Have you noticed more hair than usual in your brush or shower? Is it worrying you? Here’s what you need to know about an issue that is both common and complex.
Leanne Raditsas was just 15 years old when she began losing her hair. It started with a small bald patch, about the size of a 10-cent coin. By the time she turned 40 years of age, she was completely bald.
Leanne was told she had alopecia areata. This hair loss condition made the news earlier this year when actor Will Smith smacked Chris Rock on stage at the Oscars because he had joked about his wife’s hair. She too suffers with alopecia areata, a condition caused when the body’s immune system attacks the hair follicles. (These are openings on the surface of the skin through which hair grows.)
This sort of hair loss can affect up to 2% of the population at some point in their lifetime. It can have big impacts on how women see themselves, and on their mental health. Leanne didn’t know the face looking back at her in the mirror.
“There was a lot of shame,” she remembers. “What you see in the mirror is not who you thought you were. You don’t recognise that person. It’s bizarre at the start but as time goes on, you learn to accept it is you.”
Hair loss in women is extremely common. Jean Hailes endocrinologist Dr Nellie Torkamani says that 49% of women will be affected by hair loss in their lifetime. Often it will be temporary and hair will grow back, while for others, the loss may be permanent.
Women should really trust their instincts. They know their own bodies. If there is a significant amount of hair loss in the shower or in your brush, then it might be time to talk to your GP.”Dr Nellie Torkamani, Jean Hailes endocrinologist
There are many types of hair loss in women but the most common is known as female pattern hair loss (FPHL). A gradual thinning at the part line or a thinning at the crown of the head are the early signs of the condition.
Genes, post pregnancy, menopause, a major medical event, anorexia, an autoimmune disorder (such as alopecia areata), a hormonal condition like PCOS (polycystic ovary syndrome), even long COVID can contribute to hair loss.
Dr Torkamani says that changes in female hormone levels, especially a drop in oestrogen around the time of menopause, can result in hair thinning and hair loss in some women.
According to Dr Samantha Eisman, a dermatologist who specialises in the treatment of hair loss, the list of reasons behind hair loss is long and complex and can also include dramatic weight loss, recovering from surgery and, in some instances, adopting a diet that excludes certain food groups.
The answer is both yes and no.
Although many women like Leanne say stress is a trigger for their alopecia areata, the experts generally say the opposite is also true – that hair loss itself causes the stress.
However, stressful events can affect certain types of hair loss. Dr Torkamani explains: “COVID-19 or any stress in life can cause hair loss. If stress is continuous – like lifelong anxiety or work-related stress – then it can turn into chronic hair loss.”
Hair can start to shed about two to three months after a stressful event like giving birth or undergoing a medical procedure. Dr Eisman says treating that hair loss is not always necessary because in these instances, the hair will eventually regrow. However, if the hair shedding does not decrease or there is no evidence of hair regrowth after a six-month period, she advises women to consult their GP.
We tend to shed around 100 hairs a day, which you will see in your brush or when you wash your hair in the shower. However, any significant change from this can be worrying.
“Whenever they’re concerned, women should really trust their instincts,” advises Dr Torkamani. “They know their own bodies. If there is a significant amount of hair loss in the shower or in your brush, then it might be time to talk to your GP.”
Dr Eisman says it can take courage for women to raise the issue with their GP but the earlier a condition is identified, the easier it is to treat.
The impact on women’s self-esteem is significant. She says that hair loss can lead to depression, anxiety and relationship stress. Many turn to psychologists for help.
There is no cure for female pattern hair loss (the most common cause of hair loss in women), but several treatments can successfully slow or reduce the rate of loss. One of the cheapest options is called Minoxidil, and while it comes in lotion and tablet form, Dr Eisman says it’s most effective in tablet form. It’s important to discuss this treatment with your GP and dermatologist as it’s not suitable for all women.
Other treatments like plasma rich platelets, hair transplants and stem cell treatments are much more expensive. Results will vary from operator to operator so again, it’s best to discuss treatments with your GP before embarking on an expensive treatment regimen.
Dr Torkamani warns women to be wary of solutions that are advertised as quick or ‘magic’ fixes for hair loss.
Depending on the underlying condition, treatment such as those that reduce testosterone levels in PCOS, or menopausal hormone therapy (MHT) to some degree in menopause, can have a positive impact on hair loss.
A healthy and balanced diet is essential because some women who experience thinning or hair loss can be lacking in nutrients like vitamin B12 and iron.
The role of nutrition in hair loss is complex, says Dr Torkamani, and supplements only help if a woman’s deficiency is identified. Speak to your GP or qualified health professional before taking any medications, including supplements.
Dr Eisman says that while it’s important to replace deficiencies in a woman’s diet, it’s important to remember that supplements alone will not grow back hair.
Nearly four years ago, Leanne was put on a new drug. “And the result was magnificent,” she recalls. “I went from totally bald to a head of fluff.” She is now off the medication and has 95% of her hair back. She occasionally gets a steroid shot to cover some bald spots.
“Mine is a story of hope,” she says. “I always believe it’s important to go with your gut, do your research, and rely on medical professionals.”
Stock photos used. Posed by models.