You look in the mirror one day and notice a widening part or a patch of scalp showing through your once-thick mane. Maybe you spot an alarming clump circling the shower drain.
Such moments are especially frightening for women, says Shani Francis, MD, director of the Hair Disorders Center of Excellence at NorthShore University Health System.
Some reasons for hair loss:
- Excess styling
- A thyroid imbalance
- Low iron and low vitamin D: Have your doctor check your levels; supplement if necessary.
- Medication: Going on birth control, blood pressure medication, steroids, or antidepressants can all prompt hair to shed temporarily.
- Significant weight loss
- Hormone changes after pregnancy or during menopause
- A traumatic event, like an illness, surgery, or death in the family
By middle age, 40% of women show signs of pattern hair loss (androgenetic alopecia), a genetically-based condition in which hair follicles gradually shrink and become less active, prompting budding strands to become wispy and stubby, shed more, and grow less. Declining estrogen levels, due to menopause, may also play a role in hair loss.
Many other women go through telogen effluvium, a temporary shedding sparked by stress, illness, nutritional deficiencies, or hormonal changes. For this type of hair loss, in which hair tends to fall out in clumps, better nutrition, rest, and time may be all you need.
If you talk to your doctor and decide you want to try a hair loss treatment, you have several options.
In 2014, the FDA approved a new women's version of the over-the-counter hair-loss cream minoxidil (Rogaine). Originally used as a blood-pressure medication, minoxidil dilates blood vessels, helping to stimulate and nourish hair follicles. The new Women's Rogaine 5% minoxidil foam needs to be applied only once a day.
The main culprit of pattern hair loss for women is dihydrotestosterone (DHT), a derivative of the male hormone testosterone. When it gets inside hair follicles it damages them. The drug finasteride (Propecia) reduces DHT. Doctors advise women of childbearing age to never take it.
The FDA approved the first laser comb in 2007. Since then, the comb has been joined by laser caps, helmets, and brushes ranging from $300 to $700. One 2014 study of 128 men and 141 women found those who used a laser comb three times a week for 26 weeks saw hair thicken.