Hair Loss in Women

(LifeWire) - Every day, whether we notice it or not, about 100 hairs fall from our heads. When this process, which is very normal, goes awry, the results can be a lot harder to miss -- especially in women.

Hair loss in women has many causes and many treatments,  and it can be traced to a wide variety of factors -- both common and unusual. These can include disease, stress (mental or physical), hormone fluctuations and medication side effects, among others. Whatever the cause, however, thinning hair is naturally a source of concern.

In certain cases -- for example, cancer patients undergoing chemotherapy -- women may be expecting hair loss. More often than not, however, it comes as an unexpected and unpleasant surprise.

What should someone do in this situation? Anytime you can't determine why you are losing hair, you should promptly consult your clinician, who should be able to evaluate the problem and may be able to treat it. He or she may also refer you to a dermatologist.

To understand hair loss, it helps to review how the body produces hair. The growth cycle of hair is lengthy -- from 2 to 6 years, on average -- and most people's hair grows about a half-inch per month.

At any given time, about 90% of your hair is actively growing. The other 10% is in a "resting" or dormant phase. The dormant hair, after 2 to 3 months of not growing, falls out, and the growth process begins anew. Meanwhile, other hair follicles are entering the dormant phase.

This normal progression, when interrupted or accelerated, can lead to noticeable hair loss. Several factors may disrupt the normal cycle of hair growth.

Potential Causes of Hair Growth Disruption

Harsh hair treatments or hairstyles -- Chemical products, such as dyes, bleaches, straighteners or permanent wave solutions are generally safe for hair -- unless administered incorrectly or too often. So are hairstyles that use barrettes or rubber bands. But hair follicles can become inflamed or scarred when hair is overtreated chemically or regularly pulled into certain tight styles, such as cornrows, which can cause a condition known as traction alopecia. Depending on the extent of damage, the resulting hair loss could be permanent.

Hereditary pattern baldness -- This condition is most common among men but also affects a small number of women. Known in both genders as androgenetic alopecia, it results from the conversion of the male hormone testosterone into dihydrotestosterone (DHT), which has a harmful effect on hair follicles. Women carry trace amounts of testosterone in their bodies, but the decline of circulating female hormones at menopause can result in a hormone imbalance that leads to thinning hair on the top or sides of the head. However, few women lose all of their hair to the condition.

Other hormone imbalances -- Hair loss can occur as a result of other hormonal issues at particular life stages. Birth control pills (or their discontinuation), pregnancy, post-partum hormonal shifts, menopause and hysterectomy (surgery to remove the uterus and also the ovaries in some cases) can all contribute to hair loss if they produce sufficient upheaval in your hormonal balance, prompting more hair follicles than normal to enter the resting phase. Your doctor may look for certain diseases, such as thyroid disorders, certain autoimmune disorders, iron deficiency, and/or syphilis.

Pregnancy -- One example of life-stage-related hair loss is pregnancy. In particular, during pregnancy, hair that might normally be shed is sometimes retained until after birth (due to the unusually high levels of certain hormones). Then it may fall out in masses or clumps. Sometimes the hair loss doesn't become apparent until about 3 months after the hormonal change, and it can take another 3 months for the hair to begin growing normally again.

Physical or psychological illness or surgery. -- Illness or surgery can also cause an increased number of hair follicles to enter their latent phase. To cope with the stress that comes from illnesses -- such as iron deficiency (anemia), lupus, severe infection or thyroid disease -- the body may cease nonessential functions such as hair production. Again, the process of hair loss and regrowth may take 6 months.

Nutritional deficits -- Nutritional problems that result from heavy dieting or eating disorders, such as anorexia and bulimia, can also shock the hair follicles to temporarily stop growing. As with illness, inadequate nutrition, including insufficient protein, vitamins or minerals, taxes the body, and this may cause a shift into a protective mode that minimizes nonessential functions such as hair growth.

Certain medications and vitamins -- Cancer chemotherapy is the best-known example of how a medical treatment can inadvertently cause hair loss. The chemotherapy agents attack fast-growing cells throughout the body, including not only malignancies but also hair follicles. In addition, hair loss is among the side effects of certain medications used in treating high blood pressure and gout (a painful condition marked by the buildup of uric acid in the joints). High levels of vitamin A can also have a hair-thinning effect.

Aging -- As we grow older, the process of hair growth tends to slow down.

Given this range of potential causes, it's not always easy to prevent hair loss, but potentially helpful steps include gentle hair care habits and proper diet.

Fortunately, women's hair loss has as many treatments as causes, although there's no single, one-size-fits-all solution. Remedies range from watchful waiting to surgical restoration, and the treatment of choice for any given individual will mainly depend on the specific cause of the hair loss and how much it affects a patient's self-esteem.

Potential Remedy Treatments for Hair Loss

Topical lotions and creams -- Creams and lotions include over-the-counter Rogaine or Regaine (minoxidil), which helps restore hair, especially in those suffering from hereditary hair-thinning. These products are applied directly to the scalp. Or, consider permanent waves or shampoos that act to create a thicker appearance of hair.

Anti-inflammatory medications -- Drugs such as steroid creams or injections can be prescribed to calm follicles inflamed by excessive pulling or harsh chemical treatments.

Changes in medication -- If a prescription drug has led to hair loss, your doctor may be able to suggest an alternative without this side effect.

Hair weaves or wigs -- Wigs can restore the appearance of a full head of hair, either by adding to existing hair or by covering the head completely. While expensive, they can be particularly useful for cancer patients and others whose hair loss is temporary.

Surgery -- A number of surgical techniques can help restore a natural-looking hairline, but unfortunately, women tend to be poor candidates for such procedures -- generally because their hair loss is evenly distributed over the scalp rather than in one or two areas (as is typical for men). While many board-certified plastic surgeons offer surgical hair restoration for men and women, the American Board of Medical Specialties (an organization of two dozen medical specialty boards that oversees the certification of many specialty physicians) has no approved certification process for the field of hair restoration itself.

According to the American Hair Loss Association, which is an education and advocacy group, potential clients should proceed with caution when investigating surgical hair restoration. These procedures can cost many thousands of dollars and are usually not covered by insurance. They also carry the risk of infection, as well as the possibility of poor cosmetic results.

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