About Hair Loss for Women
Erroneously believed by most people to be a predominantly masculine condition, females, in fact comprise 40% of the total population of hair loss sufferers located in the United States.
Female hair loss has far reaching and universally debilitating consequences to a woman’s self esteem, well being, and emotional health. Regrettably, today’s society has forced many women of all ages to bear the burden of hair loss in isolation. It is perceived as far more appropriate for males to undergo the same progression of hair loss.
To add further complexity to this sensitive issue, many physicians approach the topic of hair loss in women almost as if it were nonexistent. Since hair loss doesn’t have life threatening implications, many doctors will frequently overlook a woman’s concerns about hair loss and attempt to placate their patients in an effort to minimize the impact, often suggesting the patient work toward being able to adapt to the condition rather than seek ways to treat it.
Obviously, what many of these doctors find difficult to understand is how the psychological impact caused by hair loss affects their female patients who may perceive themselves as unattractive. This can be just as damaging to patient’s well being the as any major medical condition. There is a recognized correlation between a human being’s emotional state of health that can directly impact their physical health.
It is now becoming widely recognized that hair loss for women is a serious life changing scenario that no longer can be ignored by the physician community or society at large.
Loss of hair can be categorized in two distinct ways – temporary or long lasting. Temporary hair loss can be simple to remedy when its cause is carefully discovered and properly dealt with, however difficulties can arise when the underlying cause has not been fully examined and clarified. Initial loss of a woman’s hair that could have been properly determined to be temporary may indeed transform into a long lasting condition resulting from an incorrect assessment and resulting diagnosis.
The likelihood for such mishaps to occur is frequently the most daunting aspect of hair loss for women. The information below will assist in the identification of your particular kind of hair loss and provide you and your doctors to the proper approach for the type of of hair loss you are experiencing before additional and potentially irreversible consequences can occur.
The clinical term for for excessive or abnormal hair loss is Alopecia. There are several distinct types of Alopecia. All forms of hair loss, whether among women or men, are symptomatic of some other aspect relating to the physiology of the human body.
Factors such as hormone imbalance, disease or some other set of conditions may be the underlying cause of hair loss. Conditions that often precede hair loss can be a simple genetic susceptibility to male or female pattern baldness, one of the forms of Alopecia Areata, or it may be a mixture complex factors relating to a variety of other diseases present in the body.
Fortunately for many women, hair loss can also be symptomatic of a short-term occurrence such as a pregnancy, postpartum conditions, general life stress, and common prescription medications reacting with individual body chemistry. Chemicals and substances including hormones, as well as certain medical conditions can cause a noticeable variation in hair growth, cyclical periods of shedding and the length of these cycles. Simultaneous hair growth and shedding can occur under some of these conditions.
After the underlying cause is dealt with, very often the hair will will return to its more natural and random pattern of growth followed by shedding and the resulting loss of hair ceases. In such cases where women who do not fall into these short term categories, hair loss turns into a life long battle.
A derivative of the male hormone testosterone, Dihydrotestosterone (DHT) under certain circumstances can cause permanent damage to the follicles on your head rendering them incapable of generating hair growth. As this particular condition is at the root of many kinds of hair loss we will discuss it first.
For many decades the condition known as Androgenetic Alopecia, which is commonly referred to as male or female pattern baldness, was only partially understood in the scientific community In their early research many scientists thought that Androgenetic Alopecia was caused by the predominance of the male sex hormone, testosterone, which under normal conditions is also present in women in trace amounts.
As testosterone has been a factor in the balding process, DHT is now seen as the main cause. Androgenic hormone or testosterone changes into DHT with the help of the enzyme Type II 5-alpha reductase, which is contained in a hair follicle’s oil glands.
Researchers currently believe that it’s not the quantity of distributed testosterone that’s the issue but the amount of DHT joining to receptors in hair follicles. DHT shrinks the size of hair follicles, making it impossible for strong, healthy hair to thrive. For both men and women the conversion of testosterone to DHT as part of a hormonal process can cause significant damage to hair follicles. In general, women possess a much smaller amount of testosterone levels when compared to men, however even a minute level can precipitate female hair loss triggered by DHT.
Consequently when testosterone levels increase, the hair loss factor attributed to DHT becomes more pronounced. Often times when treated by doctors the level of DHT in the woman’s blood is measured and can fall into a range considered “normal” yet frequently it is still high enough to create a hair loss issue.
Occasionally the actual DHT levels may not show any unusual increase; however, they continue to be problematic in women whose bio-chemical make up is acutely sensitive to even normal levels of hormones and chemicals. As hormones require a delicate balance in order to function in a healthy manner, male hormones known as androgens, don’t have to be increased to create a serious reaction. Their female counterpart hormones, when reduced, provide a competitive advantage to certain androgens, such as DHT.
This lack of hormonal balance can also create difficulties for women, including loss of hair. The nature of all human hormone levels is cyclical. Studies have shown that the level of testosterone in men can drop as much as ten percent per decade after the age of 30. By contrast, the level of a woman’s hormones decline with the onset of menopause, dropping drastically during menopause and beyond. This explains the parallel cyclic relationship between hair growth (or loss) tied to hormonal changes in body chemistry even when a person is experiencing a extended period of slower hair loss (and a long term rise in hair growth) while undergoing hair loss treatment.
The most common causes of women’s hair loss include: Andogenetic Alopecia Most females affected by Androgenic Alopecia experience diffuse thinning over the entirety of the scalp.
Men on the contrary, rarely encounter diffuse thinning rather they will usually exhibit distinct patterns of baldness. With respect to both men and women the role of heredity is a contributing factor in the disease. Females sometimes present a combination of these two characteristics. Frequently Androgenic Alopecia in females results from the behavior of Androgens, hormones found in men that are also commonly present in trace quantities in a woman’s system.
Androgenic Alopecia may be linked to a number of factors relating to hormonal activity; for example, the consumption of high androgen index medication to prevent birth, pregnancy itself, certain kinds of reproductive cysts, and the onset of menopause in women. Similar to males, the hormone DHT seems to be a part of the reason for the shrinking of hair follicles in women exhibiting the signs of female pattern baldness.
Telogen Effluvium.
At the time a woman experiences a traumatic situation such as child birth, a serious infection, an invasive surgical procedure, severe lack of proper nutrition or prolonged emotional stress, a significant amount of the approximately ninety percent of hair normally in the anagen (growing) or catagen (resting) state can spontaneously transition into the shedding (telogen) state.
Telogen Effluvium can begin in a time period ranging from six weeks to three months after the occurrence of a stressful event. There is a distinct possibility for a woman to loose entire hand fulls of hair when in this state. So long as the stressful conditions subside or can be minimized the probability of a complete remission is very good.
Certain females mysteriously suffer from a form of Telogen Effluvium which can manifest as a chronic disorder and remain active for months or even years absent any real presence of stressful factors outlined above.
Anagen Effluvium
A form of hair loss frequently associated with with patients undergoing chemotherapy, a condition known as Anagen Effluvium, often takes place after any injury to the hair follicle which impacts its mitotic or metabolic properties. As chemotherapy targets your body’s rapidly spreading carcinoma, your body’s remaining healthy and normal dividing cells such as hair follicles in the growing (anagen) state are also severely impacted.
In many cases right after the onset of chemotherapy a patient can loose up to ninety percent or more of the hair in the anagen state. A unique characteristic exhibited with Anagen Effluvium is a fracture of the hair shafts. The tapering or narrowing of the individual hair shafts comes from damage to the matrix and over time the shaft itself will fracture resulting in a loss of hair.
Traction Alopecia
This condition results from tight hairstyles that pull at hair over time inflicting localized trauma to the hair follicles and causing hair loss. Provided there is early detection the hair will regrow on its own. Some of the most common styling methods that cause traction alopecia are tight ponytails, braids, cornrows and hair extensions. Female hair loss isn’t necessarily as easy to detect as hair loss experienced by men.
With respect to males approximately 90 percent of all cases are the result of male pattern baldness due to heredity factors. Women on the other hand often experience hair loss which can be associated with a number of complicated conditions and circumstances.
When seeking to determine the root cause of hair loss the series of diagnostic tests outlined below should be conducted by professionals. Successful completion of these test can rule out certain factors contributing to your particular hair loss and can point the way to an underlying cause and treatment. For many patients the results often come back indicating they are within a normal range; however, it’s critical to understand that these diagnostic procedures are designed to allow the elimination of one possible cause in favor of another.
Diagnostic Tests To Be Performed by A Physician • Complete Blood Count (CBC) • Total Iron Binding Capacity (TIBC) • Thyroid Stimulating Hormone (T3, T4, TSH) • Serum Iron • Serum Ferritin • VDRL (a screening test for syphilis) • Hormone Level Screening Tests (DHEAs, Testosterone, Androstenedione, Prolactin, Follicular Stimulating Hormone, and Leutinizing Hormone) Scalp Biopsy Minimal section of the scalp typically 4mm in diameter is taken and further reviewed with microscopy to assist in the determination of the hair loss cause.
Hair Pull Test A simple diagnostic procedure where a physician gently pulls a small amount of hair (approximately 100 hairs at the same time) to make a determination if there is substantial hair loss. The acceptable percentage is approximately 1 to 3 hairs per individual pull. Densitometry This test involves a medical device known as a Densitometer, a hand-held magnification instrument that is utilized for detailed examination of individual hair shaft size.
Degree of Hair Loss
The images below reflect the benchmarks used by the Savin Scale.The first image (labeled I-1) depicts a normal central parting of a female with no hair loss. The subsequent images 2 to 4 (labeled I-2, I-3, I-4) reflect the widening appearance of the parting as it continues to increase thus dipicting hair thinning along the center of the head. The images labeled II-1 and II-2 depict diffuse thinning of the hair over the top portion of the head. The image labeled III shows a female with extensive diffuse hair loss on top of the head, but a portion of hair continues to survive.
The“advanced” image shows a female with profuse hair loss and very little to almost no surviving hair in the area affected by alopecia. Statistically few women ever get to this advanced stage and when they do it is generally an indicator pointing to a condition that where androgen hormones are being produced on an abnormal and excessive level. The final image shown is representative of a different form of female hair loss, it depicts a woman with a hair loss pattern known as “frontally accentuated” which means there is greater hair loss located at the front and center of where the hair is parted as opposed to the middle or top of the head.
