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Women’s hair loss

Baldness is slow, painless hair loss that follows a set pattern in some people as they age. In many women a gradual but slight, widespread thinning of the hair starts in adult life. It is basically a natural process and should not be regarded as abnormal. About 50% of women have significant hair loss by the age of 60. However, some women experience marked loss of hair which can be embarrassing and upsetting.

What is the female hair loss pattern?

Women experience a different pattern of hair loss from men. Diffuse thinning usually occurs on the top of the head (ie, the crown). The front hairline usually remains but in some women this can recede. Although hair loss can appear in men as early as the 20s, it rarely appears before the age of 50 in women. Some women notice a short period of considerable hair loss but this may be followed by a long, stable period of no loss. However, some women may have total hair loss.


What is the cause?

  • Significant hair loss may follow a family tendency.
  • Ageing is also a factor and hair thinning is inevitable in most people with advancing years.
  • Baldness is sometimes caused by a severe sudden illness in which hairs stop growing and then fall out in about three months. However, they usually grow back after recovery.
  • Crash dieting and anorexia can also cause this problem.
  • Certain illnesses such as thyroid disorders and iron-deficiency anaemia can cause diffuse hair loss.
  • Some fungal infections can result in bald patches.
  • Certain treatments, especially cytotoxic drug treatment — used to slow down cell growth in cancer — can cause severe hair loss. Hair usually regrows when drugs are stopped.
  • Some people are affected by a specific hair loss disorder called alopecia which causes premature hair loss and can spread to involve the whole scalp (alopecia totalis).
  • Some women notice hair thinning occurs about three months after having a baby and are aware of many loose hairs when combing. This is a common occurrence and the hair usually grows back in the following months.


Is menopause associated with hair thinning?

There is a tendency to lose hair after menopause. Some women, particularly those with a hereditary tendency, are more prone to this condition.

Is taking the combined oral contraceptive pill a problem?

Female hormones are protective against hair loss. The pill should not cause either hair thinning or regrowth.

How common is the problem?

Natural hair loss is very common in women. Each year about one person in 400 sees a doctor about unusual hair loss or baldness.


What can be done?

Doctor will investigate if there is any underlying cause of the hair loss and discuss with you the most appropriate management tailored to your situation.

In case of genetic or age related female baldness, Medication Management is a rather controversial subject, especially the use of medication. Medicated shampoos and ointments should not be used — they do not help. Do not get caught up with quack remedies. Vigorous brushing or washing of the hair also does not usually help.

Some drug treatments may slow down or prevent further hair loss. These include a topical treatment called minoxidil which is massaged into the scalp or taken as a tablets, and hormone-altering tablets, namely spironolactone and cyproterone acetate. With these treatments most women will notice a reduction in hair loss and some will notice hair regrowth but normal regrowth is exceptional. The medications are expensive and need to be used for the rest of one’s life if a good response occurs. You can discuss these medications with your doctor.

Cosmetic treatments

Include PRP (your own growth factors taken from your blood), mesotherapy (active ingredients injected into hair follicles), LED treatment and low level lasers.

Physical treatments

Other treatments include the use of wigs, hair transplantation and camouflage. Wigs can be worn on the whole head, on the bald spot, or fibres can be interwoven into the remaining hairs. Wigs made from real human hair look better but are more expensive than artificial wigs. Camouflage can be used either by having existing hair bleached by a skilled hairdresser or by colouring the scalp the same colour as the hair. Mascara can be lightly brushed into the roots of the hair at receding hairlines or along parts. You can consult hairdressing experts about camouflage.