Hair Loss

Hair Loss In Women

Hair loss in men is very common and socially acceptable but in women hair loss is considered very abnormal. Losing hair at a young age can be a very traumatic experience. Hair loss in women has a negative effect on their social life and might lead to low self-esteem and depression.

The female pattern of hair loss tends to be more diffuse, with less likelihood of the crown and frontal hairline being lost. Hair loss in women can start as early as in their 20s but the pace of hair loss tends to be gradual, often taking years to become obvious. Fortunately hair loss in women typically does not result in complete baldness.

There Are Several Causes And Types of Hair Loss In Women:

Female Pattern Baldness

In this hair starts thinning from the top of the head. This is the most common cause in women. This kind of baldness is usually less diagnosed in women and is usually genetic in nature.

Polycystic Ovarian Syndrome

Also known as PCOs, they cause abnormal growth of hair on face due to hormonal imbalance.

Hypothyroidism

Hypothyroidism leads to reduced basal metabolic rate which slows down the growth of hair and can lead to loss of hair in long run. This leads to reduced hair density and diffuse loss of hair. Correction of the cause leads to revival of the lost hair.

Telogen Effluvium

Telogen effluvium is sudden loss of hair which occurs after pregnancy, major surgery, drastic weight loss, or extreme stress. It can also be caused by various medications such as antidepressants, beta-blockers, and nonsteroidal anti-inflammatory drugs. During telogen effluvium the hair shifts faster than normal from its growing phase into the “resting” phase before moving quickly into the telogen, phase. There is generalised thinning of hairs and this type of hair loss is usually temporary in nature.

Lupus

This is a chronic autoimmune disease in which the body’s immune system attacks the healthy tissues. Many people experience hair loss which can be mild or it may be more severe leading to patchy areas of hair loss accompanied by a rash over the scalp.

Alopecia Areata

Alopecia areata is an autoimmune disorder which may be triggered by stress or illness leading to development of round, smooth patches of baldness on the scalp, eyebrows, or legs. Total loss of hair over the head is known as Alopecia Totalis, while hair loss from all over the body is called Alopecia Universalis.

Seborrheic Dermatitis

Also known as dandruff, this is an unhealthy state of scalp commonly due to fungal infection leading to loss of hair.

Anaemia And Nutrient Deficiency

Deficiency of essential minerals and vitamins in the body can also lead to thinning of hair which over the period of time leads to hair loss.

Styling And Blow Drying

Unrestrained styling of the hair in the hands of untrained person with excessive shampooing and dry blowing can cause the skin of the scalp to dry and lead to hair loss. Chemical and heat treatments like straightening of hairs can also cause hair loss.

Hereditary Hair Loss

This is also known as androgenetic alopecia and this is also an important cause of hair loss. The gene can be inherited from either mother’s or father’s side of the family. The condition develops slowly and may start as early as in 20s.

Other factors that can also contribute to hair loss are stress, trauma, immune disturbances, hormonal disturbances, infections, improper dieting, any major medical illness, medications, chemical treatment of hairs, etc.

Female pattern baldness is usually diagnosed based on ruling out the other causes of hair loss, the appearance and pattern of hair loss and detailed medical history. The signs of hormonal imbalances like abnormal new hair growth, such as on the face or between the belly button and pubic area, changes in menstrual periods and new acne.

At times a skin biopsy or other procedures or blood tests may be used to diagnose skin disorders that cause hair loss. Microscopic examination of the hair shaft is also helpful in getting the complete picture.

How Female Alopecia Is Different Than Alopecia In Men

In female pattern baldness the thinning of hair is mainly on the top and crown of the scalp. It usually starts widening from this central part. The frontal hairline remains unaffected except for normal recession, which happens due to ageing. The hair loss in women rarely progresses to total or near total baldness.

Treatment

In most cases, hair loss in females is mild to moderate. Treatment is only needed if the patient is not comfortable with her appearance.

Medications

The only medication which has been approved by the United States Food and Drug Administration (FDA) to treat female pattern baldness is minoxidil. It is used in 2% concentration and applied directly over the bald area of scalp. In most cases this slows down or stops the hair fall. Minoxidil application is to be continued as hair loss starts once again when it is stopped.

If minoxidil does not work then some second line medications like spironolactone, cimetidine, birth control pills and ketoconazole can be started but only under guidance of a physician with full knowledge of their side effects.

Platelet Rich Plasma Therapy

Platelet rich plasma therapy also referred as PRP is a very effective modality for management of hair loss or alopecia in women. In this therapy platelets with all the growth factors are directly injected into the scalp near the root of hairs. The growth factors released by platelets then stimulate the growth of hair follicles and also create the positive environment around the dormant hair follicles in the scalp and help them sprout back again. This not only makes the remaining hair healthier but also leads to growth of new hair from the scalp. The PRP injections are given under nerve block and are to be repeated every four weeks. On an average four sessions of PRP are required to get appreciable growth of new hairs.

LASER Therapy

This is the newest non-invasive modality for treatment of hair loss. Laser therapy for hair loss is US FDA approved and specially suited for females as other medications are less effective in females. The low energy laser light stimulates the growth of existing hair follicles leading to increased volume of hair. The dormant hair follicles are also stimulated and they give rise to new hair over the scalp. Over all within few months the scalp hair are healthier, longer, voluminous and more in numbers.

Scalp Enrichment Therapy

Called by various fancy names it a simple and effective procedure where the micro-environment around the hair follicles is made conducive for the growth of existing hair follicles and germination of the dormant hair follicles. In these techniques essential nutrients and various growth factors are supplied to the hair follicles by multiple injections or by making multiple pores in the scalp using dermaroller. Unique names and big fancy machines are used for this simple procedure for commercial reasons.

Hair Transplant

Hair transplant is a viable, permanent and least expensive option to manage female baldness in long run. In hair transplant hair grafts are taken from the back of the scalp and individual hair follicles are transplanted over the bald areas. Follicle unit extraction technique is a little more difficult to execute in females as compared to male. The donor site heals well and the hair follicles grow over the recipient area and in few months time all the bald area gets covered by new hair.

Indications of Hair Transplantation In Women

In contrast to men fewer women with hair loss will require hair transplant procedures. Some of the indications for hair transplant in women are:

1. Hair loss due to mechanical pulling of hair or traction alopecia specially due to some hair styles or tight application of hair band or clips.
2. Women having hair loss similar to that of male pattern baldness.
3. Women who have suffered hair loss due to trauma, including burn victims, accidents, and chemical burns.

Other Options

Hair weaving, hair growth fibre or a change in hairstyle can improve appearance. Only a change in hair style can be recommended to the patients. All other things have their own draw backs and side effects and these can fail at a wrong occasion leaving your social image shattered.
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