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Introduction
 t
is generally accepted that men lose
their hair. This is reflected in the many adverts for male hair loss products. However, hair loss is also common amongst women, but the
stigma can be difficult to handle. Furthermore, women are in poor second
position when it comes to drug treatments. Many drugs do work to some
degree for some women, but doctors are reluctant to prescribe them.
Also, companies aren't exactly falling over themselves to test
existing or new drugs specifically for their ability to prevent and
treat female pattern baldness.......it's just not big enough business
for them. Like men's hair loss however, there are underlying causes and
the good news is that a large percent of women's hair loss is completely
reversible.
CAUSES OF FEMALE HAIR LOSS
Telogen effluvium
The commonest hair loss in women is a
condition called telogen
effluvium, in which there is a widely spread out, shedding of hairs
around the scalp and elsewhere on the body. This can be a reaction to
stress on the body's, or sometimes as a reaction to
medication.
The condition can occur at any age. It
usually begins and tends to resolve itself within about 6
months, although for a few people it can become a chronic longer term
problem.
Telogen effluvium is related to the growth cycles of hair. Hair
grows in cycles. A growth phase (anagen) lasting about 3 years and a resting
phase (telogen) lasting about 3 months. During telogen, the hair
remains in the follicle until it is pushed out by the growth of a new
hair in the anagen phase.
At any time, up to about 15 per
cent of hairs are in the resting phase. However, a sudden stress on the body can
trigger large numbers of hairs to enter the resting phase at the same
time. Then, about three months later, this large number of hairs will be
shed. As the new hairs start to grow out, so the density of hair may
thicken again.
Many adults have had an episode of
telogen effluvium at some point in their lives, reflecting episodes of
illness, stress or a variety of hormonal factors.
The specific main causes of the
condition are:
Medications. A large number of drugs have been reported to cause
or possibly cause, diffuse Alopecia
Fever. A few months after a severe fever related illness, increased
hair loss can start
Nutritional Factors. Crash diets,
lengthy nutritional starvation and, alcoholism may result in some hair
loss. Discontinuation of such practices typically results in hair
re-growth. Iron and Zinc deficiency are also recognized as potential
causes. A simple blood test can reveal whether this is a factor in your
situation
The birth control pill (whilst on the pill and stopping it).
The months following childbirth. During pregnancy, more hair
follicles are maintained in the growth phase due to high estrogen
levels. After pregnancy, a greater proportion than normal of these hairs
go into the resting phase, causing a temporary loss of the hair, which
is self-correcting over time.
Systemic Illness. Various illnesses affecting the entire body
system have been associated with widely spread hair loss.
Changes in hormone levels influence the hair follicle. Especially
those of the thyroid and sex hormones. Hair loss usually disappears when
the condition is put under control.
Androgenetic alopecia
Another common type of hair loss in
women is androgenetic
alopecia, which is related to hormone levels in the body. There's a
large genetic predisposition, which may be inherited from the father or
mother.
Androgenetic alopecia affects roughly
50 per cent of men (this is the main cause of the usual pattern of
balding seen as men age) and maybe as many women over the age of 40 -
one piece of research suggests that over the age of 65 as many as 75 per
cent of women are affected.
The cause of hair loss in this
condition is a chemical called dihydrotestosterone, or DHT, which is
made from androgens (male hormones that all men and women produce) by
the action of an enzyme called 5-alpha reductase.
People with a lot of this enzyme make
more DHT, which in excess can cause the hair follicles to make thinner
and thinner hair, until eventually they pack up completely
Women's pattern of hair loss is
different to the typical receding hairline and crown loss in men.
Instead, it causes a general thinning of women's
hair, with loss predominantly over the top and sides of the head. Women
rarely go bald with this condition
Alopecia areata
Another important cause of
women's hair loss is a condition called alopecia areata, an autoimmune disease that
affects more than 2 per cent of the entire population. It does affect both sexes
and all ages and ethnic backgrounds.
It often begins in childhood. If
you have a close family member with the disease, your risk of developing
it is slightly increased. If your family member lost his or her first
patch of hair before age 30, the risk to other family members is
greater. Overall, about 20 per cent of people with the disease have a family
member who has it as well.
With this problem, the hair
follicles are attacked by white blood cells, the bodies own immune
system. The follicles then become
very small and hair production slows down dramatically, so there may be
no visible hair growth for months and maybe years. In most cases, the disease
does not extend beyond a few bare round small patches. In others, hair
loss is extensive. Uncommonly, the disease can cause total loss of head
hair (alopecia areata totalis) or complete loss of hair on the head,
face, and body (alopecia areata universalis).
After some time, hair may re-grow as
before, come back in patchy areas, or not re-grow at all. The course of
alopecia areata is highly unpredictable. Stem cells that continually
supply the follicle with new cells do not seem to be targeted. So the good news
is that in every case the hair follicles remain alive and can be
switched on again; the bad news is that we don't yet know how to do
this.
Scientists do not know exactly why the
hair follicles change and get attacked like this, but they suspect that
a combination of genes may predispose some people to the disease. For
these genetically predisposed, some type of trigger– (a virus,
dramatic environmental change) brings on the attack against the hair
follicles.
Overall Summary
Remember, when considering
treatment, you need to understand how far your hair loss has progressed,
to guard yourself against misdiagnoses of your condition. There may be
times when you will have to relay this information via telephone or the
internet to practitioners. It important to get this right. A method used
by many practices is the Hamilton-Norwood
and Ludwig
scales
The key to hair loss is to find out
what the underlying reason is, and to then evaluate your options in
dealing with it. Go to your doctor or specialist to diagnose your
condition. See index left for treatments available.
Further Reading
IN SUPPORT OF BALDNESS http://baldrus.com
Alopecia UK http://www.alopeciaonline.org.uk
Bald Girls Do Lunch http://www.baldgirlsdolunch.org/
America's NIAMS http://www.niams.nih.gov/
Women's hair loss
project
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