Monday, March 16, 2020
Losing some hair every day is completely natural. But when you’re losing a lot of hair, it can be difficult to figure out what’s causing that hair loss—especially in women.
Most of the time minor hair loss is just a sign that your body's growing new, healthy ones to replace the old. In fact, losing up to 100 hairs per day is totally normal. If you’re not sure what’s normal for you, it’s a good idea to simply pay attention to what you typically see in your brush or shower drain. And "if all of a sudden you're noticing a lot more, or your ponytail is thinner or you're seeing more scalp," then you may be losing more hair than you should, Francesca Fusco, M.D., dermatologist at Wexler Dermatology in NYC and assistant clinical professor of dermatology at Mount Sinai, tells SELF.
Figuring out why you’re suddenly losing more hair than usual can be tricky because there are many different causes of hair loss in women. Some, like hereditary hair loss (androgenetic alopecia), aren’t really in your control—you get the hand you're dealt. But others, like traction alopecia or temporary hair shedding (a very common condition called telogen effluvium), can be managed or even reversed if caught early. Making things even more complicated, some causes of hair loss in women result in sudden shedding while others may become progressively more noticeable over time.
If you've noticed your hair is falling out more than usual, looks thinner, or seems to be growing more slowly, here are some of the most common reasons for hair loss in women.
1. Genetics
When we think of hereditary hair loss, we usually go straight to male pattern baldness. But people of all genders are susceptible to hereditary hair loss. In women the hair loss is usually concentrated at the crown of the head (especially noticeable at the hair part), while it’s more likely to affect men along the hairline, the American Academy of Dermatology (AAD) notes.
Although you can’t prevent this type of hair loss entirely, there are treatments available—such as over-the-counter minoxidil or finasteride—that can slow it down and make hair stay fuller longer. So the sooner you start treatment, the better.
2. Childbirth
Normally, your hair goes through three major life stages. First, there’s a growth phase; second, there’s a transitional phase when the growing stops but the hair doesn’t fall out; and then there’s a resting phase. Finally, after the resting phase, your hair falls out.
But during pregnancy, most people notice their hair going into rapid growth mode. "That’s when everything is in a grow, grow, grow phase, because there are surges of hormones [estrogen] that make hair grow," Fusco says. Not only is the growth stage kicked into high gear, but also it lasts longer than normal, meaning that normal shedding doesn't occur.
Once estrogen levels go back to normal after delivery, hair resumes its normal growth cycles and starts to shed all that thick, luscious hair that accumulated over the last 10 months. Some women experience very mild shedding, but others experience intense shedding for a few months.
This type of hair loss (technically, hair shedding) is called telogen effluvium, and it can occur months after a stressful or major life event like childbirth, Bethanee Schlosser, M.D., assistant professor of dermatology and director of the Women's Skin Health Program for Northwestern Medicine, tells SELF. "Shedding peaks about four months after the incident" that caused it, she explains.
Postpartum hair loss is, luckily, temporary. So you don’t really have to do anything to treat it, the AAD says. But there are ways to make your hair look and feel fuller while you wait. For instance, look for volumizing shampoos and conditioners that are formulated for fine hair and avoid products that weigh down the hair.
3. Changes in birth control
Going off hormonal birth control or changing to a different type of hormonal contraception can also cause hormone-induced shedding. "Whether you're just starting it, discontinuing it, or changing brands, your body can react by causing the hair to go into an increased shedding mode," Dr. Fusco says.
This is another form of telogen effluvium, which means that it’s usually temporary. You can rely on volumizing products and styling tricks while you wait for your hair to regain its fullness.
4. Nutritional deficiencies
Creating and maintaining healthy hair relies on getting solid nutrition. In particular, deficiencies in iron, zinc, vitamin B3 (niacin), and protein have all been linked to various types of hair loss.
Treating a nutritional deficiency usually starts with a chat with your doctor and a blood test to accurately diagnose your issue. Then your doctor may treat your deficiency with prescription supplements or may refer you to an R.D. for further guidance.
5. Medications
Some "medications can cause chronic shedding," Dr. Schlosser says. In particular, those used to manage high blood pressure, cancer, arthritis, and depression are known to cause hair loss issues, according to the Mayo Clinic.
If you think your medication may be causing hair loss, check in with your doctor. In many cases, this type of hair loss is temporary. But if your hair loss becomes chronic, your doctor may be able to prescribe a different medication that doesn’t cause this side effect.
6. Dandruff or scalp psoriasis
When the skin on the scalp is inflamed and itchy, it’s obviously tempting to scratch it. But that may cause your hair to shed more than usual.
Dandruff is the most easily treated cause of hair loss, Dr. Fusco says, because you can treat it with over-the-counter products, like a shampoo containing zinc pyrithione or exfoliating ingredients such as the classic Head & Shoulders Classic ($9, Amazon) or Oribe Serene Scalp Anti-Dandruff Shampoo ($46, Dermstore). "Consistency is the trick," Dr. Fusco says, so it's important to find a shampoo and conditioner you like enough to use regularly.
But other conditions can also cause itchiness and scalp flaking, including seborrheic dermatitis (a more severe version of dandruff caused by a buildup of yeast and oil) and psoriasis (an autoimmune condition that causes thick patches of skin). Treating these issues may take more time and effort than dandruff, so it’s important to check in with a dermatologist if you think you may be dealing with one of these conditions.
7. Intense emotional or physical stress
When you're experiencing something stressful or traumatic—not your average day-to-day stress, but something big and life-altering like a divorce, a death in the family, a significant job change, or a big move—you may experience a temporary halt in hair growth as your body puts its resources toward getting you through said big event.
"Hairs don’t all grow at the same rate," Dr. Schlosser explains. "Some are growing, some are resting, and some are actively being shed. When you have these conditions, your body halts hair growth, and then things get restarted and all these hairs that have been halted start to get pushed out at the same time." The same thing can happen with physical stress and trauma, like having a big operation, being hospitalized, or even losing a significant amount of weight very quickly.
Usually this type of hair shedding is temporary. But if it bothers you, check in with a dermatologist to learn more about styling changes and products you can use to make your hair look and feel fuller.
There are things you can do to prevent hair loss.
If you notice your hair is thinning and it bothers you, there are some easy ways to make it appear fuller and simultaneously help prevent more hair loss or breakage. For instance, as SELF explained previously, it’s important to:
Wash as often as you need to—but no more. Both under- and overwashing can affect the volume and feel of your hair. Not washing enough causes a buildup of product and oil that can weight your hair down. But washing too frequently can strip the hair of its natural oils, making it more dry and prone to breakage. Experts recommend sticking to washing about two or three times per week and adjusting as needed for your particular situation.
Always use conditioner after shampooing. Conditioner makes your hair shinier and helps reduce static electricity, both of which helps thinning hair look fuller and glossier. But remember: A little goes a long way, and too much will weigh hair down.
Try leave-on products. Leave-in conditioners and detanglers help keep your hair moisturized throughout the day and protect against the effects of heat styling that otherwise can cause thinning and breakage.
Use hair masks for deep conditioning. If your hair tends to be dry and brittle, an occasional deep-conditioning mask may be just what it needs to regain some life and strength. These can also help hair look shinier.
Style your hair gently—and without heat, if possible. Because heat can cause damage to the hair that leads to shedding and breakage, it’s important to limit or avoid heat styling entirely. And when putting your hair up, choose styles that don’t put too much pressure on your hair or scalp. Styles like tight braids, dreads, and ponytails can be particularly damaging when worn repeatedly or for extended periods of time.
Treatment for hair loss is out there.
Most cases of increased shedding will gradually resolve on their own without treatment, Dr. Schlosser says. But if your hair doesn't return to its normal fullness after within nine months, see a doctor for an evaluation to find out whether something else is going on. And if you have other worrying symptoms, like itching, pain, burning, flaking, or redness, you should seek help sooner.
See your primary care provider or go directly to a dermatologist who specializes in treating hair loss. They can determine what type it is and what the right treatment approach is for you.
In addition to changes in products and hairstyling habits, your doctor may prescribe topical treatments to treat hair loss, like minoxidil, or direct you to an over-the-counter version, like Rogaine ($44, Amazon). They might also recommend treatments like platelet-rich plasma injections (PRP), which can be helpful for some patients, SELF explained previously. If you’re curious about your options, check in with your doctor or dermatologist.