Hair Loss in Women And Children: What Can Be Done?
It’s a real blow to many men when they start losing hair because it’s one of the most visible symbols of their masculinity.
But men have traditionally been described as “distinguished” when they begin balding; it’s much worse when a woman or child starts losing hair. In the eyes of society at large, women with hair fall aren’t distinguished. While a child’s hair loss due to illness or disease focuses public attention on his or her medical problem. For each, loss of hair causes incalculable self-esteem issues.
Thankfully, women’s baldness and hair loss in children are less common than men’s hair fall issues, but that doesn’t make the problem any less heart-breaking for those who have to deal with it. Hair loss in women isn’t as unusual as you might think; the American Academy of Dermatology says nearly half of all women experience visible hair fall by the time they reach the age of 40. And it can get distinctly worse after that, as menopause and hair loss go hand-in-hand for hormonal reasons.
Here’s what you need to know about the reasons for hair loss in women, treatment options for balding women, and steps for the prevention of female balding. We’ll also briefly discuss the terrible problems of infant hair loss and child hair loss.
Hair Loss In Women: Causes
For most people, baldness is defined as a male problem. After all, the most common type of hair loss is known as MPB – male pattern baldness. That’s actually a misnomer, however, because androgenetic alopecia (the medical name for pattern baldness, also referred to as AGA) can affect both men and women – it’s just more common for males. (By the way, alopecia doesn’t only mean pattern baldness, it’s the umbrella term used to describe hair loss in general.)
AGA in women usually starts with a bit more hair loss than usual in the shower or when brushing, which is easy to miss. A human’s normal hair fall per day is 50-100 hairs, and at the onset of pattern baldness that increases to a hair loss per day of just 100-150 hairs. This issue can begin when females are in their 20s and 30s, and is even responsible for some hair loss in teens. However, it’s only when women’s hair begins to become noticeably thinner that most realize that they’re seeing an actual hair loss symptom and seek some sort of treatment for hair thinning.
The answer to what causes hair fall like this isn’t clear. AGA apparently is primarily due to heredity and hormones – particularly the hormone DHT, which is a by-product of testosterone. Over time it causes hair follicles to shrink, produce thinner hair and eventually stop creating new hairs altogether. Fortunately, the follicles affected in pattern baldness don’t die but are simply dormant. That’s the reason that many hair treatments for hair growth are able to work well for those with androgenetic alopecia.
There are many other causes of hair shedding and hair loss which are referred to by laymen as hair loss disease, or alopecia. Hormones are a major culprit for women; as we’ve mentioned, female hair loss often accelerates after menopause, and it’s also common for women to temporary lose some hair after giving birth. The common link is estrogen. Hair loss occurs when the female body has lower estrogen levels, which of course happens during menopause. Conversely, estrogen levels in the body are higher during pregnancy, which is why women’s hair seems to be thicker and shinier before they give birth – but afterward, hormone levels drop and all of that “extra” hair tends to fall out. Another example is seen when women discontinue birth control pills; without the extra estrogen supplied by the pills, their hair is likely to thin or fall out. The issue reverses itself naturally, though, once the body is able to adjust to its normal hormone levels. Women’s hormones and hair loss are constantly engaged in a pas de deux.
These are all examples of androgenetic alopecia. The second most-common cause of baldness in women and men is known as telogen effluvium, or TE, and it gives some credence to mothers who have told their children since time immemorial, “You’re making my hair fall out!” TE is usually caused by some sort of major stressful or traumatic incident such as a serious accident, surgery, major life change or malnutrition, and acts by causing functional hair follicles to go into a “resting” stage. TE can cause shedding, or even lead to sudden hair loss in women causing entire clumps of hair to fall out at once; this usually happens a few months after the traumatic event. Usually the problem disappears after the triggering event ends or the problem is solved, but some people do suffer chronic TE without ever knowing why. In those cases, the same treatment for female hair loss used for AGA can sometimes be effective.
Other types of female hair loss are less often seen but can be just as devastating. They include:
- Alopecia Areata: Believed to be an auto-immune “loss of hair disease,” AA causes inflammation at the roots of hair follicles and prevents hair from growing. The telltale sign of alopecia areata is the hair loss patterns it creates: bald patches on the scalp, usually circular and few in number. Female hair loss remedies aren’t usually advised for AA, because nearly three-quarters of all sufferers regain all of the lost hair within a couple of years, with or without any sort of treatment. Those who do need medical assistance should see a dermatologist; hair loss due to AA is usually treated with corticosteroids. Diabetes hair loss is usually due to alopecia areata, although there can be other contributing factors including the required drug regimen, diabetes-related hormonal changes and stress from the disease. Diabetes is just one of the “hair loss diseases,” which also include lupus, hyper- or hypothyroidism, cancer and muscular dystrophy.
- Anagen Effluvium: This is most commonly seen in cancer patients who are receiving chemotherapy. The poisonous drugs used for that therapy also shock the patient’s hair follicles into a suspended state, causing the hair to fall out. About 30 days after chemo drugs are out of the body hair growth will resume, although the characteristics of the patient’s hair (such as its natural color) may change permanently.
- Traction Alopecia: This condition often causes hair loss in young women and hair loss in black women, because of the tight hair styles they often wear like cornrows, extensions and tight braids. Pulling the hair so tightly causes trauma to the follicles, damaging them and inducing hair fall. As long as the hair styles are changed or at least alternated regularly, the hair usually regrows on its own without a problem.
We’ve mentioned the heart-breaking problems of children or infants with hair loss or born without hair. These are different issues than alopecia, and are described as hypotrichosis. Alopecia is the loss of hair which once grew, while the many types of hypotrichosis are congenital problems which usually prevent hair from growing in the first place. The exception is a condition called congenital atrichia, in which a child’s hair grows naturally at first but then falls out and won’t regrow due to a gene defect. All of these issues are serious and require immediate medical attention; no hair treatment for baldness will be effective, and none should be used.
Now that we’ve looked at the different causes of loss of hair in women, let’s move on to an examination of how to prevent and how to restore hair loss, whether medicine to stop hair fall is an option for women, and the best hair loss remedy for women facing baldness.
Prevention For Women
It would be wonderful if you could be vaccinated against hair loss, just as we’re all vaccinated against chicken pox and polio. Needless to say, that’s only a dream; there’s no way to prevent pattern baldness, and no way to guard against the type of stressors which can bring about telogen effluvium. Avoiding birth control pills and pregnancy can help you avoid the temporary hair fall issues which can result from fluctuating estrogen levels – but that’s not a sensible route for most women, and eventually menopause will raise its head and lower your hormone levels.
However, experts do have a few suggestions on how to help hair loss from developing. The first is to cut down on sugary desserts and fried foods (you knew that was coming, right?), because sugar and oil are both substances which when broken down by the body can contribute to the creation of DHT, the enemy of healthy follicles. Proponents of vitamin therapy suggest eating foods rich in vitamins A, B6, B12, folate, C and D, or taking multivitamins containing those vitamins as well as zinc, iron and calcium. Some studies have shown a possible benefit to vitamin D, although most medical experts downplay the effect other vitamins can have as either a preventative or treatment of hair fall.
There’s no such thing as a hair loss shampoo for women, but there is a shampoo you can use which might help prevent AGA or as a supplement to thinning hair treatments. It’s a non-prescription product called Nizoral A-D, which contains the antifungal ketoconazole. That substance is normally used in prescription shampoos for serious dandruff, but it fights dandruff by lowering testosterone in the hair follicles, so that would theoretically mean you’d have less testosterone available to be converted into the DHT which is so culpable in pattern baldness. Nizoral won’t promote hair growth for women, but it might prevent both dandruff and hair loss.
Treatment For Women
So now we get down to the important question: if you’re a woman, is there a treatment for losing hair that is truly effective? Before we consider the medical establishment’s standard female hair loss solutions, let’s consider some alternative types of hair thinning treatments.
There are no “natural” hair loss products endorsed by doctors or medical experts, but there some sprays, oils, supplements and herbs which natural practitioners suggest can reverse the cause of female hair loss. Some spray manufacturers say their hair treatment for hair loss works by making strands of hair stronger and less likely to fall out. Others say that their vitamin sprays are an effective hair baldness treatment. There’s no solid proof for either claim, but there’s no harm in trying them. The one type of spray to avoid claims to unclog hair follicles which have been blocked; those products have been banned by the FDA. The most common sprays are really just “concealers,” which either add colored particles to your scalp or put a coating on the hair that’s already there, to make it look like you have thicker hair; treatment for hair fall should really be more than just coloring, though.
What about oils as a hair loss treatment for women? There’s no hard evidence supporting it, but a common “losing hair” treatment is rubbing castor oil, warm virgin olive oil or sweet almond on the scalp. Castor oil contains ricinoleic acid which supposedly increases circulation to the follicles, olive oil has lots of vitamin E and fatty acids, and almond oil contains vitamins D and E; proponents claim those are natural hair growth products although there’s no scientific proof. Supplement advocates suggest a healthy intake of black currant oil, evening primrose oil, and/or Omega-3 fatty acids (although hair loss nutrition experts say eating plenty of wild salmon, walnuts or flaxseed is the best way to get fatty acids), and herbalists claim that saw palmetto works for pattern baldness by stopping the creation of the DHT which inhibits natural hair growth.
Then there are the home remedies to regrow hair – bald treatments which you can easily find on the Internet or by asking your grandmother. Rub onion juice or a paste made from black pepper and lime seeds onto your head (making sure to put a clothespin on your nose first, of course), drink plenty of spinach juice or alfalfa juice (or if you’re feeling less adventurous, make a shake from bananas, yogurt, honey and skim milk) and poof! You have instant hair loss remedies for women. Do they work? Don’t ask us, ask the Internet or your grandmother.
Hair Loss Medications
Females often seem to draw the short straw compared to males, and one more example is in the area of medical hair loss solutions for women.
First of all, many doctors are unwilling to prescribe medications for treatment of baldness in women. That’s because they’re afraid that whole-body treatments will negatively impact a female’s hormone balance. Those prescriptions are usually only issued after physicians determine whether a woman’s hair balding is because of too much androgen or an over-reaction to androgen in her body.
The drug of choice for female patients is minoxidil (marketed as Rogaine), but not the pills that men often take. Instead, it’s applied topically to the scalp where the amount absorbed is unlikely to affect hormone balance or cause side effects. The good news? Minoxidil is usually more effective for women than it is for men. Because it doesn’t stop DHT production, versions of minoxidil are used given to men as “hair health maintenance” drugs than “hair growing” products. But in women, clinical studies have shown nearly 20% of patients with pattern baldness exhibited moderate hair regrowth and more than a third had at least minimal regrowth. The FDA has only approved a 2% solution for this purpose, but many dermatologists will prescribe a stronger strength (5%) which has been shown to work significantly better. It can take at least three months to see results.
The most common drug prescribed for male AGA, finasteride (that’s the generic version, which is also sold under the brand names Propecia or Proscar) is not usually given to women and is not approved by the FDA for female patients, because of the risk of birth defects in children conceived or born while their mothers were taking it. However, it has been to shown to work as a treatment for hair fall in some female patients when proper precautions are taken.
Since what causes hair loss in women can be very different than in men, some types of androgen receptor inhibitors are prescribed off-label for female patients, when their hair loss reasons are believed to be androgen-related. These include spironolactone (Aldactone), cimetidine (Tagamet) and cyproterone acetate (not available in the United States because of possible toxicity and serious side effects). All three have shown a significant ability to keep DHT from binding to follicle receptors. None of these drugs are recommended for men because they can drastically affect male hormones.
If a woman’s causes of hair fall are either menopause or low estrogen, doctors may prescribe estrogen or progesterone creams or pills as medical products for hair loss and thinning hair. Similarly, they may prescribe low-androgen birth control pills, for women whose medical history doesn’t include specific risk factors and whose hair loss reason is androgen-related.
Transplants for Women
Here’s one more example of women getting the short straw (or in this case, the short hair) when it comes to top hair loss products. Most women are not good candidates for transplants as a hair baldness treatment. That’s because their hair loss is usually “diffuse,” meaning their hair falls or thins all over their scalp – including the areas normally used as “donor areas” for men. Why is that a problem? In most men, the follicles in donor areas are perfect for use in transplants because they aren’t affected by DHT. In women, they are. So any hair taken from a woman’s donor area and transplanted would simply fall out.
Experts say that no more than five percent of women are good candidates for transplants. Those are ones suffering from the same pattern of AGA as men (which is very unusual), those with issues like traction alopecia (or a similar condition, alopecia marginalis), or those who have lost hair in very specific areas due to plastic surgery, accidents or burns. Otherwise, females are out of luck when it comes to hair loss surgery.
Those few women who qualify may not be interested, though, due to the high hair transplant surgery cost. The average hair transplant price ranges from $5000 to $10,000 and can go even higher. So perhaps women are actually the lucky ones in this case, since most don’t have to think about whether the hair transplantation cost is worth it.
Laser for Hair Loss
One option that’s equally available for men and women suffering from what some call “losing hair disease” is laser hair replacement or restoration, officially known as low laser light therapy or LLLT. As you probably know, lasers are often used to remove hair. But it has been found when a red laser is used with less power than required for removal, it can actually stimulate hair growth instead. There are clinics where you can have LLLT performed, but the process takes as many as six months (with visits twice weekly) and costs thousands of dollars. For that reason, companies now sell “laser combs” for home use which supposedly do the exact same thing for a few hundred dollars. They’re FDA-approved for safety, but there’s no proof anywhere that lasers are really how to treat hair fall with any real results – other than the glowing reports you can read in hair loss product reviews, of course.
Treatments for Women
You’d probably guess that there’s always new research underway on hair fall causes and treatment, and you’d be right. There’s plenty of interest, and money, in hair. Treatment for hair loss now includes something called PRP, which stands for platelet-rich plasma. Here’s what the hour-long process requires: the drawing of blood, the extraction of plasma, the addition of nutrients, and then a series of injections into the scalp in the shape of a grid. (Yes, local anesthesia is used). Does it work? Patients claim it does, and it should, for a price of $1400 for the one-hour session – but there’s no medical evidence of efficacy. Hair restoration doctors say that women respond to PRP better than men, if you’re looking for a little good news to offset the price.
Research is also being done on the possibility of using hair follicle stem cells as a baldness remedy, and on new medication for hair loss suitable for women. But those searching for signs of a breakthrough that can stop hair loss now will be searching for quite a while.
If you’re feeling down about the fact that all of the best hair regrowth products seem to be suitable only for men, cheer up – it could be worse. Believe it or not, alopecia is also a problem for dogs, and there are even fewer alternatives for them. Canine hair loss is usually caused by mange, trauma, infection or disease, and the only real hair products for hair loss in dogs are topical shampoos and antibiotics, with no hair growing alternatives available. On second thought, that probably doesn’t make you feel much better. But it’s never a good idea to get too worked up over baldness; hair loss stress can lead to baldness. At least, that’s what we’ve read.