Hair—the color, the style, the abundance—is one of the first things you notice when a woman enters the room. Women invest a lot of energy and money into maintaining beautiful stylish hair. Unlike men who bald and retain their good looks, when a woman starts to experience hair loss, it can be a devastating ego blow.

Why do women lose hair?

Heredity can be the main cause. Of all the wonderful things you would want to inherit from your parents (your mother’s great legs, your father’s expressive eyes), hair loss isn’t one of them! Yet in women, hereditary hair loss can begin in the 30’s and 40’s when estrogen decreases and the level of male hormones, which are normally present, rise. It usually starts with thinning on the top of the head.

Hair grows and sheds in a cycle. Dr. Elaine Cook, M.D., explains that hair grows in a cycle. The growth phase (anagen) lasts approximately 2-8 years followed by a transitional phase of 10-14 days, then a resting phase (telogen) lasting 3-5 months, and finally a shedding phase. When hair is shed, it is replaced by a new hair, starting the cycle again. Normally 85% of hair is in the growing phase, and 15% is resting and falling out. It’s normal to lose up to 100 hairs per day.

Treatment options for female hair loss

Birth Control Pills containing the progesterone component drospirenone, desogestrel or norgestimate, lower testosterone in the blood. For menopausal or post-menopausal women who do not need birth control, Estrogen Replacement Therapy can be prescribed. Dr. Elaine does not prescribe birth control pills or estrogen replacement therapy, but will work with your gynecologist or physician. Spironolactone (Aldactone) is another option. It is a diuretic which lowers male hormone levels. It is only used if there is no chance of pregnancy and with monitoring of blood pressure and potassium.

What else causes hair loss in women?

• Telogen Effluvium – Caused by many factors and occurs when more than the normal 10% of hairs are in the telogen (resting) phase and shed.
• Acute Telogen Effluvium (ATE) - Caused by a trigger, most commonly surgery, general anesthesia, high fever, severe illness, post childbirth, or crash dieting. Once the trigger resolves, hair starts to regrow in 6 months.
• Chronic Telogen Effluvium (CTE) - Shedding lasting longer than 6 months, can be secondary to a variety of triggers including diseases such as anemia and hypo or hyperthyroidism.
• Alopecia Areata (AA) – An autoimmune condition in which the body’s immune system literally rejects the hair follicles causing them to go dormant. Balding can occur in one small area or all over the body.
• Anagen Effluvium – Is caused by cancer treatments. Hair grows back but sometimes with a different texture and color.
• Trichotillomania (Hair pulling) – Some children and adults twist or pull at scalp hair, eyebrows and eyelashes due to habit or stress.
• Tinea Capitus – Ringworm fungus of the scalp and can be contagious. It is treated with oral antibiotics.
• Hair Breakage – Especially common in women due to perms, bleach and dyes that cause hair to break. Physical damage to the hair also comes from use of hair dryers, straighteners and curling irons. Even hair that is frequently pulled into tight ponytails or braids can cause breakage.

Nutrition Solutions

Women should also be aware of their nutrition since hair growth is very sensitive to adequate nutritional intake. Dr. Elaine suggests women review their food intake with a nutritionist but notes that for healthy hair, women’s diets should contain:

Specific Nutritional Recommendations for Treatment of Hair Loss

• Calories—at least 1200 calories/day
• Protein—46 g grams/day
• Essential Fatty Acids (Omega 3 and 6) —1-4 grams/day of fish oil or equivalent
• Iron—18 mg elemental/day. Eat red meat and dark green vegetables. We may ask you to take a supplement.
• Biotin— at least 0.3 mg (300 mcg)/day. Hair and Nail supplements are available 2.5 mg (2500 mcg) or higher
• Zinc— 8-15 mg/day
• Folic Acid—0.4 mg (400 mcg)/day
• Calcium—1000 mg elemental/day
• Vitamin D—600 IU/day
• Vitamin A— 2,500 IU/day. Do not take more than 10,000 IU of Vitamin A per day.

With so many conditions, reasons, treatments and possibilities, it can be confusing for women to know where to turn for help. We understand how upsetting hair loss is for women. Contact Dr. Elaine for a consultation to learn about more options for fighting female hair loss.