Female hair loss can be quite a distressing occurrence, especially if unexpected. It often helps to understand the cause of one’s hair loss before considering ways to address it. There are two main categories of hair loss: scarring and non-scarring. Here we will touch upon non-scaring types of hair loss which encompasses the majority of cases:
Androgenetic alopecia: Also known as female-pattern hair loss this is the female version of male pattern baldness. This is the most common cause of hair loss in women. It is slowly progressive type of hair loss that is hereditary in nature and most often starts in post-menopausal women. However, many women notice thinning much earlier in life, especially when there is a strong family history.
Telogen effluvium: this is a dramatic and sudden loss of hair induced by a major “shock to the system” such as a febrile illness, major surgery, a traumatic accident, childbirth etc. Diffuse hair loss is noted about 2 months after this shock to the system and it takes about 6 to 9 months for the full recovery though in some cases recovery is not complete. Rarely telogen effluvium can become chronic in nature.
Hormonal imbalance: drastic changes in certain hormones can precipitate hair loss in women. This could be from an endogenous hormonal abnormality as such as thyroid dysfunction (both high and low thyroid), polycystic ovarian syndrome, and pregnancy, among others. It could also be from external hormonal sources such as changes in oral contraceptives.
Nutritional/elemental abnormalities: deficiencies or excesses in certain nutrients and essential elements may contribute to hair loss. A good example of this is chronic iron deficiency which leads to anemia and eventually can induce hair loss. Less commonly severe dietary protein deficiency or excessive vitamin A supplementation can trigger hair loss.
Alopecia areata: this common form of hair loss can be recognized by its patchy nature where smooth circular patches of hair loss appear, seemingly out of the blue. This is an autoimmune form of hair loss but there appears to be no clear trigger in most people. Rarely, thyroid abnormality can be associated with this type of hair loss. While it’s usually localized to one or few patches there are more severe subtypes of alopecia areata that affect the hair more diffusely.