Hair loss in women

Håravfall hos kvinnor

There are many reasons for female pattern hair loss. Everything from medical conditions, hormonal changes, stress, to nutritional deficiencies, can affect how your hair feels. It is not always easy to find the root cause of hair loss, so below we describe some reasons why hair may fall out and become thinner.

What are the different types of hair loss?

Hair loss can look different, depending on the root cause. You may notice that you are losing hair all of a sudden, or maybe just that your hair has become thinner over a longer period of time.

Some signs include:

Total thinning of the hair. Gradual thinning of the hair on top of the head is the most common type of hair loss in women. While men tend to see a receding hairline, women generally notice thinning throughout.

Bald spots. These spots can be circular or uneven. They can resemble coins in size and are usually seen on the scalp.

A handful of hair. You may experience a sudden loss of hair, especially after emotional or physical trauma. The hair may fall out when you wash or brush your hair.

All hair falls out. In some medical situations, especially with medical treatments such as chemotherapy, you may suddenly lose all the hair on your entire body.

What are the different types of hair loss?

Alopecia simply means "hair loss". There are a variety of different types of hair loss caused by everything from genetics to hair care routines or something triggering the immune system which in turn attacks the hair follicles.

Androgenic hair loss (alopecia):

  • Male pattern baldness occurs due to increased sensitivity to testosterone of the hair follicle which eventually goes into involution (regrowth). Affects genetically predisposed men and can start after puberty already at the age of 17-18. Usually manifests in middle age in more than half of all men.
  • Female hair loss (androgenetic), as with male hair loss, there is a genetic predisposition and testosterone-sensitive hair follicles. Debuts later than male pattern baldness, at the age of 25-30 and affects about 10% of women. Androgenic alopecia is female pattern hair loss or hair loss caused by genetics or family history. It is the main cause of hair loss in women.

Age-related (senile) hair loss: as part of general aging, you get a reduction in the number of active hair follicles, around 20-30%. Affects both men and women. Can also start early in adulthood (presenile).

Alopecia areata is an uneven hair loss that appears suddenly on the head or body. It usually starts with one or more round bald spots that may overlap.

Cicatricial alopecia is a condition that causes irreversible hair loss through scarring. The hair falls out and the hair follicle is replaced by scar tissue. In up to 3 percent of all hair loss sufferers, this form of scarring hair loss can be found.

Traumatic alopecia causes the hair to fall out as a result of hair styling. The hair may break off after using a hair dryer, straightener, or the use of certain chemicals used in dyeing, etc.

What health conditions can cause hair loss?

Some medical conditions lead to direct hair loss, whether through disruption of hormones, such as with thyroid problems; scarring of the skin, as in ringworm; or autoimmune diseases, such as celiac disease, where the body attacks itself.

Health conditions that can lead to hair loss include:

  • Hypothyroidism (too little thyroid hormones are produced)
  • Hyperthyroidism (too much thyroid hormones are produced)
  • Hypopituitarism (secretion of one or more pituitary hormones is deficient)
  • Hashimoto's disease (also called Hashimoto's thyroiditis and chronic lymphocytic thyroiditis)
  • Systemic lupus erythematosus (SLE)
  • Addison's disease (In Addison's disease, you lack the hormones cortisol and aldosterone)
  • Celiac disease (gluten intolerance)
  • Ringworm (fungal infection of the skin or scalp)
  • Scleroderma (inflammation and fibrotization of the skin and subcutaneous tissue as well as blood vessels and internal organs)
  • Trichorrhexis invaginata (distinct abnormality of the hair shaft)

You may also experience a range of other symptoms if your hair loss is caused by an underlying health condition. Hypothyroidism can cause everything from fatigue to weight gain, muscle weakness to joint swelling. Ringworm can cause scaly and painful, grayish or red patches on the scalp. Celiac disease can cause everything from mouth ulcers to headaches, as well as skin rashes to anemia (lack of blood), etc...

Menopause and hormonal imbalances can cause hair loss

Women may experience hair loss during menopause due to decreased production of the hormones estrogen and progesterone . These changes also lead to symptoms such as irregular menstrual cycles, dry skin, night sweats, weight gain, and vaginal dryness. This increased stress on the body can also worsen hair loss.

Some women may even notice thinning hair and more hair loss after stopping hormonal birth control pills. Why? Again, hormonal changes of any kind, especially falling estrogen levels, can temporarily disrupt the hair life cycle.

Stress can cause hair loss

If you have been under emotional or physical stress, it can lead to hair loss. Things like a death in the family, major surgery or a serious illness can cause the body to shut down certain processes, such as hair production.

There is about a three-month lag between when a stressful event occurs and when the hair falls out.

If you feel that your hair has become thinner but cannot see the reason here and now, think about whether you were exposed to stress back in the day. Hair loss due to stress is generally temporary. The hair can start growing again after the event has passed and the follicle starts producing hair again.

Sudden and temporary changes can cause hair to fall out

The second most common cause of hair loss is called telogen hair loss (effluvium). Here you can lose a lot of hair in the telogen phase in a short time, perhaps 1000 hairs daily, for one or a few weeks. Usually the hair loss comes 2-3 months after the triggering cause which can be:

  • Infectious disease with fever

  • Partus (childbirth)

  • Stress, mainly mental and acute onset

  • Disease state, mainly at the time of onset
    - Thyroid disorders (hypothyroidism, hyperthyroidism)
    - Anemia
    - Deficiency diseases (protein deficiency, zinc deficiency, iron deficiency even without anemia)

    Also chronic diseases such as:
    - Rheumatoid arthritis
    - Diabetes

  • Drug-induced - many different pharmaceuticals can come into question - the most common are anticoagulants (heparin and warfarin derivatives), beta blockers and lithium.

You can sometimes identify telogen hair loss by looking at the root of the hair. Telogen hair has a "lump" of keratin at the root.

Telogen hair loss is generally caused by anything that can shock the body and disrupt the hair's life cycle. There can be a considerable delay – up to three months – before you notice the effects of what shocked the body.

Taking certain medications, such as retinoids, beta blockers, calcium channel blockers, antidepressants, and non-steroidal anti-inflammatory drugs (NSAIDS) can also lead to telogen hair loss. The good news is that this type of hair loss is usually reversible, and eventually the hair will start growing back.

Lack of vitamins and minerals can cause hair loss

Lack of certain vitamins and minerals can also lead to thinning of the hair or hair loss in women and men.

Red meat and other animal foods are rich in iron, a mineral that supports hair growth. Women are already vulnerable to iron deficiency due to blood loss during menstruation, so not getting enough iron in the diet can lead to deficiencies and in turn hair loss.

A deficient diet can lead to vitamin and mineral deficiencies. In particular zinc , iron, vitamin D, vitamin B6 (folate) and vitamin B12 (cobalamin), all of which are important for healthy hair. Even a lack of protein can prevent optimal hair growth.

If you think you have a nutritional deficiency, you can do a BLOOD TEST to see if your hair loss is due to an underlying nutritional deficiency.

What can be done to reduce hair loss?

Hair loss caused by stress or hormonal changes, such as pregnancy or menopause, does not require immediate treatment. Instead, the hair loss will likely stop on its own after the body adjusts.

Nutritional deficiencies also do not require any direct medical treatment – ​​beyond possible dietary supplements, unless the deficiency is caused by an underlying health condition. However, any medical health condition that leads to hair loss should be treated immediately, to address the entire health condition, not just its symptoms.

There are a number of possible medications and treatments for hair loss. You may need to use one or a combination of different treatments for months or years to see the full results:

Minoxidil is a drug that counteracts hair loss and thinning hair. It is meant to be rubbed into the scalp daily and usually needs to be used long-term for months and years to effectively prevent hair loss and promote hair growth.

Spironolactone is a drug that works to treat hair loss by addressing androgenic hormones in the body, by binding to the androgen receptor.

How can male pattern baldness be treated?

Some hair loss treatments are more effective for women than men, and some hair loss treatments, such as the drug Finasteride, are not normally recommended for women.

Finasteride is a drug used for alopecia (hair loss) in men. Finasteride is not recommended for use in women, especially those of reproductive age, as it may cause problems with fetal growth and development.

A doctor may prescribe Finasteride for men if they have male pattern baldness (androgenic alopecia). Men with mild to moderate hair loss may benefit from using Finasteride. Finasteride is a synthetic 4-azasteroid, a specific competitive inhibitor of the intracellular enzyme type II-5-α-reductase. The enzyme converts testosterone to the more potent androgen dihydrotestosterone (DHT). Finasteride therefore lowers the level of DHT, which is a major contributor to male pattern baldness. In this way, Finasteride slows down the hair loss process and prevents further hair loss, in men.

Can surgery make hair thicker?

In a hair transplant, hair follicles are taken from an area where there is more hair and moved to the area where the hair is missing. Hair transplants are not a common treatment for female pattern hair loss due to the fact that hair loss looks different for women.