HAIR LOSS IN A WOMAN

This handout explains some common reasons for hair loss in women and what you and your doctor can do about it.

Causes of Hair Loss in a Woman?

• Female pattern hair loss – FPHL causes a gradual thinning of hair over the top of the scalp, often with a widening part.
• Telogen effluvium – TE causes a shedding of hair, often 1-3 months after major stress such as pregnancy, illness or surgery. Luckily, once the stress is removed, the hair usually grows back.
• Low iron – Low iron is a common cause of hair thinning in young woman. Heavy menstrual periods, blood donation and poor absorption of iron in the diet can all can contribute.
• Low vitamin D – Vitamin D supports healthy hair growth. Low Vitamin D can contribute to hair loss.
• High male hormones – High male hormones in a woman can cause excess hair shedding or thinning. Acne, irregular periods and/or unwanted hair growth in other areas may be associated.
• Alopecia areata –AA is caused by the body’s own immune system attacking the hair follicles. The diagnosis of AA is usually obvious as it causes discrete patches of hair loss.
• Other causes of hair loss: thyroid problems, scalp infections, or tight hairstyles.

What if my doctor tells me I have low iron?

Your blood ferritin level (a measure of iron storage) should be above 40 for health hair. To help raise it, you can take ferrous sulfate 325 mg once a day. Take your iron supplement with a source of vitamin C (such as orange juice or a small fruit) to improve absorption. Avoid taking it at the same time as coffee, tea, dairy, or calcium supplements, which can block absorption. Eating foods rich in iron also helps—lean meats, chicken, fish, lentils, beans, tofu, spinach, and fortified cereals are all good sources. Pairing plant foods with fruits or vegetables high in vitamin C (for example, beans with tomatoes or spinach with citrus) can increase the amount of iron your body absorbs.

What if my doctor tells me I have low vitamin D?

Take vitamin D 2,000 international units (IU) once daily with food (available without a prescription).

What if my doctor tells me my hormone levels are off?

If your hormone levels show either elevated male hormones or thyroid issues, your doctor will likely refer you to an endocrinologist (a hormone specialist) for further care.

What if my hair loss was caused by stress?

Hair loss can follow major stress, such as pregnancy and delivery, a car accident, or a serious illness or hospitalization. The good news: once the stress is over, the hair usually grows back in 3 to 6 months.

Am I getting enough protein?

Hair is made of protein, and not getting enough protein in your diet can trigger hair shedding (called telogen effluvium). This can happen with crash dieting, rapid weight loss, poor appetite, illness, or diets that are very low in protein (e.g., below 0.6–0.8 g/kg/day). Hair shedding from low protein usually starts 1–3 months after intake drops and is typically reversible once protein intake improves. Aim to include a good source of protein at each meal, such as eggs, fish, chicken, lean meat, tofu, beans, lentils, Greek yogurt, or soy products.

What treatments are available?

Minoxidil (Rogaine®)

• You can use topical minoxidil 5% foam (available without a prescription). Apply once daily to your scalp.
• Give it 6-12 months to have its full effect. Be patient.
• Important safety tip: Minoxidil is toxic to pets (especially cats and dogs).
• Keep it in its container, away from animals.
• Don’t let pets lick your skin where you applied it.Don’t let your pet sleep on your pillow, as it may cause transfer of the medication.

Lifestyle / Non-pharmacologic Approaches

• Eat a healthy diet: target at least 3 fruits and 2 servings of vegetables per day.
• Make sure you get enough protein and whole grains.
• Avoid tight hairstyles that pull on the scalp.
• Be gentle with hair care (limit heat, harsh chemicals, and frequent tight ponytails/braids).
• Manage stress, since stress can worsen hair shedding.
• There are many supplements and vitamin products being sold without any clinical studies proving they work. Don't waste your money.

What should be expected with treatment?

• Hair regrowth is slow. It may take 6–12 months to see improvement, and not everyone will have full regrowth.
• Early treatment gives the best chance for success
• Ongoing treatment is usually needed to maintain results.
• Hair loss can affect mood and self-confidence. Support groups or counseling may help.

Key points to remember

• Hair loss in women is common and often treatable.
• The most common cause is female pattern hair loss, but other causes should be checked.
• Topical minoxidil is the main treatment for most women.
• Correcting low iron or vitamin D, gentle hair care, and reducing stress may also help.
• Protect your pets if using minoxidil.
• Results take time, so be patient.