POSTED: 18 Aug 2023

Hair Loss in Women: Causes, Prevention and Treatments That Work

Hair loss is a sensitive topic, and it can be particularly distressing for women. When hair start to thin or fall out, it can be distressing and the most common reaction is to wonder are there any effective treatments? Understanding why hair loss occurs is key to finding the best solution. In this article, we’ll explore the causes of hair loss in women and how to prevent it. We also review how effective available treatment options are to stop hair loss in women.

Causes of Hair Loss in Women

There are a number of reasons why women may experience sudden or gradual hair loss. There might be a single cause or a multitude of causes. Its important to understand the cause of hair loss as this will determine how to stop hair loss in women and which treatment will work best for you. Below are the main causes of hair loss in women.

Hormonal Changes

One of the primary causes of hair loss in women is hormonal imbalance. This is mainly due to pregnancy, menopause and polycystic ovarian syndrome (PCOS).

Pregnancy can bring about a number of skin changes and many women may also notice their hair becomes thicker. However, this is usually fleeting. In the first few months postpartum, as hormone levels plummet, some women may experience telogen effluvium. This is a condition wherein hair shifts from the growing phase to the shedding phase en masse. Whilst the hair loss may seem dramatic, the good news is it’s temporary. It usually resolves by itself as hormone levels stabilise.

Similarly, menopause and perimenopause can bring about a number of skin and hair changes. Menopause is marked by a reduction in oestrogen and progesterone. These decline in these two hormones can result in hair thinning. Your hair texture might also change and hair might become becoming finer or more brittle. Hormone replacement therapy can treat menopause related hair loss.

Polycystic Ovary Syndrome also causes hormonal imbalances. While it often leads to unwanted hair growth on the face and body, PCOS can paradoxically cause hair thinning on the scalp. This is primarily due to an overproduction of androgens, sometimes referred to as ‘male hormones’. These can shrink hair follicles and shorten the hair growth cycle.

Thyroid Disease

The thyroid is a butterfly-shaped gland in the neck. It produces hormones which orchestrate your metabolism. Any imbalance, can cause an overactive (hyperthyroidism) or underactive (hypothyroidism) thyroid. Hair follicles follow a set cycle of growth and rest, and severe or prolonged thyroid imbalances can push more follicles into the resting phase. This leads to hair loss throughout the scalp.

Alopecia Areata

This is an autoimmune disorder where the body’s immune system mistakenly targets and attacks its hair follicles, leading to hair loss. Alopecia areata manifests as sudden round patches of baldness. It often starts with small, coin-sized areas that can merge into larger patches over time. The exact reason why the immune system targets hair follicles remains unclear. However, it’s believed to be due to a combination of genetics and environmental triggers. Though the hair loss is usually temporary, the condition can repeatedly recur. Alopecia totalis and alopecia universalis are advanced forms of alopecia areata. However alopecia totalis causes hair loss throughout the scalp leading to baldness. Whilst more rare, alopecia universalis causes hair loss all over the body.

Lichen Planus

This is an inflammatory condition that affects the skin and mucous membranes. When lichen planus targets the scalp, it’s termed lichen planopilaris. This causes hair loss due to the inflammation around the hair follicles which leads to scarred and permanently damaged follicles. Over time, this results in patchy hair loss, where the affected areas may become smooth and shiny due to the absence of hair follicles. The exact cause of lichen planus is unknown, but it’s considered to be related to an abnormal immune response.

Lupus Erythematosis

This is a chronic autoimmune disease in which the body’s immune system attacks its tissues. When lupus affects the skin, specifically the scalp, it can cause discoid lupus erythematosus. This condition is characterised by round, disc-like lesions that can cause scarring. Once the skin is scarred, the hair follicles within those areas are damaged, leading to irreversible hair loss. While the exact cause of lupus is multifactorial, involving genetic, environmental, and hormonal factors, its manifestation on the scalp is a clear example of how systemic conditions can directly impact hair health.

Medications

Some medications can lead to hair loss as a side effect. The most common medicines that can cause hair loss include some types of antidepressants, blood thinners, chemotherapy drugs and blood pressure medications.

Stress

Stress significantly influences hair health and can act as a critical disruptor in its growth cycle. Hair undergoes three distinct phases: the anagen or growth phase, the catagen or transitional phase, and the telogen or resting phase. Stress accelerates the transition of hair follicles into the telogen phase. This leads to a condition known as telogen effluvium. As a result, a substantial amount of hair sheds prematurely. Furthermore, stress can activate the body’s immune response against hair follicles which can trigger hormonal, thyroid or autoimmune conditions that cause sudden hair loss. Stress also indirectly compromises hair health by influencing lifestyle choices. It often results in sleep deprivation, poor dietary habits and reduced physical activity. All of these can negatively affect hair quality and growth.

Eating disorders

Conditions such as anorexia or bulimia can result in nutrient deficiencies. This can be due to insufficient nutrient intake or nutrient absorption disruptions. This can significantly affect hair health and cause hair loss.

Genetics

Hair loss can be an inherited trait. This genetic predisposition is known as female-pattern baldness or androgenic alopecia. Typically, it manifests as a widening part or thinning primarily at the crown of the head. Female-pattern baldness is a progressive condition. Hair follicles shrink over time and produce increasingly finer hairs until growth ceases altogether.

Ageing

As women age, a natural thinning of the hair occurs. Hormonal changes post-menopause can exacerbate this, as lower oestrogen levels can result in a reduction of hair volume. Hair growth rates can also decelerate with age, and individual hair strands may become finer. This can make the scalp more visible in certain areas.

Trichotillomania

Also known as hair-pulling disorder, Trichotillomania is a mental health condition where individuals have an irresistible urge to pull out their hair. This can be hair from the scalp, eyebrows or other areas of the body. This repetitive behaviour can result in noticeable hair loss and bald patches. The exact cause of trichotillomania is not entirely understood, but it is believed to be a combination of genetic, neurological, behavioural and environmental factors. The act of pulling can serve as a way to cope with stress, anxiety, tension or other negative emotions. Over time, hair-pulling can become a compulsive act. This leads to a vicious cycle of increased stress and further hair-pulling. Treatment typically involves cognitive-behavioural therapy, which can help address the underlying triggers and develop strategies to reduce or stop the hair-pulling behaviour.

Diet and Nutrition

Diet and nutrition play a pivotal role in maintaining optimal hair health in women. When there’s an imbalance or deficiency, it can directly impact the quality and growth cycle of hair. This can lead to hair loss or thinning. Here are the most common ways diet and nutrition can cause hair loss in women:

  • Protein deficiency: hair primarily consists of a protein called keratin. A diet low in protein can hinder hair growth and may even cause hair shedding. This is because the body might conserve protein by shifting more hairs into the resting phase.
  • Iron deficiency: iron plays a central role in the production of haemoglobin in the blood, which delivers oxygen to various cells, including hair follicles. An iron-deficient diet can lead to anaemia which is a common cause of hair loss in women. Reduced iron levels can deprive hair follicles of oxygen hence hampering their growth and vitality.
  • Vitamin D deficiency: vitamin D is essential for hair follicle cycling. Deficiency can potentially lead to hair loss or hinder regrowth.
  • Biotin, Zinc, and Selenium deficiency: these are vital micronutrients for hair. A deficiency in any of these can weaken hair at the roots which makes it more susceptible to breakage.
  • Rapid weight loss: extreme or rapid weight loss of any kind can stress the body. This leads to a higher proportion of hair follicles entering the shedding phase.
  • Excessive Vitamin A: whilst vitamin A supports hair growth, excessive consumption can have the opposite effect and leads to hair loss. This is usually due to supplements,
  • Omega-3 fatty acids deficiency: these provide the oils that prevent the scalp from becoming dry and dandruff-prone. Deficiency can affect hair growth.

Hairstyling and Treatments

Prolonged and excessive hairstyling techniques can inflict significant stress on your hair. Tight hairstyles like ponytails, buns and braids exert continuous tension on hair follicles. This can lead to traction alopecia; a type of hair loss caused by constant pulling force. Similarly, the recurrent use of heat tools like straighteners and curling irons can weaken hair, making it more susceptible to breakage. Chemical treatments, such as perms or hair dyes, can also compromise the hair’s structural integrity. This causes it to become brittle and thin over time.

Environmental Factors

External environmental factors can play a considerable role in hair health. Prolonged exposure to the sun’s UV rays can weaken the hair strands, leading to dryness and brittleness. Pollutants in the air can deposit on the scalp and hair, disrupting the natural balance and potentially leading to hair loss. Even water quality, especially hard water, can impact hair texture and strength. Regular exposure to these elements without protective measures can overtime negatively affect hair health and growth.

How to Stop Hair Loss in Women

Prevention is the first line of defence against hair loss. Start by identifying a possible cause of your hair loss. If it is due to any medical conditions or medications then see your doctor immediately. They will be able to start you on treatment for the underlying medical problem which will stop your hair loss. If the hair loss is as a side effect of any of your medications, they may be able to change you to an alternative medicine.

If your hair loss is due to lifestyle factors like stress then correcting these is the best treatment. Always ensure that you east a balanced diet, rich in essential vitamins, minerals and proteins. This is crucial for maintaining robust hair health. You may need to see your doctor or a nutritionist for further help on supplements or dietary adjustments. This is especially helpful if you are on a diet or weight loss injections or have an underlying medical condition like Diabetes where you need to manage your food intake carefully. In addition, opt for loose hairstyles, reduce the frequency of heat styling and use gentle hair products to protect your hair and reduce breakage.

Since it is a common cause of hair loss in women, its vital to manage stress. Practice relaxation techniques like meditation and deep-breathing. Exercise can also help. If you’re finding it difficult to manage your stress, seek the help of a medical professional as they can advise on techniques and treatments to reduce your stress.

Effective Treatments for Hair Loss in Women

As mentioned above, its crucial to find out whether medical conditions or medications are the cause of hair loss in women. Treatment of the condition will stop the hair loss. Equally, life style improvements can significantly improve the health and appearance of your hair. For hair loss due to ageing or genetics or hormonal changes then the following treatments can help.

Minoxidil

This is one of the few proven treatments for hair loss in women. Minoxidil is available as as a foam, lotion or serum and it’s applied directly to the scalp. One of the primary mechanisms by which minoxidil operates is its role as a vasodilator. It widens the blood vessels, thereby increasing the flow of blood, oxygen and nutrients to hair follicles. This improved nourishment can potentially revive dormant hair follicles. It is also believed to prolong the anagen phase of the hair follicle. This promotes longer periods of hair growth. Minoxidil increases the size of hair follicles and decreases miniaturisation which can occur in female-pattern badness. This results in thicker hair strands over time. It also

In the UK minoxidil is available over-the-counter (OTC) in up to 5% concentration. For women, 2% minoxidil solution is recommended initially. If OTC minoxidil doesn’t work for you, you should see a dermatologist as they can prescribe higher concentrations and formulations mixed with other hair stimulating medications. Whilst minoxidil can be effective, it’s important to note that its benefits only persist as long as the treatment continues. If you stop using it, your hair loss will return.

Spironolactone

Spironolactone is a prescription only medication normally used to treat conditions like hypertension and oedema. It is also used-off label by doctors as a hormonal hair loss treatment for women. Spironolactone has anti-androgenic properties. Androgens are male hormones present in both men and women. Overproduction of these can sometimes contribute to hair thinning in women. this causes a condition known as female pattern hair loss or androgenic alopecia. By blocking the action of androgens, spironolactone can potentially halt the progression of hair loss and even promote regrowth. It is usually used topically and combined with other treatments like minoxidil and tretinoin to amplify its effects. Just like other hair loss treatments, you need to use Spironolactone for a prolonged period before you see results. It typically requires months of consistent use and you will need to keep using it to maintain your results.

Finasteride

Finasteride is a prescription-only-medicine commonly used for treating male pattern baldness and an enlarged prostate in men. However, it is also sometimes used as a treatment for hormonal hair loss in women. Finasteride works by inhibiting the enzyme 5-alpha-reductase, which is responsible for converting testosterone to its more potent form, dihydrotestosterone (DHT). DHT has been identified as a key factor in hair thinning and baldness in those genetically predisposed to it. By reducing DHT levels, finasteride can potentially halt or even reverse hair thinning. Finasteride is usually prescribed as a topical treatment and is often combined with minoxidil and Tretinoin to enhance its effects.

Hair Growth Shampoos

These can improve the appearance of the hair and may help with mild hair loss. Hair growth shampoos are widely available and there’s a huge variation in their ingredients. Whilst they don’t generally stand up to the hype as a hair loss treatment for women, they can improve the condition of the hair and reduce breakage.

Look for ingredients like biotin, which can strengthen the hair and caffeine which may stimulate hair follicles. Ketoconazole, containing products can be good for dandruff or scalp infections treatment of which can potentially reduce hair loss. Saw palmetto is another ingredient with potential for hair loss treatment. It is believed to counteract the effects of DHT, a hormone implicated in hair loss in women. There is no scientific evidence backing hair growth shampoos but that doesn’t mean they’re completely useless. Its important to use them consistently for a prolonged period (as long as you don’t experience irritation or allergies). Its also worth managing your expectations and know that any improvement is likely to be modest at best.

Hair Vitamins & Supplements

Over the years, hair vitamins and supplements have become increasingly popular. They are promoted as beneficial for healthier, stronger and thicker hair. The idea behind them is that nourishing the body from within can have positive external manifestations including hair health. The most common hair vitamins and supplements are:

  • Biotin: this is the super star ingredient in hair supplements. Biotin is a B-vitamin that plays a key role in keratin formation which is essential for hair structure.
  • Vitamin D: some studies link vitamin D deficiency to alopecia and so its used in supplements to promote hair growth.
  • Iron: this is essential for red blood cell production which help transport oxygen to hair follicles.
  • Zinc: this plays a role in hair tissue repair and growth. Zinc also ensures the oil glands around follicles work optimally.
  • Omega-3 Fatty Acids: these may help nourish the hair, supporting its growth and reducing dryness and flakiness of the scalp.
  • Collagen: this protein is vital for skin and hair strength and elasticity. As we age, natural collagen production decreases, which can result in weaker hair.

Whilst a lot of people swear by the benefits of hair supplements, the scientific evidence on their efficacy remains mixed. Some people may notice improved hair health, while others may not. If you want to try them, it’s vital to approach hair supplements as a complement to a balanced diet, not a replacement. Also be aware that overconsumption of certain vitamins and minerals can be detrimental. For instance, excessive vitamin A can lead to hair loss.

Platelet-Rich Plasma (PRP)

In recent years, PRP has garnered significant attention in the field of dermatology and trichology as a potential treatment for hair loss. PRP involves drawing a patient’s blood, processing it, and then injecting it into the scalp to stimulate hair growth. The theory behind it is that PRP is rich in growth factors, which are proteins that promote cellular repair and regeneration. When injected into the scalp, its supposed to stimulate hair follicles. Although several studies and anecdotal evidence suggest positive outcomes with PRP, comprehensive research on its long-term efficacy and standardisation of treatment protocols is still ongoing. This is treatment needs a sterile medical setting. You should only see an experienced and qualified medical practitioner. Ensure that they are operating out of a clinical setting.

Microneedling

A mainstay in skin rejuvenation, microneedling is increasingly popular as a hair loss treatment for men and women. This procedure involves using a device equipped with fine needles to create thousands of tiny, superficial punctures in the scalp. These tiny wounds stimulate vascularisation cell turnover. This enhances blood circulation to hair follicles and bolsters their nutrition. Additionally, when used with treatments like Platelet-Rich Plasma (PRP) microneedling is supposed to boost their absorption and amplify their benefits. Preliminary studies suggest that regular microneedling sessions can lead to noticeable hair regrowth in some individuals. However, more evidence is needed. To avoid risks like infection and scarring, you will need to see a qualified and experienced medical practitioner.

Laser Therapy

Low-Level Laser Therapy (LLLT), is a popular alternative treatment for hair loss, particularly androgenic alopecia. Operating under a red light spectrum, LLLT targets the hair follicles with photons, to rejuvenate their cellular structure. These photons are supposed to be absorbed by weaker cells and hence selectively acts on underperforming hair follicles. Manufacturers of laser therapy claim that, when administered correctly, it can prolong the growth phase of the hair cycle, curb hair loss and stimulate regrowth. There are a number of at home devices including laser combs, caps and helmets. Although there are some people who have had positive outcomes with laser therapy, results can differ widely. Furthermore, this is an emerging treatment and hence comprehensive long-term studies are needed to validate the claims.

Hair loss in women can be devastating, but understanding what is causing your hair loss is key to prevention and effective treatment. Treating medical and medication related causes is usually enough to reverse hair loss. Stress and lifestyle factors are also major reasons for hair thinning and again simple healthy modification can help stop hair loss. For hormonal or age related hair loss in women, there are a number of good over the counter, prescription and professional skin treatments. Its best to consult with a dermatologist or healthcare professional to look for underlying reasons and best treatments for your hair loss. If you’re considering medical treatments, please ensure that you see a qualified medical practitioner to reduce potential risks and maximise benefits.

We wholeheartedly believe that beauty and skincare are intensely personal journeys. This drove us to launch our virtual skin clinic where we provide personalised hair loss treatments with active ingredients like Minoxidil, Spironolactone, Finasteride, Dutasteride and Tretinoin. We also treat skin concerns like acne, hyperpigmentation, melasma and signs of skin ageing. Schedule your virtual consultation and start your journey to great skin.

SOURCES

https://www.nhs.uk/conditions/hair-loss/coping-tips-for-women/

https://cityskinclinic.com/pregnancy-skincare/

https://www.aad.org/public/diseases/hair-loss/insider/new-moms

https://cityskinclinic.com/menopause-skin-changes/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8291365/

https://www.btf-thyroid.org/hair-loss-and-thyroid-disorders

https://www.aad.org/public/diseases/hair-loss/types/alopecia

https://www.ncbi.nlm.nih.gov/books/NBK563225

https://rarediseases.info.nih.gov/diseases/614/alopecia-universalis/

https://dermnetnz.org/topics/lichen-planopilaris

https://www.lupus.org/resources/hair-loss-and-lupus

https://www.health.harvard.edu/staying-healthy/treating-female-pattern-hair-loss

https://www.ncbi.nlm.nih.gov/books/NBK470434/

https://www.nhs.uk/mental-health/conditions/trichotillomania/

https://cityskinclinic.com/weight-loss-injections/

https://cityskinclinic.com/hair-loss-men-treatments/

https://cityskinclinic.com/collagen-supplements/

https://cityskinclinic.com/guides/guide-microneedling/

https://cityskinclinic.com/guides/the-definitive-guide-to-tretinoin/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8922312/

https://cityskinclinic.com/online-booking/

Authored by:

Dr Amel Ibrahim
Aesthetic Doctor & Medical Director
BSC (HONS) MBBS MRCS PHD
Founder City Skin Clinic
Member of the Royal College of Surgeons of England
Associate Member of British Association of Body Sculpting GMC Registered - 7049611

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