treatments and surgeries that may cure the ailment, but cause hair loss as a side effect. Treatments like chemotherapy, steroids, typhoid medications, heart disease, depression, and conditions like thyroid issues may cause extreme hair fall.
Alopecia was found to be one of the common adverse effects of Voriconazole, an antifungal medicine (11).
- Acne medications containing vitamin A (retinoids)
- Antibiotics and antifungal drugs
- Birth control pills
- Anti-clotting drugs
- Cholesterol-lowering drugs
- Drugs that suppress the immune system
- Drugs that treat breast cancer and other cancers
- Epilepsy drugs (anticonvulsants)
- High blood pressure medications (anti-hypertensives), such as beta-blockers, ACE inhibitors, and diuretics
- Hormone replacement therapy
- Mood stabilizers
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Drugs for treating Parkinson’s disease
- Thyroid medications
- Weight loss drugs
8. Thyroid Disorders
Thyroid disorders and anti-thyroid medication almost always lead to hair loss. The hair looks sparse, and the hair loss is evenly distributed all over the scalp. Successful treatment often can cause the hair to grow back.
9. Over processing And Styling
Going overboard with chemical hair treatments and hot styling tools can lead to hair fall. Heavy usage of hair products and hair accessories can lead to hair loss. Some hair products, like those containing sulfates, may harm your scalp in the long run. Hair accessories (like elastic bands) are known to pull on the hair. These can cause your hair to fall out. Hairstyles that require the hair to be pulled tight (like tight braids or ponytails) can also cause hair fall.
10. Decrease In Serum Ferritin, Anemia, And Blood Loss
Deficiency of red blood cells in the body, sudden blood loss, and reduced serum ferritin levels in the body can also cause hair loss.
11. Crash Diets And Malnutrition
Insufficient nutrient intake or being on a crash diet can cause malnourishment, leading to excessive hair fall.
Over-supplementation of nutrients like vitamins A and E, and selenium, was found to cause hair loss (15). Consulting your doctor before going for any supplements is ideal. Also, it is better to get your nutrients first from organic foods.
These are the major causes of hair loss in women. While some of them can be reversed with dietary changes, some of them need a medical diagnosis. We have discussed the signs and symptoms you need to look for before visiting a doctor.
When To Consult A Doctor: Symptoms Or Signs To Look For
Consult a doctor if you experience any of the following symptoms:
- Hair loss in an unusual pattern
- Pain or itching along with hair loss
- Red, scaly, or abnormal-looking scalp
- Male pattern baldness (in women)
- Bald spots on the eyebrows
- Weight gain, muscle weakness, temperature sensitivity, or fatigue paired with the hair loss
- A scalp infection with hair loss
The doctor will first check your hair density. They would then conduct a pull test to check the amount of hair that is shedding (the doctor may ask you not to wash your hair for a day or two). The hair is pulled at the ends to see how many hair strands fall out. You may have hair loss if more than 10% of the hair falls. The doctor may also conduct tests to check serum ferritin and Hb levels, thyroid function, vitamins B12 and D levels, and DHT. Lastly, a hair strand is checked under a microscope to determine the phase in which the hair loss occurs.
The Relationship Between Hair Loss And Menopause
Hair loss is common during menopause (16). Period to menopause, the estrogen levels in women decrease and androgen concentrations increase. These changes lead to hair thinning near the front and sides of the hairline.
A change in sex hormone concentration during this time also contributes to hair loss. This change leads to the production of dihydrotestosterone originating from testosterone. It can influence the hair follicles and inhibit hair growth (16).
Women in their mid-forties are more likely to observe a reduction in their hair diameter and density (17).
Dealing with hair loss can be hard. But with the right measures and treatment options, hair regrowth is often possible. Understanding what is causing your hair loss can help you adopt the right practices to treat your condition. Talk to a dermatologist or trichologist who will suggest the right mode of treatment for you.
- Female Pattern Hair Loss: Current Treatment Concepts,
- The Postpartum Telogen Effluvium Fallacy,
- Effect Of Pregnancy On The Human Hair Cycle,
- Diet And Hair Loss: Effects Of Nutrient Deficiency And Supplement Use,
- Stress And The Hair Follicle,
- Drug-Induced Diffuse Hair Loss In Females: An Observational Study,
- Alopecia: Introduction And Overview Of Herbal Treatment, https://www.researchgate.net/publication/307582836_Alopecia_introduction_and_overview_of_herbal_treatment
- Hair Loss In Women,
- The Role of Vitamins and Minerals in Hair Loss: A Review,
- Alopecia Areata,
- Alopecia And Nail Changes Associated With Voriconazole Therapy,
- Telogen Effluvium: A Review,
- Drug-Induced Alopecia: Review Of The Literature,
- Drug-Induced Hair Loss And Hair Growth. Incidence, Management And Avoidance,
- The Diagnosis And Treatment Of Iron Deficiency And Its Potential Relationship To Hair Loss,
- Nutrition Of Women With Hair Loss Problem During The Period Of Menopause,
- Hormonal Changes In Menopause: Do They Contribute To A ‘midlife Hair Crisis’ In Women?,