What Women Can Do To Stop Hair Loss – Dr. Judith Reichman

by Y on November 27, 2007

What Can Women Do To Stop Hair Loss - Dr. Judith ReichmanAn article came out today on MSNBC.com discussing women’s hair loss. I think the article provides a good overview of hair loss so I’m posting it here. The question asked to Today Show medical contributor, Dr. Judith Reichman was, “I’m in my early 40s and I’ve noticed sudden hair loss. I’m devastated. Why is this happening and what can I do?” (The original article can be found here) Here is her reply:

Women don’t expect to lose their hair (unlike men), so when it happens it’s extraordinarily traumatic. We normally have, on average, 100,000 hairs on our scalp. And as evinced by our changing hair lengths, roots and visits to our hairdressers, those hairs grow; in fact, 90 percent of our hair is actively growing at any given time. Hair is the second fastest growing tissue in our body after (I’d love for you to guess) … bone marrow. To keep its place on your head, your hair needs the right conditions. (Note I didn’t say conditioner.) You may find that you’re unexpectedly losing hair if you impose restrictions on hair growth or if your genes are such that continued hair growth is not in your destiny.

There’s a simple test you can do to help determine whether you are losing hair, it’s just thinning or you are damaging it by abusive hair products or pulling it too tight (which can occur with braiding). Pull on several strands of your hair — do they come out easily at the root? If so, it suggests that the hairs are indeed “shedding” and have gone into what we call an excess telogen phase.

To explain this telogen phenomenon, I must first go into hair physiology 101. As hair actively grows, it’s in the anagen phase. Each hair is connected to a hair shaft (or follicle), which remains in its secure position in the scalp for three to seven years before falling out and being replaced by a new follicle. Once the anagen phase naturally runs its course, there’s a two-week catagen phase, in which the hair follicle dies. The hair then goes into the telogen phase for the next three months, during which time it falls out. Normally we lose 100 telogen hairs a day, but in certain cases (and this sounds like your situation), many, if not most, of the hairs go into the telogen phase. This causes alopecia (balding). The condition of overwhelming telogen loss is termed telogen effluvium; the anagen to telogen ratio has gone from its normal 90:10 to 70:30 or less. If I do the math correctly, this means you lose at least 300 hairs a day, compared to 100 hairs.

Some sort of stress or medication that started three months before you see the actual hair loss usually causes telogen effluvium. And there are many stresses that can lead to this condition. These include all major illnesses, especially if you’re bedridden and/or have a high fever, surgery, childbirth (giving birth can be stressful, but the hair loss is also due to the body’s reaction to a sudden loss of hormones after delivery), rapid weight loss, nutrition deficiencies (we see this more in vegetarians who don’t get enough iron or protein), or hemorrhage and subsequent anemia. Hormonal changes often have a negative effect on hair. Hair loss occurs with thyroid disorders or in instances when there is a sudden cessation or change in hormones (such as stopping the birth control pill, surgical menopause, discontinuing hormone therapy and, as I stated above, after childbirth).

Then there’s the hair loss effect of taking certain medications, rather than stopping them. There is a long list of drugs associated with hair loss, but here are the most common ones (in which hair loss occurs in more than 5 percent of people taking it):

  • Heparin, interferon, Accutane (for acne), Altace, certain anticonvulsant drugs such as Klonopin and valproic acid

Drugs that less commonly lead to hair loss (but can cause this side effect) include:

  • Acyclovir, Lupron, Cyclosporin, certain anti-arrhythmia medications, high doses of naproxen, and antidepressants such as Paxil, Zoloft, and Effexor

You may wonder about chemotherapy drugs and their impact on hair loss. These drugs don’t actually change the status of hair, because they cause hair to fall out during the anagen phase. The hair loss from chemo usually occurs 7 to 14 days after onset of treatment.

The good news is that hair loss associated with telogen effluvium is temporary, and usually the hair will grow back within six months of the initial hair loss trigger. That said, there are individuals in whom it takes years for full hair recovery, possibly due to ongoing hair loss triggers or subsequent triggers that added insult to hair injury.

I suspect that your hair loss is due to one of these hair stressors. But we should go over other causes of hair loss that are usually more gradual. The most common is female pattern hair loss (hair thinning), which can occur any time between puberty and old age. Although we associate thin hair and balding with male gender, female pattern hair loss (called androgenic alopecia) occurs in 38 percent of women. Usually the center part of the scalp goes first, though hair on the lateral sides can also start to thin. A topical 2 percent minoxidil solution applied twice a day helps treat this type of hair loss. It has been found to increase “minimal” hair growth in 50 percent of women who use it and “moderate” hair growth in 13 percent. However, you need to wait 32 weeks to see these results. For women who’ve waited patiently and don’t see any growth, doctors can prescribe a 5 percent solution. (Please note, however, although this is quite commonly prescribed, the FDA hasn’t approved this concentration for use in women.) If long-term female pattern hair loss does not respond to topical therapy, the option of hair transplantation can be considered.

Finally, some of my patients complain of what they think is “typical” male pattern hair loss. If they also have acne and hair growth on other parts of their body, I will check their male hormone levels. If they are high or they are diagnosed with a condition called PCOS, I might prescribe medications that block male hormones. One that is commonly used is the mild diuretic spironolactone.

Dr. Reichman’s Bottom Line: If you have sudden hair loss and you’ve had previous physical stress don’t freak. Once the stress is gone, you’ll see regrowth of the hair in six months. If you’re taking a new medication, find out if it causes hair loss. If it does, ask your doctor if you can stop taking that drug or change to another.

Article Can Be Found Here: http://www.msnbc.msn.com/id/21991411/

{ 12 comments… read them below or add one }

Kathy November 28, 2007 at 8:06 pm

Thanks for sharing this article. It cleared up some of the questions I had as to what was going on with my hair!


Arsh January 10, 2008 at 8:29 pm

The question I would have is I have been told HT is a bad idea for women because it is just moving one part of your thinning hair to another part..so it doesn’t increase volume. Any thoughts?


sherry vannorstran January 22, 2008 at 9:16 am

what kind of hair loss is it when you are loosing it all around the middle of your head (sides and back are worse than the hair loss on top of head)?


ellen April 14, 2009 at 7:32 pm

I am looking for a physician in the San Fernando Valley/ Los Angeles area specializing in female hair loss. Any suggestions?


amanda July 2, 2009 at 4:24 pm

My hair is thinning some but not that bad, but I dye my hair every 6 months and always have and I got a perm and then all the dead ends started to come till I had to get my hair cut up to the new began at and I had hair to my waist and now it is at my shoulder line and I’m very upset with this. Is their a treatment I can use that will help my hair to grow back healthier and longer and faster?
Enjoyed your article.


Kay July 23, 2009 at 9:27 pm

I have “old lady” hair where it’s so thinned that you can see through it on top and it has a dry brittle texture. It has been like this since I was in my 20’s and just gets more hideous every year. It’s especially bad for me because I have a naturally large forehead like Christina Ricci and have to wear bangs. My bangs are so thin that I have to pull hair down from the top to make bangs which makes my top look flat and creates a hole that people notice. No doctor has an answer for me other than to laugh and say just be glad you don’t have cancer. I have never taken birth control and my iron levels are fine. Anyone else in the same boat?


Michelle October 8, 2009 at 10:10 pm

Could telogen effluvium be caused by a reaction to hair dye? For some silly reason, I dyed my hair 2 times in one month with permanent hair color, had never dyed it before, and now I am shedding a lot. Everyone-hairdressers, doctors, dermatologists, all tell me that dyeing hair will not make the hair come out from the root/follicle, and that this must be related to stress. I have been really anxious about why I dyed my hair in the first place, do you think this could be telogen effluvium?


veronica October 15, 2009 at 5:54 am

Looking for expert in women hair loss in Miami area, any recommendations?


Earnestine April 13, 2010 at 1:01 pm

I am a fifty year old young lady, my hair has been sheading alot it seems to
me for a year now. I am a black lady and I shampoo it every week, if not it
really starts to shead. Can you help me, I stop taking hormone therapy some
years ago. Its really thinning on the sides, bottom back and in top. any suggestion for hair expert in Augusta, Ga.


KDC April 28, 2013 at 2:30 pm

You know, everywhere, I see people say, essentially, it takes 6 months from the stressor and then everything will be okay. Which stressor? my parents being diagnosed simultaneously with cancer, my pnuemonia, my adult onset asthma, the pulmonary emboli, the warfarin, the menstrual hemmohrages, or the eventual blood loss anemia, or my father’s death, or my stepmother’s abuse of me after his death. Or maybe from when my depression got really bad. Where do I count the months from? The first or the last, or does each one reset the clock? Or has the stress lasted so long that this is it, I should cut my hair short so that I don’t have to fucking look at it.

I am so sick of hearing give it six months. My hair was 41 inches long. I lost 50-70% of it in a couple of months. 6 months won’t make everything okay. It will take 6 FREAKING YEARS, if at all. And if we count from the blood transfusion, it’s been 8 months. I don’t see real growth. I can still see my scalp at my crown. and even if it had grown six inches, my hair would still look thin and pathetic.

I’d cut it off, but then I would be stuck looking at it more often.


Dana October 16, 2013 at 7:40 pm

I’ve been gradually shedding hair for over a year. It’s very very thin n the bang area. I can see my scalp big time. I’ve gone to my regular doctor several times a two different dermitologist. I hate washing and blow drying my hair because it causes me sooo much anxiety. I took anti depressants for years and I’ve been off of them for 2 years. I don’t know if that has anything to do with it or not. Doctors say it’s either stress or just age. All my blood tests are normal. They say try rogain, but I’m scared because there is a warning on the box that says u could possibly lose more hair before it starts to grow back. I know stressing over it makes it worse. I’ve use Nioxin, but that stuff makes my hair feel even thinner. I message my scalp a lot and take biotin everyday for a yr and see nothing. I can’t afford a transplant. Anyone else having these same issues?


DreaMeR September 25, 2014 at 5:28 am

Im 31 years old, happy, moody, energetic blob of person. I have noticed the middle parting is thinning (visible to me each time I see my reflection, than to others), but most of the people around me things im going psychotic, stressing about it so much.

I’ve had lush black silky hair & still have hair all the way up to my butt & I’ve always been obsessed with my hair since I was a little girl. Been nice to it, loved it, been thankful for it, and haven’t abused it much (except for tying a bun for longer hours).

So I cover my head at work which sums up to about 11 hours, but for about a year I’ve started having migraine headaches, period+cluster+tension headaches as per my doctor. The left temple is the epicentre of my migraines & interestingly (for me at least) the left hemisphere is also tingly at random times.

My doctor also boils down all my symptoms to stress, stress & stress. For the past 6 months, give or take, I’ve felt like the side parting seems to have expanded slightly closer to the hairline, after a month or two felt the middle parting seems to be doing a better split than the hair further down my scalp.

I worry easily & this has been taking a toll on me emotionally 🙁 Its very traumatizing & Im usually envied for my hair.

I’ve started oiling every week, started vitamin e tablets, had blood work done, plan on getting bangs so tying up my had doesn’t pull on the frontal hair, try to stress less… what can I do?!?! what else can be done 🙁 Im so afraid of loosing hair & before had any of this, I seriously sympathized with men who loose hair around their 30’s …so, cant be karma

Please helppp


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