Few things prepare you for the amount of hair you can lose after having a baby. You might notice clumps coming out in the shower, hair covering your pillow every morning or a visibly thinner mane. It can be extremely alarming, especially at a time when you’re already dealing with the physical and emotional demands of a new baby. Postpartum hair loss is extremely common and can affect over 90% of new mothers. The good news is that it is usually temporary and in most cases resolves on its own. In this article, we explore exactly why postpartum hair loss happens and how long it takes to recover. We also review when to consider treatment and which ones are safe for postpartum hair fall even during breastfeeding.
Why Does Hair Fall Out After Pregnancy?
Postpartum hair loss is a form of telogen effluvium. To understand why it happens, it helps to know how pregnancy affects the hair growth cycle. During pregnancy, rising oestrogen levels prolong the anagen (active growth) phase of the hair cycle. This means that hairs that would normally have finished growing and entered the resting phase stay put instead. The result is that fewer hairs fall out during pregnancy which is why many women notice their hair looking thicker and fuller than usual. Basically existing hair is able to stay in place for longer than it normally would.
After delivery, oestrogen levels drop sharply as the body returns to its pre-pregnancy hormonal state. This sudden withdrawal triggers all of those retained hairs to enter the telogen (resting) phase at once. After the typical two to three month lag of the telogen phase, they begin to shed. The result is a sudden and dramatic increase in hair loss that can be alarming. However, it is just the body catching up on months of delayed shedding. Breastfeeding can add an additional layer to the timeline. This is because lactation slows down the oestrogen decline. This means that the hair shedding may not peak until you reduce or stop breastfeeding.
What Does the Postpartum Hair Loss Timeline Look Like?
It’s important to try to understand the typical timeline post postpartum hair falling out to help manage expectations and reduce anxiety. In general, postpartum hair loss tends to follow a pattern:
- 1-2 months postpartum: Hair usually appears normal during this period. The hormonal shift has occurred but the telogen hairs have not yet reached the point of shedding.
- 3-4 months postpartum: This is when most women first notice significant shedding. Hair may come out in clumps during washing and brushing. You may see more hair on your pillow, in the drain and on your clothes. The shedding can be most noticeable around the temples and along the parting. This is typically the peak of postpartum hair loss.
- 4-6 months postpartum: Shedding usually continues but may begin to slow down. Many women notice that the volume of hair loss is reducing gradually compared to the initial peak.
- 6-12 months postpartum: For most women, the hair growth cycle begins to normalise during this period. New regrowth becomes visible, often appearing as short fine hairs around the hairline and parting. These are “baby hairs” are a positive sign that the follicles are cycling normally again. By the time the baby reaches their first birthday, most women find their hair has returned to or is approaching its pre-pregnancy fullness.
It’s worth noting that this timeline can vary. Women who breastfeed for extended periods may find the shedding phase is delayed or prolonged. Nutritional status, stress levels, sleep quality and whether there are any underlying health conditions at play can also affect the timeline.
When Should You Be Concerned About Postpartum Hair Loss?
Whilst postpartum hair loss is usually temporary and self-resolving, there are situations where it’s worth seeking medical advice. The main signs your postpartum hair loss may not resolve by itself include:
- Shedding that continues beyond 12 months postpartum: If your hair is still falling out significantly more than a year after delivery, this may indicate that something other than simple postpartum telogen effluvium is going on.
- Development of bald patches: Postpartum telogen effluvium causes diffuse thinning across the scalp. If you are developing distinct bald patches, this could suggest a different type of hair loss like alopecia areata which is an autoimmune condition that requires different management.
- Accompanying symptoms: If your hair loss is accompanied by excessive fatigue, unexplained weight changes, feeling unusually cold, dry skin or mood changes, this may indicate a thyroid disorder. Postpartum thyroiditis affects up to 10% of new mothers and can present with hair loss as one of its symptoms. Similarly, symptoms like extreme tiredness, pale skin tone, breathlessness or heart flutter alongside hair loss may suggest iron deficiency anaemia which is also common after childbirth.
- Hair loss that doesn’t follow the typical pattern: Straightforward postpartum shedding causes diffuse shedding across the entire scalp. If your thinning is mainly at the crown or along the parting and the remaining hairs seem to be getting progressively finer rather than simply falling out, it may suggest androgenetic alopecia. What sometimes happens is that the fuller hair of pregnancy masks an underlying predisposition to pattern hair loss that was already developing gradually. When the postpartum hormonal shift triggers shedding, it highlights the thinning underneath.
If you have any concerns, it’s worth asking your doctor to run some blood tests. A thyroid panel, serum ferritin (iron stores), full blood count, vitamin D and zinc levels are all reasonable initial investigations for postpartum hair loss that isn’t resolving as expected. If there are scalp changes or signs suggestive of autoimmune disease, they may also refer you to a dermatologist or other medical specialist.
What Treatments are Safe for Postpartum Hair Loss?
This is where things get a bit more tricky because many of the proven hair loss treatments are either not safe or not well studied during breastfeeding. As a general rule, the following measures are safe to use if you are breastfeeding and have postpartum hair loss:
- Nutritional optimisation: This is the single most important step you can take. Pregnancy and breastfeeding are nutritionally demanding and deficiencies in iron, zinc, vitamin D, B vitamins and protein can all contribute to prolonged or worsened hair shedding. Continuing a high-quality postnatal vitamin is advisable. If your doctor identifies a specific deficiency on blood testing, targeted supplementation can make a meaningful difference. Iron supplementation in particular is important as iron deficiency is common postpartum and is a well-established cause of telogen effluvium independent of hormonal changes.
- Gentle hair care practices: These can help minimise additional breakage and make the hair you have look and feel better. Avoid tight hairstyles such as ponytails, buns and braids that place tension on the hair and can contribute to traction alopecia. Use a wide-toothed comb and be gentle when detangling wet hair. Reduce heat styling where possible and use a heat protectant when you do. Volumising shampoos and conditioners can help give the appearance of fuller hair during the shedding phase.
- Scalp massage: This can potentially help improve blood flow to the hair follicles. Gentle daily scalp massage for a few minutes is low-risk and may help boost hair re-growth.
- Low-level laser therapy (LLLT): Using at-home devices such as laser caps or combs is generally considered safe during breastfeeding though check the device’s specific instructions. LLLT uses light energy to stimulate follicular activity. It has evidence for improving hair density in androgenetic alopecia and may also be beneficial in supporting recovery from telogen effluvium.
Unfortunately, some of the best known hair loss treatments are not recommended for use during breastfeeding. Below are the treatments you can consider if your postpartum hair loss doesn’t resolve and you are not breast feeding:
- Topical minoxidil: This is the most popular treatment for female pattern hair loss but its safety during breastfeeding is not fully established. The LactMed database notes that topical minoxidil could be acceptable once breastfeeding is established if not used in large volumes. However, there are case reports of babies developing facial hypertrichosis (excess hair growth) whilst the mother was topical minoxidil. This suggests that it either passes on through the breast milk or the baby’s skin after touching the mother’s hair. Given the limited data, it’s probably best to avoid topical minoxidil whilst breastfeeding. If that’s not possible, then at least discuss with your doctor or dermatologist before using it whilst breastfeeding.
- Oral minoxidil: This passes into the mother’s blood stream and into breast milk. As such you should not take oral minoxidil during breastfeeding due to the potential for cardiovascular side effects in the infant.
- DHT blockers: Finasteride and dutasteride are absolutely contraindicated during pregnancy and breastfeeding in any form. These DHT blockers can cause serious abnormalities in a developing male foetus and should not be handled by women who are pregnant or may become pregnant. In fact, they are generally not recommended for use in pre-menopausal women. Similarly, spironolactone which is an overall androgen blocker is also not recommended during breastfeeding.
What About Hair Loss After Miscarriage or Stillbirth?
cruelly, postpartum hair loss can also occur following miscarriage or stillbirth. The hormonal mechanisms are similar to those following a live birth. Essentially, the body experiences a sharp decline in pregnancy hormones which can trigger telogen effluvium. This hair loss follows the same timeline and is usually temporary. However, the emotional stress of miscarriage or stillbirth can also compound hair loss and delay recovery. Please don’t hesitate to speak to your doctor for support with emotional and physical recovery following miscarriage or stillbirth.
Will Postpartum Hair Loss Happen Again with Future Pregnancies?
Unfortunately, if you experienced postpartum hair loss after your first baby, it is likely to recur with subsequent pregnancies. This is because the underlying hormonal mechanism is the same. However, the severity can vary between pregnancies. Some women can find it milder the second time around whilst others find it worse. The severity of postpartum hair loss depends on many factors. These include placental development, baby’s healthy, twin or multiple pregnancies, nutritional status, stress levels and overall health of the mother. Starting a postnatal supplement early in pregnancy and maintaining good nutrition can help support the hair follicles. This can reduce the severity of postpartum shedding.
Postpartum hair loss is one of the most common causes of hair loss and least discussed aspects of the post-pregnancy experience. It can be distressing but in the vast majority of cases it is temporary and the hair recovers fully within the first year. The most important things you can do are manage your expectations, maintain good nutrition, be gentle with your hair and know when to seek medical advice. If your shedding is prolonged, accompanied by other symptoms or doesn’t follow the typical pattern of diffuse thinning, it’s worth getting a medical opinion. Normally it recovers by itself but there are some supportive measure you can take to support recovery even if you’re breastfeeding. For thinning that persists or of there’s an underlying cause, then there are a variety of hair growth treatments. However, you would usually need to wait until you’ve finished breastfeeding to start these.
We believe in a personalised approach to hair care which is why we offer custom hair loss treatments for women through our online skin clinic. Our doctors create custom hair growth treatments using actives such as Minoxidil, Spironolactone, Melatonin, Caffeine and Tretinoin where appropriate for each and every patient. Start your virtual consultation and begin your journey to great hair today.
This article is intended for general informational purposes only and is not a substitute for medical advice, diagnosis or treatment. Always consult a qualified medical professional with any concerns about your hair or treatment options.
