Noticing a larger-than-usual clump of hair in a tub drain or on a hairbrush -- early signals that hair loss is underway -- can be alarming for any woman. Females are not supposed to lose their hair. But the fact is that more than 20 million women in the United States suffer from hair loss, ranging from mild to severe, so anyone facing this problem has plenty of company.
The first thing to know is that hair loss (the medical term is alopecia) is not just one condition, but several. How to treat it, cure it or learn to live with it will depend on what caused it. The good news is that most female hair loss is temporary and reversible, and even when it isn’t, there’s a lot that can be done about it.
Temporary and reversible causes
- Hair can thin or fall out due to hormonal changes following childbirth, going off birth-control pills, severe illness with high fever or surgery. These are temporary conditions, which usually resolve on their own once the body stabilizes.
- In the case of other hair-loss triggers -- thyroid abnormalities, a hormonal imbalance, anemia, flare-ups of lupus or diabetes, certain medications (chemotherapy drugs, drugs used to treat heart problems, high blood pressure, arthritis, gout and depression), megadoses of vitamin A, crash diets resulting in rapid weight loss, extreme emotional stress, hairstyles that pull the hair too tightly or some chemicals used in hair straightening or perms -- the problem is reversible as soon as the cause is eliminated. Hair almost always regrows when chemotherapy is completed and when thyroid disease, anemia or other disorders are brought under control. In the same way, when emotional stress is relieved or hair abuse stops, so usually do the hair-loss effects.
Conditions requiring treatment
- Androgenetic alopecia. This most common type of hair loss results in hair thinning on the top and sides of the head. The predisposition for it is hereditary. While this condition most commonly occurs after menopause, it may begin as early as puberty.
- Alopecia areata. This type of hair loss affects less than two percent of the population and results in either patchy hair loss from the scalp or, more severely, in total loss of hair from the scalp and body. It affects both sexes and most often strikes children and young adults. While its exact cause is unknown, it is thought to be a disorder of the autoimmune process, in which the body’s immune system mistakenly attacks its own hair follicles. For reasons that are also unknown, alopecia areata sometimes goes into spontaneous remission and hair grows back.
- A woman experiencing hair loss should not waste her time with any of the “wonder cures” that are so widely hawked. “Instead,” says Jon Fortgang, a director of the American Hair Loss Council, “she should consult a dermatologist, who can identify the cause of the problem and go about treating it.” Some options:
- Topical medication. Minoxidil (Rogaine and generic brands) is a liquid applied directly to the scalp. It offers mild to moderate improvement for the majority who use it. Treatments must be continued for life; regrown hair will fall out once it is discontinued.
- Oral medication. Antiandrogen pills, such as spironolactone (Aldactone), have proven effective for many patients. But women who are pregnant or plan to become pregnant should not use this drug.
- Hormones. Female hormones, such as those used in birth-control pills and hormone replacement therapy, are given to stop further hair thinning, but won’t start new hair growth.
- Cortisone. Injections of cortisone into the scalp are used to treat alopecia areata. Cortisone pills, a more potent form of treatment, may also be given.
- Hair transplants. Although women haven’t taken to hair transplants as readily as men, modern techniques are starting to make hair transplantation a more viable option for them. In transplantation, hair follicles are taken from a donor site, usually the back or side of the scalp, and then implanted into the areas where hair is needed. Many sessions may be required. In order to be a good transplant candidate, a woman needs an area of hair that is dense enough for hair to be removed for transplanting.
- Cover-up products. For women with minor hair loss, such as a widening part of a small sparse area on the crown, there are topical hair-building sprays that bind thousands of tiny hairlike fibers to existing hair to cover thin spots on the scalp. They stay in place until shampooed out and do not smear or stain.
- Hair extensions.
- To add volume to thinning hair, there are many kinds of human or synthetic hairpieces, some woven or braided onto existing hair, others clipped or bonded to the head. Depending on how the hairpiece is attached, it may be removed at night or worn for as long as a month.
- Wigs. Women with complete hair loss (temporary or permanent) will find a full selection of natural-looking, lightweight and comfortable-to-wear wigs in a wide range of styles and colors -- made of human hair, synthetic fibers, or a combination of both.