Each year, women spend countless hours — and dollars — on their hair. It can play a major role in a woman’s self-confidence and self-esteem, making female hair loss a potentially debilitating condition, socially and emotionally. But it doesn’t have to be.
Dermatologist Valerie D Callender, MD, clinical assistant professor of dermatology, Howard University College of Medicine, Washington, DC, says female pattern hair loss, a condition that affects approximately 30 million women in the US, can occur in women as early as age 20 and it affects all races and ethnicities. This type of hair loss usually comes from a genetic predisposition inherited from either side of the family tree.
“By age 40, visible symptoms of female pattern hair loss are present in 40 percent of women,” says Dr Callender. “Since society has placed a great deal of social and cultural importance on hair and hairstyles, hair loss in women can be devastating.”
Recent research suggests that the psychosocial effects of hair loss are greater in women than in men. Women with hair loss report a higher incidence of feeling introverted, anxious and less attractive, which can interfere with their daily lives.
“Quality of life studies have suggested that there is an increased prevalence of personality disorders in women experiencing this type of hair loss compared to the general population,” says Dr Callender, illustrating one more reason patients need correct diagnosis and treatment.
The first things to check
A common but often overlooked cause of hair loss is diet. Are you eating well, taking in enough protein and other nutrients? Some nutritionists suggest that B vitamins (in particular folic acid, B6 and biotin) as well as minerals magnesium, calcium and zinc. Also consider upping your intake of Omega-3 fatty acids, which are found naturally in fish but are also available in supplement form.
Stress and extreme dieting/weight loss, as well as many types of hormonal imbalances, can also cause excessive hair shedding, which can even lead to bald patches.
Determining female pattern hair loss
“A receding hairline or balding spot usually characterizes hair loss in men, but female pattern hair loss rarely displays either of these symptoms,” explains Dr Callender. “Instead, women see an overall thinning of their hair.” They may notice their center part gradually getting wider, a decrease in ponytail diameter or more hair than usual in the shower drain, on the pillow or in a hairbrush.
“Identification of the cause of hair loss is the key to determining the best treatment,” says Dr Callender. To diagnose hair loss, dermatologists will perform a thorough history, physical exam, laboratory evaluation and in some cases, a scalp biopsy. This relatively simple procedure usually takes place in the office under local anesthesia and involves removing a small piece of scalp for microscopic examination, which can be extremely helpful in diagnosing the type of hair loss.
Medical treatment options
Often a dermatologist’s first step is to use topical minoxidil, which is available without a prescription, to treat female pattern hair loss. It is applied to the scalp twice a day and must be used for at least four months before the patient will see results. “Minoxidil actually works to help reverse the shrinking process seen in these hair follicles and stimulates new hair growth,” says Dr Callender. “It has been proven to re-grow hair in approximately 60 percent of women with female pattern hair loss.”
Another option is hair transplantation, a good choice for women experiencing minimal to moderate hair loss. Though most commonly performed in men, this procedure is becoming increasingly popular with women. This permanent form of hair replacement involves removing healthy hair follicles from one area of the scalp and transplanting them to the areas of hair loss.
“There are several factors that are considered in deciding whether or not a female patient is a good candidate for hair transplantation,” says Dr Callender. “The most important is that the patient has healthy hair in another location that can be transplanted.” While the replacement technique is the same for men and women, there are some additional challenges with women. Transplant locations are usually chosen based on the density and texture of the hair in various areas, which must be carefully considered, especially in women.
“Because women typically have many different hairstyles to choose from, hairstyling must be taken into consideration when choosing the appropriate place to remove the hair,” says Dr Callender.
Check before just covering it up
Another option for women experiencing minimal hair loss is to employ the use of wigs, hair weaves and/or hair extensions. But Dr Callender stresses, “Women experiencing hair loss should see their dermatologist for early diagnosis and proper treatment. By addressing the conditions early, many of the long-term social and emotional effects of female pattern hair loss can be avoided.”