Why do women lose hair? Is it normal? Most likely the majority of women worldwide can relate to that moment when they have to pull strands of hair from their hairbrush after using it. But to what degree is this degree of hair loss normal, and at what point should it cause concern?
Women losing hair is a completely natural process. On average, between 50 and 100 hairs on our head fall out our heads every day.[1]. When this rate of hair loss turns into hair thinning, bald patches, and receding hairlines, you might automatically think this only applies to men. However, women are actually just as affected by hair loss.[2]
In addition, women arguably suffer more from the consequences of thinning hair than men – it’s inevitable that femininity, sexuality, attractiveness, and personality are associated with a full head of luscious locks.[3] For many women, extreme hair loss can cause great emotional distress and shame.[4]
Discover more about alopecia in women and baldness in women, as well as the causes of hair loss in women. You can also read about how your diet and other lifestyle hacks can prevent hair loss and which treatment options are available to you.
Head over to our Health Portal for more information about male hair loss.
What Is Hair?
Before talking about alopecia or baldness in women, let’s first visit the basics. What is hair, and why is it important for us to have hair? Nowadays, hair has only a few practical functions to fulfill, such as protecting us from the sun’s UV rays, the heat, or the cold. Today, however, we only really consider our hair for aesthetic reasons.
What Is Our Hair Made Up of?
A hair follicle is the small hollow from which our hair grows. The part of the hair that is not visible is called the hair root; the part of the hair outside the follicle is called the hair shaft. The hair root is supplied with blood, and hair cells are produced in the hair root with the help of the protein keratin.
Soft, fuzzy baby hair is replaced by thick hair before a baby is born. When an adolescent reaches puberty, this is when terminal hair develops, which is thicker, stronger, and more pigmented – and grows not only on the head.[5]
Do hair follicles grow back? No, when we are born, we already have all our hair follicles – even if you cannot yet see many of the hairs growing from them. After birth, no new follicles can form. If a follicle is destroyed, no new hair will grow from it.[5]
What Are the Reasons for Hair Loss in Women?
Our hair follicles constantly alternate between growth and recovery phases.[6] Most of our head hair – about 80 to 90 percent – is in the anagen (or growing) phase; this is when the hair grows. This phase can last between two to eight years.[7] The other ten to fifteen percent of our hair is in the telogen (or resting) phase, which lasts about three months, at the end of which the hair shaft detaches. Subsequently, cells form a hair again in the hair follicle, and the growth phase begins again.[9]
How long this cycle lasts varies from person to person. The duration depends on your biological clock, the complex processes of which are still being researched. If this growth cycle is disrupted, this can affect hair growth and can be one of the reasons for hair loss in women. Possible causes of hair loss in women in particular include chronic and hereditary diseases as well as various factors that influence metabolism or stress levels or disrupt our natural rhythm.
Not all hair loss is the same. The way you lose hair, what has happened in the recent past, and how long hair loss lasts are all clues that indicate a certain form of hair loss. Doctors distinguish between diffuse hair loss, which is where the hair on your entire head becomes thinner, and circular hair loss (alopecia areata), which leaves certain areas of your scalp bald.[10]
What Is Diffuse Hair Loss?
If you suffer from diffuse hair loss, it means that you lose a lot of hair within a certain period of time. It lasts between three to six months. After that, your hair usually regenerates completely and grows back again.[9] It usually starts suddenly and progresses very quickly. In addition, it usually affects your whole head, not just individual areas, and the hair becomes thinner overall.[11]
What Causes Diffuse Hair Loss in Women?
Diffuse hair loss occurs about two to three months after a triggering event. The cause of acute diffuse hair loss may be the following:
- Febrile illnesses
- Birth
- Accidental trauma
- Surgery
- Medication
- Emotional stress
- Crash diets
If diffuse hair loss lasts longer than six months, there is a risk that it has developing into chronic hair loss. This can be triggered by the following:
- Iron deficiency
- Zinc deficiency
- A general deficiency
- Thyroid condition (like hypothyroidism and hyperthyroidism)
How Can I Stop Diffuse Hair Loss?
If you suffer from diffuse hair loss, medication or other treatment methods are not necessarily required. Hair loss usually resolves itself after three to six months. This is often linked with how long it has been since a triggering event, starting medication, removing certain stress factors, changing your diet.[11]
What Is Androgenetic Alopecia in Women?
Circular hair loss (androgenetic alopecia) can often only be treated with permanent therapy methods.[3]
As the term “circular” already suggests, hair falls out mainly in the middle of the head; your frontmost hairline usually remains. This type of alopecia in women is similar to known forms of hair loss in men. However, the difference between this hair loss in men and women is the age at which it begins, how fast hair is lost, and the pattern of progression.
What Causes Androgenetic Alopecia in Women?
For a long time, experts suspected that an excessive production of androgens (male hormones) was to blame for alopecia. These hormones reduce the growth phase of the hair on your head.[12] As a result, the hair roots regress, which can lead to baldness in women.
However, most patients were found to have normal levels of androgens. Researchers therefore suspect that more sensitive hair follicles could also be the cause of the disease.[6]
In addition, women affected may lack aromatase, an enzyme responsible for converting male sex hormones into female sex hormones (estrogens). This increases the concentration of androgens at sensitive hair follicles. Estrogens, on the other hand, are known for promoting hair growth.[13]
How Can You Treat Circular Hair Loss?
The most common treatment method is to prescribe medication containing certain active ingredients. For example, minoxidil, finasteride, duasteride, and hormonal treatment with estrogens are often used.
If too much androgen is one of the reasons for hair loss, anti-androgens can also be administered. In extreme cases, treatment includes light and laser therapy or hair transplants.[6]
Circular hair loss, which can be hereditary and hormonal, is very unlikely to have a definitive cure. Any form of treatment must be continuous in order to treat the condition.[3]
How Are Menopause and Hair Loss in Women Linked?
Hair loss is a well-known phenomenon that takes place during menopause, affecting about 20 to 60 percent of all women by the time they reach the age of 60. During menopause, the concentration of the hormone estrogen decreases. As a result, the concentration of the male hormone androgen naturally increases at the same time.
Read more about the function of estrogen in women in our dedicated Health Portal article now.
Even before reaching menopause, the concentration of sex hormones often changes, which can affect a woman’s skin and hair. These hormone fluctuations, which occur before menopause, can cause androgens to be produced in excess, which then contribute to hair loss during menopause.
You can add nutrients to strengthen your hair and prepare it for the hormonal fluctuations of menopause through your diet.[14]
How Do You Prevent Hair Loss?
The American Association of Dermatology has published some tips for women, so they can protect their hair and prevent hair loss:[15]
- If necessary, see a dermatologist early to find out why you’re losing hair.
- Wash your hair without over-treating it: Using gentler shampoos, special conditioners, and hair care products that make combing through your hair easier are ideal. Also be gentle with your hair when brushing.
- Trust the professionals: To have your hair colored, permed, or permanently straightened, go to a hairdresser rather than trying to do it yourself at home.
- Avoid smoking, as smoking is bad for your hair.
- Make an effort to eat a balanced diet.
Did you know that not only your car but also your hair can suffer mechanical damage? If you brush your hair vigorously, braid it too tightly, and pull on it constantly, you can really damage your hair. This can lead to mechanical hair loss. Wear your hair loose more often or find hairstyles that put less stress on your hair.[15]
What Should I Eat for Healthy Hair?
Hair loss is often related to general malnutrition, such as crash diets or eating disorders. A healthy and balanced diet benefits your whole body.[15] Your hair also needs to be fed the right things – especially proteins and minerals such as iron, zinc, and selenium. Omega fatty acids, biotin, folic acid, antioxidants like vitamin A and vitamin E, and vitamin D are key to keeping your hair healthy and strong.[16] By eating the right foods, you can help heal hair loss that is not hereditary or hormonal and stimulate hair growth.
Iron deficiency is one of the most common deficiencies. Scientists agree that too little iron can be a cause of hair loss, but to what degree this is the case is still unknown. Zinc and vitamin D are also essential substances that affect hair growth. If you suspect you may be deficient in vitamin D, you can make an appointment with your doctor or take a vitamin D test or iron deficiency test – and take supplements if your suspicions were correct.
However, you should always check your nutrient levels before taking supplements. If you supplement nutrients without actually being deficient in them, this may actually contribute to greater hair loss. For example, selenium is known to cause hair loss when taken without any deficiency present.[17, 18] Therefore, you should always establish which nutrient you are deficient in and how you can get it from food or, if necessary, from a dietary supplement.
Which Natural Products Help with Hair Loss?
You don’t always have to opt for the most expensive shampoo. You can also find many hair-friendly remedies in your home. Most home remedies are more environmentally friendly and just as effective as the product from your local drugstore.
Apple Cider Vinegar
A common household remedy that promotes hair growth by regulating the body’s acid-base balance.[19] To do this, simply mix apple cider vinegar and water (with a ratio of one to five) and rinse your hair thoroughly with it again after shampooing your hair as normal. The smell will disappear throughout the day. However, you can also keep the vinegar in your hair by rinsing your hair again with cold water after leaving it on for five to ten minutes.
Aloe Vera
The sap of this plant not only helps with sunburn. Aloe vera gek´l can be applied externally to your hair and scalp as a treatment as well as be taken as a supplement to stimulate metabolism. In particular, your hair root is revitalized and strengthened, and you promote hair growth. This counteracts baldness in women.[20]
Argan Oil
This oil boasts a long tradition.[21] Massage the oil into your scalp, leave it in, and then wash it out. It stimulates hair growth, and the substances it contains, such as unsaturated fatty acids, linoleic acid, and vitamin E, revive the hair.[22] The later the resting phase starts, the longer your hair will grow, and the later your hair will fall out.
Coconut Oil
Coconut oil is rich in unsaturated fatty acids and lauric acid and thus promotes healthy hair. Massage the oil into your scalp and lather it into your hair. Afterward, simply rinse it out in the shower.[23]
Baldness and Alopecia in Women – at a Glance
Why Does Our Hair Fall Out?
Our hair is either in the growing phase or the resting phase. At the end of the resting phase, hair sheds and falls out, and new hair can start growing in the hair follicle.
What Causes Hair Loss?
Hair loss can be hereditary, in which case it needs to be treated permanently. It can also be triggered by stressors such as childbirth, an accident, stress, crash diets or certain medications. Certain nutrient deficiencies (iron, vitamin D, zinc, biotin) or menopause can also lead to increased hair loss.
How Can I Prevent Hair Loss?
In the case of hereditary hair loss, treatment with active substances such as minoxidil, finasteride, or duasteride should be used. Diffuse hair loss often goes away on its own or can be managed relatively easily by addressing factors such as medication, stress, or the wrong diet. Certain nutrients can also be enhanced through dietary supplements. There are many natural remedies in your home – for example, aloe vera or apple cider vinegar, which naturally support hair growth.
Sources
[1] American Academy of Dermatology, “Do you have hair loss or hair shedding?” available at https://www.aad.org/hair-shedding, accessed on November 5, 2019.
[2] Singal, A., Sonthalia, S. Verma, P. “Female pattern hair loss,” Indian Journal of Dermatology, Venereology, and Leprology, September 1, 2013, available at /han/sfx/https/link.galegroup.com/apps/doc/A341738086/AONE?sid=lms, accessed on Novermber 5, 2019.
[3] Dinh, Q. Q., Sinclair, R. “Female pattern hair loss: Current treatment concepts,” Clin. Interv. Aging, vol. 2, no. 2, pp. 189–199, June 2007.
[4] Hunt, N., McHale, S. “The psychological impact of alopecia,” BMJ, vol. 331, no. 7522, pp. 951–953, October 2005.
[5] Braun-Falco, O., Plewig, G., Wolff, H. H. “Erkrankungen der Haare,” in Dermatologie und Venerologie, Braun-Falco, O., Plewig, G., Wolff, H. H., Eds. Berlin, Heidelberg: Springer, 1984, pp. 661–685.
[6] Herskovitz, I., Tosti, A. “Female Pattern Hair Loss,” Int. J. Endocrinol. Metab., vol. 11, no. 4, October 2013.
[7] Malkud, S. “Telogen Effluvium: A Review,” J. Clin. Diagn. Res. JCDR, vol. 9, no. 9, pp. WE01–WE03, September 2015.
[8] “Duden | Involution | Rechtschreibung, Bedeutung, Definition, Herkunft.” available at https://www.duden.de/rechtschreibung/Involution, accessed on November 6, 2019.
[9] Rebora, A. “Telogen Effluvium,” Dermatology, vol. 195, no. 3, pp. 209–212, 1997.
[10] Wolff, H., Kunte, C. “Haarausfall und Alopezien bei Frauen,” Gynäkol., vol. 36, no. 7, pp. 605–618, July 2003.
[11] Shrivastava, S. B. “Diffuse hair loss in an adult female: Approach to diagnosis and management,” Indian J. Dermatol. Venereol. Leprol., vol. 75, no. 1, p. 20, January 2009.
[12] Sawaya, M. E. “Biochemical Mechanisms Regulating Human Hair Growth,” Skin Pharmacol. Physiol., vol. 7, no. 1–2, pp. 5–7, 1994.
[13] Conrad, F., Paus, R. “Estrogens and the hair follicle,” JDDG J. Dtsch. Dermatol. Ges., vol. 2, no. 6, pp. 412–423, 2004.
[14] Goluch-Koniuszy, Z. S. “Nutrition of women with hair loss problem during the period of menopause,” Przegla̜d Menopauzalny Menopause Rev., vol. 15, no. 1, pp. 56–61, March 2016.
[15] “Hair loss: Tips for managing.” available at https://www.aad.org/managing-tips#treatment, accessed on November 6, 2019.
[16] Guo, E. L., Katta, R. “Diet and hair loss: effects of nutrient deficiency and supplement use,” Dermatol. Pract. Concept., vol. 7, no. 1, pp. 1–10, January 2017.
[17] Aldosary, B. M. “Case Series Of Selenium Toxicity From A Nutritional Supplement: Clinical Toxicology: Vol 50, No 1.” available at https://www.tandfonline.com/doi/abs/10.3109/15563650.2011.641560, accessed on Novemebr 6, 2019.
[18] Lopez, R. E., Knable, A. L., Burruss, J. B. “Ingestion of a dietary supplement resulting in selenium toxicity,” J. Am. Acad. Dermatol., vol. 63, no. 1, pp. 168–169, July 2010.
[19] Joshi, V. K., Sharma, S. “Cider Vinegar: Microbiology, Technology and Quality,” in Vinegars of the World, Solieri, L., Giudici, P. Eds. Milano: Springer Milan, 2009, pp. 197–207.
[20] Basmatker, G., Jais, N., Daud, F. “Aloe vera: a valuable multifunctional cosmetic ingredient.,” 2011.
[21] Charrouf, Z., Guillaume, D. “Argan oil: Occurrence, composition and impact on human health,” Eur. J. Lipid Sci. Technol., vol. 110, no. 7, pp. 632–636, 2008.
[22] Guillaume, D., Charrouf, Z. “Argan oil and other argan products: Use in dermocosmetology,” Eur. J. Lipid Sci. Technol., vol. 113, no. 4, pp. 403–408, 2011.
[23] Rele, A. S., Mohile, R. B. “Effect of mineral oil, sunflower oil, and coconut oil on prevention of hair damage,” J. Cosmet. Sci., p. 18.
