Female Pattern Hair Loss: 7 Major Facts You Need to Know
It’s normal for us to lose several strands of hair everyday as each hair follicle goes through different phases in its life cycle. So, at any given day, some of these hairs meet their end and simply fall off usually without us knowing. As a matter of fact, you shed about fifty to a hundred hair strands a day.
So when should hair fall be a cause for concern? This is what we aim for you to learn with this blog.
If you noticed your side part widening or the volume of your hair getting smaller, you may have female pattern hair loss. It is clinically referred to as androgenetic alopecia and it affects millions of women, making it one of the common causes of hair loss in females.
Unlike men who lose hair in a predictable pattern and eventually grow bald, women generally don’t. Female pattern hair loss is characterised by generalised or diffused hair thinning which affects your overall hair volume. But, even though the scalp is visible, the hairline usually does not recede. It may appear less thick but it still retains its form, compared to how it regresses in men. Without treatment, some women may develop widespread thinning.
For most women, female pattern hair loss begins in midlife, or sometime between her 40s to 60s; however, it can also start earlier for some. The extent of hair loss increases with age, with fewer than 50 percent of women maintaining a full head of hair throughout their lives.
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III. Different types of hair loss besides pattern hair loss
Besides Androgenetic Alopecia (pattern hair loss), there are other types of hair loss that can affect females. Beyond genetics, other factors such as stress, medications, and even the wrong hairstyles can lead to serious consequences to the hair. Take a quick look at what these are, below.
1. Telogen Effluvium
This is the term used for the common cause of temporary hair loss due to excessive shedding of resting or telogen hair. It is also referred to as club hair due to the shape of the roots which can be easily distinguished from anagen effluvium where it has a pointed or tapered tip.
Typically, hair is in the anagen phase (active phase) for two to four years before it enters the telogen phase. This resting period runs for two to four months where the hair sheds and is replaced by growing hairs. As mentioned earlier, it’s normal to lose up to a hundred hairs each day, but with telogen effluvium, you could lose up to 300 hairs a day on average. In this condition about 30% of the hairs on your head go into resting phase before it falls out.
Usually, other people won’t observe anything unusual at first look. However, you may notice more hair than usual accumulating on your pillowcase, on the bathroom floor, or on your hairbrush. While the hair loss is subtle, your scalp hair may feel or appear less dense than usual.
Telogen effluvium can be triggered by several causes which, includes:
- Excessive weight loss
- Significant change in diet
- Iron deficiency
- Major psychological stress
- Major physical trauma
- High fever, severe infection or other illness
- Abrupt hormonal changes, including those associated with childbirth and menopause
- Hypothyroidism or hyperthyroidism
- Some medications
2. Alopecia Areata
This type of hair loss is classified as an autoimmune disorder, which means that your immune system (your body’s defense system) attacks and destroys healthy body tissues by mistake. It is also considered a “polygenic disease,” which means that both parents must contribute a number of specific genes for an offspring to develop it.
A distinguishing characteristic of alopecia areata are bald patches in hair-bearing areas. However, there are also some cases where it affects the entire scalp (alopecia totalis) or the entire body (alopecia universalis). If it doesn’t leave any obvious change in the texture of the skin, it is referred to as a non-scarring alopecia.
Currently, there is no cure for alopecia areata, but when it’s “active,” your hair follicles remain alive. This means that you can still grow hair back again even if it usually takes a long time to do so.
3. Traction Alopecia
This is the type of hair loss that results when a person frequently wears tight, hair-pulling hairstyles (e.g., braids, weaves, cornrows, tight pony-tails, heavy locks, hair rollers, etc). Prolonged and repeated tension on the scalp hair can leave your follicles badly traumatised. Over a long period of time scar tissue may form which can hamper hair from growing back.
Alopecia areata is common in African-American women, but it can also affect ballerinas, gymnasts, military personnel, and certain professionals who are required to wear their hair pulled back. Initially, traction alopecia is temporary, but unless you change your hairstyling habits, the hair loss may become permanent.
4. Anagen Effluvium
If telogen effluvium occurs during the resting phase, anagen effluvium is the kind of hair loss that occurs during the anagen or growth stage of the hair cycle. At any given time, people have 80-90% of their hair in the anagen phase, so if someone suffers from anagen effluvium, they will experience abrupt and rapid shedding. It affects the entire scalp, and it comes in a diffused hair loss pattern that
It is often caused by drug reactions, chemotherapy, protein malnutrition, toxin exposure and infection. Hence, the classification also varies based on the different factors causing it.
Doctors base their diagnosis on two parameters – the intensity and pattern of hair loss. The basic tool to classify the extent of hair loss women have is the Ludwig Scale and the Savin Scale. Today, we can also find a Ludwig – Savin Scale, which is an integrated and comprehensive table that serves as the female counterpart of the Norwood Scale in men.
While checking the degree of thinning, clinicians will also take note of the location. Furthermore, a hair strand test may also be done to assess the integrity of the hair follicles and also determine if what was lost can be grown back or not. You may also be referred to a dermatology specialist or a trichologist, and get a dermatoscopic exam or scalp biopsy.
Laboratory testing can also check the concentration of androgen in the blood, as well as other hormones such as thyroid-stimulating hormone (TSH) and prolactin. Further testing may include an assessment of vitamin and mineral deficiencies, like vitamin D, iron, and zinc.
The approach to any hair loss is challenging and involves a combination of a patient’s medical and family history, trichoscopy, laboratory evaluation, and potential biopsy to further examine the possibility of an inflammatory and scarring alopecia.
This over-the-counter (OTC) medication is the first-line treatment of female pattern hair loss. The ones suitable for women to use come in two preparations, and you can buy them without prescription from pharmacies and other retail outlets. It comes in foam or liquid form and it should be spread on the scalp everyday. Minoxidil solutions should be applied to the affected areas of the scalp 1 to 2 times a day, while foam is applied once a day. It may have to be used for six months or more to prevent further hair loss and promote hair growth.
Before using a Minoxidil treatment, you need to make sure that this is the right treatment for you. It’s important that you speak with a doctor or pharmacist:
- If you are pregnant or breastfeeding.
- If you are not sure what is causing your loss of hair.
- If the skin on your scalp is sore, or if you have a skin condition which affects your scalp.
- If you have a heart condition, blood vessel disease, or high blood pressure.
- If you ever had an allergic reaction to a skin preparation, or to any other medicine.
- If you are using other skin preparations or taking any other medicines. This includes over-the-counter medications, as well as herbal and complementary medicines.
What makes this shampoo effective against hair loss is its organic compound that has anti-inflammatory and anti-androgenic properties. The anti-androgenic mechanism decreases the dihydrotestosterone at the level of the hair follicle. To ensure that the ingredients do their job, you are supposed to lather the shampoo and leave it on for 5 minutes before rinsing off.
Women with androgenic alopecia may consider trying prescription ketoconazole at a strength of 2 percent. It is prepared as a shampoo which contains an antifungal agent that may reduce the body’s production of testosterone and other androgens (male hormones) that cause hair loss.
It’s important to consider supplements as a complementary treatment to fight hair loss. It primarily fills in the nutritional gaps that may have contributed to falling hair (e.g. iron deficiency, biotin deficiency).
Currently, there are different nutrients and special ingredients that have established benefits in controlling hair loss and encouraging hair health. Companies invested in research to add unique components that have hair-building capacities.
As a consumer, it’s important to cover the basics. Important nutrients to look for include:
- Vitamin A
- Vitamin C
- Vitamin D
- Vitamin E
- Folic Acid
Low-Level Laser Therapy (LLLT)
Laser devices are non-invasive treatments that stimulate hair growth for people with androgenic alopecia and pattern balding. They can be used without a prescription, and they come in the form of combs, brushes, and other handheld items that emit light and make existing hair thicker.
While it may be called by other names such as red light therapy, cold laser, or soft laser, it’s worth noting that not all lasers are the same. To experience the therapeutic effect, one study emphasised the importance of having the right wavelength, timing, pulse and power density. Furthermore, if the wrong dosage is applied to a particular treatment, the effectiveness can be lower or the treatment may not produce any results at all. If you seek treatment in an aesthetic clinic, we assure our patients that we use medical-grade lasers to ensure a safe, efficient, and effective service while aiming for good quality results. More than that, Dr Tyng Tan is trained and certified to use this device
This treatment is a less invasive option than hair transplant. Regenera Activa uses regenerative potential protocol through ‘Stromal Vascular Fraction.’ It means that it relies on your body’s own cells to stimulate hair follicles to combat hair loss and grow new hairs. It does so by ‘activating’ the follicles that have become dormant.
It is a good option for female patients because the process is minimally invasive and discreet. That means you don’t have to shave the entire head since it only requires small skin samples taken from the occipital area of the scalp (back of the head); the area least susceptible to hair loss. It is done for about 30-45 minutes with practically no downtime, and this already sets into motion a natural hair growth process which can last you up to two years.
According to experts, there is a small percentage of women who are good candidates for hair transplant surgery. A smaller percentage of women, compared to men, are suitable candidates for surgery since the ladies have limited donor hair available.
Suitable candidates include the following:
- Women who have suffered hair loss due to mechanical force (nonhormonal), also referred to as traction alopecia.
- Women who have had previous cosmetic or plastic surgery and are concerned about hair loss around the incision sites.
- Women who have a distinct pattern of baldness, similar to that of male pattern baldness. This is often characterised by hairline recession, vertex thinning (on the crown or top of the scalp), and a donor area that is not affected by androgenetic alopecia.
- Women who suffer hair loss due to trauma, including burn victims, scarring from accidents, and chemical burns.
- Women with alopecia marginalis, which is hair loss that primarily occurs along the hairline and temples, similar to traction alopecia.
Hair loss in women is associated with significant psychological impact which boils down to society’s perception of beauty. Although not life threatening or painful, societal norms dictate that hair is an essential part of a woman’s sexuality and gender identity. Therefore, hair loss generates feelings of low self-esteem and anxiety from a perception that it diminishes one’s attractiveness.
As a result of hair loss, women are more likely than men to have a lowered quality of life. Society tends to regard hair loss in men to be expected and normal due to the greater visibility of hair loss within this group. In women, however, the progression of hair loss breeds psychosocial complications which include low self-esteem, depression, and altered body image. These problems may lead women to avoid social engagements, or they may find it less enjoyable.
The struggle may be harder in women, but there are professionals and support groups available to help you manage this problem. You may speak to your dermatologist, primary physician, or a hair transplant surgeon for proper interventions. There are also different online groups that you can tap so that you can get the support and information you need about hair loss and how to deal with it.
If you wish to speak to someone who is in authority when it comes to hair loss and its treatment, you may approach Dr. Tyng Tan of Aesthetics and Hair Clinic in Singapore today. Since every case is unique, your treatment approach deserves a personalised touch to ensure effect the change you seek. To learn more about the treatments designed for Asian women hair, call us now or simply fill out our inquiry form today!
About Dr Tyng Tan
Dr. Tan Tyng Yuan, MBBS is one of the few doctors approved by the Singapore Medical Council to carry out both FUE and FUT hair transplant (which includes non-shaved FUE where donor hair length is preserved and reduction in downtime after surgery is possible to achieve). Her special interest is in hair loss and hair transplantation and she is recognized as a graduate fellow of the ISHRS after completing a lengthy fellowship at an ISHRS approved institution.
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Dr Tyng Tan Aesthetics and Hair Clinic
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