The reasons for hair loss in women are many and vary greatly from woman to woman. Normally, a woman loses about 50-100 strands of hair on a daily basis according to the American Academy of Dermatologists. Although this may seem like a big number, it really does little to change the appearance of our hair in general. This is because we have more than 100,000 strands of hair all over our scalp.
Hair loss in women over the age of 20 typically occurs in two ways; female pattern baldness (medically known as Androgenetic Alopecia) and Telogen Effluvium, which is when hair is “coming out in handfuls”. In the first case, hair loss begins by thinning of the hair follicles mainly in and around the forehead and near the temples. This is usually a gradually occurring process beginning in teenagers and slowly increasing as women age. Telogen Effluvium, however, typically affects the top of the scalp and is brought on by factors such as extreme stress, pregnancy, and other hormonal changes.
To answer the question of why women have hair loss can be tricky and contribute to a number of factors. Here are the top 10 reasons why I think women have hair loss problems.
1. Poor Hair Ettiquette
Surprisingly, most hair loss in women happens because of self-inflicted reasons. Certain hairstyles, like a super tight ponytail/bun/braids/cornrows, parting hair the same way, a tight headband, and using a wrong hair comb/brush can all contribute to repeatedly stretching or splitting out the hair follicle, thereby hampering hair growth. This is called Traction Alopecia.
Excessive use of hair styling tools like hair dryers and flat/ curling irons and hair products like gel, mousse, hair sprays, hair dyes, etc can further aggravate the condition. How frequently and infrequently you wash your hair, what shampoo you use (harsh chemicals), excessive brushing or towel drying wet hair can all make hair weaker, increasing more fall out.
2. Severe Stress
Our daily lives are full of stress and anxiety but the key is to manage these levels of stress even when life gets super chaotic. Certain kinds of life changing events like marital conflicts leading to a divorce, death of a loved one who was being cared for, losing a job, and even relocating to a new city or town can all lead to extreme stress that can cause significant hair loss.
Trauma or tragedy arising from an unfortunate event like a house fire, car accident, natural disaster, etc can all cause extreme levels of emotional stress that trigger a response in our body, stopping the cycle of hair growth. Normally, our hair growth cycle begins with the growth phase, followed by a resting phase, and then ending with the shedding phase. These traumatic life events can trigger severe stress that pushes hair straight into the shedding phase.
3. Hereditary & Age
Genes have an important role to play in the process of hair loss in women. A higher family history of female pattern hair loss from either side of the family appears to be a risk factor for developing the condition (Androgenetic Alopecia) . The onset is said to be seen in as early as teenage years and hair loss gradually increases as a woman grows older. However, genetic reasons for hair loss are more commonly linked in men than women, causing baldness or hair to shorten and resemble “peach fuzz”. Women rarely develop baldness from hair loss and tend to lose hair more slowly than men do.
Androgen production: Female pattern hair loss in some women is a result of excessive androgen levels, more specifically dihydrotestosterone (DHT), which is a sex hormone produced from testosterone. DHT causes a disruption in the normal life cycle of hair, either killing off the follicle or causing less hair growth. Women with this type of hair loss usually notice a diffuse thinning pattern across the scalp.
PCOS:Polycystic Ovarian Syndrome is a hormonal condition prevalent in women of childbearing age with high blood sugar levels, insulin resistance, or obesity. In this condition, the excessively circulating androgens convert to DHT that further cause fluid-like sacs or cysts to form in the ovaries. Due to the hormonal imbalances in the body, hair growth is negatively affected causing more hair loss.
Pregnancy: Hair loss connected to pregnancy usually occurs after delivery (Postpartum hair loss). This is because the rise in female hormones during pregnancy keeps the hair in the resting phase and hair begins to fall rapidly 3-4 months after delivery when hormones are returned to normal levels and hair returns to its normal cycle.
Menopause affects the body’s normal production of female hormones (estrogen & progestin), increasing its sensitivity to male hormones (specifically DHT). This triggers hormonal hair loss affecting the hairline and overall hair density. Depending on the age women tend to enter menopause, is when they will start to notice hair thinning (normally between age 50-60, but also as
5. Iron Deficiency (Anemia)
Anemia is when our body is unable to produce sufficient levels of iron. Iron is critical for the production of hemoglobin, a protein that helps red blood cells deliver oxygen all throughout our body. Most of the time, iron deficiency in women is a result of a poor diet that’s lacking in nutrients.
Another common cause for low iron levels is a heavy menstruation that reduces adequate supply of folic acid in the body. This results in low hemoglobin production, which means less oxygen supply to our vital organs. When oxygen is unable to reach our hair follicles, hair tends to become brittle and weak, thereby causing more hair fall than normal.
6. Protein Deficiency
Our hair is made up of a fibrous protein called keratin that forms the entire structure of our hair. Keratin is vital for healthy hair because it helps in creating and building hair follicles by providing it sufficient nutrients that help hair grow and stay rooted in our scalp. When we fail to have a protein-rich diet, the body immediately begins to safeguard the remaining protein in our body for our vital organs. Since hair is not vital for our survival, protein is depleted from our hair follicles, causing it to become weak and fall out prematurely.
7. Rapid Weight Loss
Sudden weight loss or losing an extreme amount of weight can cause physical stress leading to hair loss. Women typically are overzealous to lose weight fast and consequently, try crash diets that deprive their body of essential nutrients. These strict diets place a ban on certain food groups that provide the body with much-needed protein, fats, vitamins, and iron. Lack of these nutrients sends our hair into the dormant phase (Telogen phase),where hair follicles usually fall excessively or stop growing. Eating disorders like Anorexia also causes rapid weight loss and furthers the risk of increasing hair loss in women.
8. Injury or Infections
Physical trauma, surgery, or shock to the head can have an adverse effect on the hair follicles. It may either damage an area on the scalp causing permanent lack of hair growth or it may cause temporary damage to the hair follicles causing ripping/uprooting of hair strands. Depending on how severe the head injury is, hair loss will occur accordingly.
Scalp infections that are fungal or bacterial can enter the scalp through hair follicles or damaged skin. This can lead to a build up of sebum (dandruff) that causes the scalp to become dry, flaky, and itchy (a condition called Seborrheic Dermatitis). This in turn, dramatically reduces the health of the scalp, hair follicles and the overall shaft of the hair, promoting more hair loss.
9. Autoimmune Illnesses and Other Conditions
Alopecia Areata is an autoimmune disease where the immune system mistakenly attacks the hair follicles causing round patches of hair loss. This form of “spot baldness” is thought to be caused by hair follicles becoming dormant.
Lupus is another autoimmune disorder where antibodies created by the body infiltrate the hair follicles, causing the hair shaft to be rejected by the body and fall out. Sometimes hair may regrow but if there are any scarring in the follicles, hair loss may be permanent.
Thyroid disease: thyroid glands play an important role in proper growth and development of our hair with the help of secreting vital hormones. Both hypothyroidism (under-active thyroid) and hyperthyroidism (overactive thyroid) can cause hair to become dry, brittle, and weak.
Diabetes has a significant impact on the blood circulation of the body. Fewer amounts of nutrients and oxygen are delivered to the upper and lower extremities of the body (feet and scalp areas). Due to this poor blood flow to the scalp, hair follicles die resulting in hair loss.
Psoriasis is a skin condition which usually occurs in the elbows, knees, knuckles but may also occur on the scalp. When the scalp is impacted, scaling is severe and as a result the diameter of the hair is affected causing hair breakage.
Hair loss is a common side effect of many medications. These medications oftentimes damage the hair follicles directly, disrupting growth at different stages. Various hormone therapies produce hormone imbalances in women resulting in hair loss that may or may not be permanent. Women who are on birth control pills for contraception or hormone replacement therapy (HRT) may experience hair loss as a side effect if they abruptly discontinue using them. Post menopausal women may also be affected by hair loss since they may be undergoing HRT. Chemotherapy drugs are notoriously known for causing hair loss because they are powerful medications that attack rapidly growing cells, including those in hair roots.
There may be many more reasons for hair loss in women but the important thing to remember is how much hair loss is considered abnormal. If you want to find out, you can do an easy at-home-test called the “Pull Test” where you take a small amount (around 60-100 strands) of hair in your hand, and lightly pull. If you see a fall out of more than 3 strands, it is considered positive.
It is imperative to determine the real reason behind hair loss so you can begin a treatment plan early. Good thing to know is that most hair loss is actually treatable if caught early. So make sure you seek medical advice by going to the doctor to determine what treatment plan is best for you.