Overview: What does hair loss in women look like?
Some hair falling out in the shower or on a hairbrush is a normal part of the hair growth cycle. Most hair that falls out grows back. Hair loss happens when hair doesn’t grow back when it falls out. While most people think of hair loss as involving the top of the head, hair loss can happen anywhere on the body. Hair loss can happen gradually, or it can fall out rapidly. It may get thinner or leave a bald spot. Hair loss can be uniform or fall out randomly, resulting in bald patches. Sometimes, hair loss is accompanied by skin symptoms such as plaques, scars, redness, swelling, or discolored skin. Hair loss can be reversible or permanent. It depends on the underlying cause.
What causes hair loss in women?
The most common cause of hair loss among women is age-related female-pattern hair loss (FPHL), also called androgenic alopecia or androgenetic alopecia. It is similar to male pattern baldness, but the hair loss pattern is slightly different. Women primarily lose hair on the top of the head rather than a receding hairline. Female pattern hair loss sometimes begins during a woman’s reproductive years. Approximately 12% of women have detectable hair loss by the age of 29 and 25% by the age of 49. It’s more common after menopause. Over half of women older than 80 have female pattern hair loss.
Medical conditions are also common causes of hair loss in women. These include:
Fungal infections such as tinea capitis
Other types of infections
Autoimmune disorders, including alopecia areata (an autoimmune reaction in which the immune system attacks hair follicles), scalp psoriasis, lupus, Grave’s disease, and Hashimoto’s thyroiditis
Hormone disruptions including underactive thyroid, overactive thyroid, polycystic ovary syndrome (PCOS), and childbirth
Severe chronic illness
Cancer
Malnutrition, particularly iron deficiency and vitamin D deficiency
Eating disorders such as anorexia
Injury to the skin, including burns and chemical damage
Physical stress
Hair thinning and hair loss can also be due to lifestyle factors or behaviors such as:
Hairstyling can also thin the hair through:
Tight hair styling (traction alopecia) such as braids or ponytails
Excessive or forceful hair brushing
Excessive hair washing
Use of certain types of hair products that damage the skin or hair follicles
Use of certain types of hair styling processes that damage the skin or hair follicles
Drugs can also cause female hair loss as a side effect, particularly chemotherapy drugs, anticoagulants, hormonal birth control methods, and corticosteroids. Fortunately, hair loss as a medication side effect is usually reversible.
RELATED: Why is my hair falling out? Learn the causes of hair loss
Should I be worried about hair loss in women?
Although hair loss is distressing, it is not a health threat. Even so, unusual, unexplained, or rapid hair loss can indicate an underlying medical condition that should be evaluated and treated. See a healthcare professional if hair loss involves:
Hair shedding or falling out in clumps
Scars, skin discoloration, skin flaking, swelling, or other skin problems in the areas where hair is falling out
Patchy hair loss
Unusual hair loss, such as eyelashes, eyebrows, or other parts of the body
Other whole-body symptoms such as weight change, fevers, or fatigue
How is the cause of hair loss in women diagnosed?
To find the cause of hair loss, a healthcare professional will start with a medical history and physical examination. Women may initially see a primary care physician or similar healthcare provider. They may refer her to a specialist in skin diseases called a dermatologist, a specialist in hormone disorders called an endocrinologist, or other specialists.
In a physical examination, a healthcare provider will examine the hair to determine the type and extent of hair loss. The clinician will look for bald patches, scarring, discoloration, or other skin problems.
The clinician may also perform a few tests on the hair to determine how it’s falling out. These tests might include:
Pulling on the hair and counting the number of hairs that come out (pull test)
Trying to break hairs above the root to see where on the hair shaft the breakage occurs (tug test)
Parting the hair to evaluate new hair growth (card test)
Asking a woman not to shampoo for five days and then collecting hairs that fall out during shampooing for evaluation (modified wash test)
Pulling 60 to 80 hairs from the scalp and examining the hairs under a microscope (trichogram)
A skin biopsy may be needed if the clinician suspects there may be an infection or an autoimmune disorder. Blood tests can help identify thyroid issues, hormone levels, or nutritional deficiencies.
RELATED: When to see a dermatologist
How long does hair loss in women last?
Hair loss or thinning in women may be temporary or permanent, depending on the cause. Some types of hair loss can be treated with hair regrowth medications or procedures:
Female pattern hair loss is not reversible without treatment and, even then, may only be partly reversible
Hair loss due to drug side effects, chemotherapy, hormone imbalances, stress, habits (such as hair pulling), hair styling, and nutritional deficiencies are usually completely or partly reversible when the underlying cause is fixed
Hair loss due to infections or autoimmune disorders may or may not be reversible, so some or all the hair loss may be permanent
How to stop hair loss in women
If hair loss is due to female pattern baldness, some hair regrowth is possible through hair regrowth treatments. These include:
Research has yet to prove that many of these medical treatments are effective except for minoxidil. Hair transplants are considered a viable treatment option when hair loss has stabilized.
When there’s an identifiable cause, such as an infection, health condition, behavior, or drug side effect, the underlying cause is treated. The hair loss is often reversible when the cause has been treated. This includes:
Some causes of hair loss destroy the hair follicles. This includes autoimmune disorders, burns, injuries, infections, or hair pulling. The hair loss is permanent, and there are few treatment options for restoring hair growth.
RELATED: Does finasteride work for women?
Living with hair loss in women
No matter the cause, women who experience hair loss may find it distressing or hard to live with, especially if it is permanent. In addition to medical treatments, women have several options to slow the progress of hair loss:
Avoid hairstyles that pull on the hair
Use gentle hair products
Avoid harsh hairstyling, perms, and chemicals
Use a gentle brush, and don’t overbrush
Practice good skin and scalp care
Avoid getting a sunburn on the scalp or other parts of the body
Manage stress
Practice relaxation techniques
Eat a healthy diet
Avoid crash diets that promise rapid weight loss
Hair weaves are successful at filling out thin scalp hair. Wigs are also successful and can be custom-made.
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