Hair Loss: How Does It Affect Women
On seeing a bald man walk past, most of us wouldnt take a second glance. But would this be the case if a bald woman walked past? It is doubtful. Hair loss although distressing is generally more accepted in men, despite women accounting for 40% of all hair loss sufferers in the US. In this Spotlight, we look at the main causes of hair loss in women, the emotional toll it can take and why research is lagging behind in treatment for female hair loss.
The most common cause of hair loss in both men and women is androgenetic alopecia, also referred to as male or female pattern baldness.
A hereditary condition, androgenetic alopecia is believed to be caused by dihydrotestosterone , which derives from the male hormone testosterone.
An enzyme called Type 2 5-alpha reductase present in the oil glands of hair follicles, the skin organs that produce hair helps convert testosterone to DHT. This derivative then binds to and shrinks hair follicles, killing healthy hair.
Because men have higher testosterone levels than women, they are likely to produce higher DHT levels, leading to increased hair loss. As such, men with androgenetic alopecia often experience a receding hairline which can progress to partial or complete baldness, while women tend to experience hair thinning on the top and sides of the scalp.
But androgenetic alopecia is not the only cause of hair loss in women.
Are There Other Treatment Options For Fphl
Women want innovative treatments for FPHL. To meet this need, researchers continue to look for new ways to stimulate hair growth and stop hair breakage. Other treatments that you may find for FPHL include the following.
Lasers for at-home use: The FDA has approved laser combs, helmets, and other devices, which are available without a prescription, to treat hair loss at home. These devices emit a low level of laser light that may help stimulate new hair growth. A few studies show that this can be effective for treating FPHL.
As with minoxidil and prescription medicines, you must continue using an at-home laser device to see results. We still do not know whether these devices are safe for long-term use or if they can continue to produce new hair growth.
Platelet-rich plasma therapy:
It is believed the platelets help stimulate your cells to grow hair.
Researchers are just beginning to study this therapy as a treatment for hair loss. The early findings show promise, but more studies are needed to know whether this is a safe and effective treatment for FPHL.
Stem cells: Using stem cells to treat FPHL is still in the experimental stages. Like platelet-rich plasma therapy, more studies are needed to know whether stem cells are a safe and effective treatment for FPHL.
Hair loss shampoos: These shampoos tend to do one of the following.
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Help your hair hold moisture, which makes hair look fuller and thicker
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Lessen breakage, which can reduce thinning
What Steps Can I Take To Prevent Or Slow Hair Loss
Unfortunately, certain types of hair loss are genetic, and very little can be done to prevent them. Genetic types of hair loss include alopecia areata and female pattern hair loss.
But other types of hair loss can be brought on by stress and a poor diet. Do your best to eat a balanced diet, and find ways to take care of your mental health.
For added benefit, stay up to date with your routine checkups. Anemia, low levels of vitamin D and abnormal thyroid hormones can all affect the health of your hair. Simple bloodwork from your primary care physician can determine if these conditions are contributing to your hair loss.
Black women in particular are prone to a type of hair loss called traction alopecia, which is caused by heat, chemicals and tight styles that pull at the hair root, including some braids, dreadlocks, extensions and weaves.
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What Is A Trichologist
Trichology is the branch of dermatology that deals with the scientific study of the health of hair and scalp. A trichologist is usually a doctor who can diagnose the causes of hair loss, diseases of the scalp and treat accordingly. All dermatologists are trichologists and female hair loss is a particular interest of mine.
What Are The Other Common Causes Of Hair Loss In Women
Telogen effluvium is a form of hair loss that can develop when the body is put through extreme stress, such as child birth, malnutrition or major surgery.
The condition involves a sudden shift from hair growth or resting phases to the hair shedding phase, known as telogen. This can occur within 6 weeks to 3 months after a stressful experience.
According to Dr. Shani Francis, also a fellow of the American Academy of Dermatology and director of the Hair Disorders Center of Excellence at Northshore University HealthSystem in Illinois, telogen effluvium is much more common in women than men. It is the typical shedding that happens after childbirth in some women, she told us.
She added that some triggers of the condition such as iron deficiency and changes in medication are more likely to occur in women. These triggers typically affect women more than men due to menstruation, the most common cause of iron deficiency in women, and the high prevalence of birth control use some women change birth control quite frequently, she explained.
Traction alopecia is another form of hair loss that is more likely to occur in women. It is triggered by trauma to the hair follicles, most commonly through hair styling that continuously pulls at them such as braiding, tight ponytails and hair extensions. This type of hair loss is primarily seen in African-American patients, said Dr. Glashofer.
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What Is A Hair Loss Dermatologist
Hair is technically part of your skin , and while we dont normally think of hair as an element of skin, the two are crucially linked in function and health.
A hair loss dermatologist, then, is just a dermatologist who has specific experience or skill sets related to hair health within their dermal specializations.
Typically, a hair loss dermatologist can help you figure out whats going on with your hair in relation to your skin.
Did your hair fall out following some kind of rash? Are you noticing thinning after switching shampoos? Whats up with all that dandruff? Where did this noticeable hair loss come from?
If these are the types of questions you find yourself asking, consulting a dermatologist that specializes in hair loss could most definitely help provide some insight into what youre dealing with.
Patterns Of Female Hair Loss
Clinicians use the Ludwig Classification to describe female pattern hair loss. Type I is minimal thinning that can be camouflaged with hair styling techniques. Type II is characterized by decreased volume and noticeable widening of the mid-line part. Type III describes diffuse thinning, with a see-through appearance on the top of the scalp.
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How Can A Dermatologist Help With Hair Loss
If youre facing prolonged and unexplained hair loss, set an appointment with your dermatologist as soon as possible. Your dermatologist will perform a detailed assessment of your medical history as well as perform a physical examination. Youll need a blood test to assess your hormones, thyroid, and any deficiencies in some cases. From there, there are several strategies your dermatologist can use to help restore hair growth.
Hair Loss: Diagnosis And Treatment
Dermatologist examining a patient with hair loss
To find out what’s causing your hair loss, a dermatologist may use a tool called a dermascope to get a closer look.
Effective treatment for hair loss begins with finding the cause. To get an accurate diagnosis, it helps to see a board-certified dermatologist. These doctors have in-depth knowledge about the many causes of hair loss and experience treating the diverse causes.
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What Treatments Are Available
Once your dermatologist diagnoses your hair loss, they will determine whether treatment could be effective. Treatments can either help hair regrow more quickly or slow future hair loss. Keep in mind that age-related or genetic hair loss may not be reversible.
Patients who have a medical condition causing hair loss, like a thyroid issue or infection, will need to treat that condition before addressing the hair loss. In some cases, your dermatologist will refer you to a specialist for treatment. If you have a medical condition like alopecia areata, the dermatologist may prescribe medications or recommend an over-the-counter treatment.
In-office procedures can also be effective for some patients. These treatments can include corticosteroid injections, laser therapy, and platelet-rich plasma therapy. You may require repeated treatments before seeing improvement in hair growth.
Its also important to mention that your dermatologist may recommend lifestyle changes to prevent future hair loss. This may include changing your diet, as well as avoiding certain hairstyles and hair pieces.
Hair loss can be complicated, but the team at Pacific Dermatology Specialists can diagnose your condition and recommend treatment. Located in Long Beach, CA and a number of other convenient locations, our medical dermatology professionals are committed to helping you look and feel your best. Contact us today to get started.
How Will A Healthcare Provider Diagnose Hair Loss In Women What Tests Are Done
The tests performed to diagnose hair loss in women can be simple or complicated:
- Gently pulling on your hair to see how many hairs come out.
- Blood tests. These check for vitamin and mineral levels and hormone levels .
- Scalp examination under a microscope and trichoscopy.
- Scalp biopsy to remove and examine a very small piece of scalp skin.
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What Causes Female Pattern Hair Loss
FPHL has a strong geneticpredisposition. The mode of inheritance is polygenic, indicating that there are many genes that contribute to FPHL, and these genes could be inherited from either parent or both. Genetic testing to assess the risk of balding is currently not recommended, as it is unreliable.
Currently, it is not clear if androgens play a role in FPHL, although androgens have a clear role in male pattern baldness. The majority of women with FPHL have normal levels of androgens in their bloodstream. Due to this uncertain relationship, the term FPHL is preferred to female androgenetic alopecia.
The role of oestrogen is uncertain. FPHL is more common after the menopause suggesting oestrogens may be stimulatory for hair growth. But laboratory experiments have also suggested oestrogens may suppress hair growth.
Causes Of Thinning Hair In Women
Some of the causes of female hair loss can include:
- Stress, childbirth and crash diets, which can push your hair suddenly into the resting phase.
- Certain medicines.
- Having an underactive thyroid gland.
- Being short of iron .
- Not enough high quality protein in your diet.
Your doctor may suggest a blood test to check your thyroid and iron levels if you are concerned about hair thinning.
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Lifestyle Changes Can Help
Sometimes certain life events, habits, and circumstances could be behind your hair loss. The goal would be to pinpoint these issues and find a way to resolve them. When this happens, there should be a natural response by the hair follicles. Some of these changes include:
- Review your hairstyles. Tight styles and products can cause traction alopecia or CCCA.
- Look at the products youre using in your hair, such as relaxers. These can cause long-term damage and slow down new growth.
- Stress can cause hair loss over time. Look for ways to reduce stress or remove stressful situations.
- Hair loss can be diet-related. Some diets lack the vitamins and minerals needed for consistent hair growth. Try to add iron and zinc to your diet. Generally, a complete diet with leafy greens, vegetables, and whole grains can improve overall health and support other hair loss treatments.
Your dermatologist can provide much-needed counseling in these areas, along with medication and in-office treatments.
Hair replacement surgery is a viable option to treat hair loss. It is often the last resort for patients with scarring alopecia, where there is severe, permanent damage to the follicles. However, those with pattern baldness can also benefit from surgery.
A Trichologist Is Not Medically Trained
A trichologist can of course help in some cases but can only give patients topical treatment for hair loss, as they are not medically trained. Unlike a dermatologist, they cannot perform tests that help with the diagnosis and evaluation of the condition and inform the best course of treatment these require special training.
For example, a dermatologist can perform a trichoscopy with a video dermatoscopy, a non-invasive technique that allows a rapid and magnified observation of the skins surface enabling the evaluation of hair thickness, presence of regrowing hairs and scalp inflammation. We can also perform a trigonometry, which involves an instrument that provides a numeric value of the hair quality. All of which are vital to in-depth diagnosis.
Dermatologists can also carry out a scalp biopsy, where a sample from the scalp is taken under local anaesthetic and tested under the microscope by a histopathologist. These tests are often necessary to evaluate cases of hair loss.
Only a dermatologist is qualified to carry out these tests, without which a full and thorough evaluation and diagnosis is not possible. Getting to the cause of your condition leads to better treatment. Furthermore, there are a variety of oral treatments available for hair disorders which a trichologist cannot prescribe but a dermatologist can so these are some reasons why you need a dermatologist for hair loss and not a Trichologist.
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How To Find A Dermatologist Specializing In Female Hair Loss
Medically reviewed by Kristin Hall, FNP
We typically think about our hair in cosmetic contexts. Your hair gets styled, cut, colored and otherwise cosmetically altered by professionals who are largely focused in their expertise on how hair looks.
So if youve got long hair and want to make it short, you go to someone who knows how to wield a pair of scissors with precision.
But what about the opposite situation? What happens when your hair isnt growing at all, or is beginning to show signs of damage?
Hair specialists arent a common topic in the medical industry for a reason: hair doctors are typically specialists within another specialty field: dermatology.
So if you have hair problems, you go to a dermatologist. But will just any dermatologist do? Maybe not.
If youre having serious hair issues , its important to find the right healthcare professional for your locks.
How to do that is actually quite simple, once you know what questions to ask, and where to look.