Female hair loss

Hair loss in women can occur for a number of reasons. Diagnosis can be difficult. It is unlikely that you are going to make a precise diagnosis using a website. If you think that you have a hair problem, SkinCompare, recommends that you see either your GP or a Dermatologist who will be able to guide you further. You need to get a precise diagnosis which may involve scalp biopsies and blood tests.

Skin condition: Female hair loss

Basic biology to aid understanding

All hair follicles contain a number of stem cells. These cells can regenerate over and over again and are essential for continued hair growth. Hairs have three stages in their life cycle-

  1. Anagen ( growth) , the length of anagen varies between individuals ( 4-7 years generally). Some women can grow their hair down to their waist whereas others never manage this as their anagen duration is shorter. There is a condition called short anagen syndrome characterised by hair that only grows for 1-2 years. Children present to clinic having never needed a haircut.
  2. Catagen ( present but not growing, lasts 2 -4 weeks)
  3. Telogen ( falling out)

 

What is this condition?

Hair loss in women can occur for a number of reasons. Diagnosis can be difficult. It is unlikely that you are going to make a precise diagnosis using a website. If you think that you have a hair problem, SkinCompare, recommends that you see either your GP or a Dermatologist who will be able to guide you further. You need to get a precise diagnosis which may involve scalp biopsies and blood tests.

Due to the unregulated nature of much of the UK cosmetic and food supplement industry you will come across all manner of products making very bold claims about they can benefit your hair. Do not be taken in. In some cases of hair loss some simple blood tests may be needed to exclude iron deficiency or an underactive thyroid. Taking hair supplement tablets, often bought at great expense online, is not the correct approach. If there was an easy solution to hair loss by taking supplements, the medical profession would tell you about it and would have evidence from clinical trials to prove the benefits.

There are five  groups of hair disorders that can occur. Some are easier to recognise than others. Some can be treated but in some cases treatment is very challenging and other options such as wigs or hair weaves such as the intralace system ©  may be needed.

  1. Alopecia areata (AA). The classical form of AA is where small circles of hair loss appear on the scalp. The hair will often regrow without treatment. This can take 2-3 months.  A small proportion of patients become more severely affected. Eye brows, eye lashes and body hair may be affected. There is sometimes a family history. Studies have identified gene variations that are linked to AA. It remains unclear what the triggers are for the condition and why the severity varies so much between individuals.

 

  1. Telogen effluvium. Hairs are normally found in different phases of the growth cycle. Under some conditions such as pregnancy or illness, the hair growth can become synchronised and lots of hairs enter anagen at the same time. This means that following the end of the pregnancy or illness large number of hairs enter telogen at the same time and all fall out together. Following the pregnancy or during recovery from the illness the hair usually returns to normal.

 

 

  1. Chronic telogen effluvium. In this condition women notice a generalised thinning of the hair all over the scalp. This condition has not been totally unravelled. What seems to happen is that the growth cycle of the hair is adversely affected by various factors. These include conditions such as iron deficiency or an underactive thyroid, various medicines, possibly stress and probably other unknown triggers. The proportion of hairs entering telogen increases and possibly the proportion entering anagen reduces. In other words, there are more hairs falling out than growing. There are still some new hairs growing so complete balding does not occur but over time a general thinning of the hair is seen. Click here for a list of medications that may contribute to hair thinning.

 

This can be one of the most challenging forms of hair loss. If a precise cause is not found do not be tempted to waste money on supplements. Make sure iron stores and thyroid function are normal and possible medication triggers have been removed. Eat a healthy diet.

You may want to try Regaine although the results are sometimes disappointing.

 

  1. Female pattern hair loss. In this condition the hair becomes thinner on the top of the scalp. In contrast to male pattern hair loss the frontal hair line is normally preserved and recession at the frontal hair line whilst possible is unusual. As with male pattern hair loss hormonal factors including an increased sensitivity of the follicles to testosterone is thought to be involved but the precise mechanism is not clear. Some hair scientists feel that female pattern hair loss is not simply the female version of male pattern hair loss. Female pattern hair loss can affect young women but becomes more common in older post-menopausal women.

 

  1. Scarring alopecia. There are a number of different disease processes that can lead to scarring alopecia. These include discoid lupus, lichen planopilaris, frontal fibrosing alopecia (FFA) , folliculitis decalvans, traction alopecia, central centrifugal alopecia and pseudopelade . These conditions all have different clinical characteristic features but they all share the problem that follicle stem cells are damaged and the hair follicles lose the ability to produce new hairs leading to the appearance of scalp scarring with absent hair follicles. Once the stem cells are destroyed they cannot be replaced. Scarring alopecias can be very difficult to treat. Early diagnosis is important but treatment is not always effective. Click here for more information on FFA.

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