While hair loss in women isn’t as prevalent as in men, a much higher percentage of women lose hair than would be expected.

Exact numbers are difficult to gauge since women don’t report losing hair as much as men do.

Hair loss in men is expected and therefore accepted.

But hair loss in women is a much more serious problem. Women generally care more about their physical appearance than men. Also, men don’t seem to mind aging as much as women.

It used to be believed that women’s hair loss didn’t usually occur until menopause. But hair loss in women can actually occur as early as their teenage years.

In women, pattern baldness is a diagnosis of exclusion, meaning no other causes for their hair loss can be discovered.

Unlike men, pattern baldness in women does not cause the bald spot in the crown or the frontal and temporal recession and it is usually more generalized loss from the entire top of the scalp.

There are visual cues that women can look for over time. Men’s hair tends to recede from the forehead or the crown of the head, women’s hair tends to thin on the top third to one half of the scalp.

A woman’s part may gradually become wider. She may see more of her scalp when she pulls her hair back.

It is important to know what causes hair loss and see if there is anything you can do to prevent it. And just because a person suffers from hair loss doesn’t mean that this must continue.

A wide variety of hair restoration treatments for women are available.

Treatment for women’s hair loss must always be based upon an accurate diagnosis. Several medical conditions may be related and should be treated concurrently.

After this, many of the treatments for women are the same as they are for men.

Get your free hair loss consultation in NYC to explore your options.

Causes of Hair Loss in Women

There are several factors that contribute to women’s hair loss. Vegetarians and anorexics have a higher chance of hair loss than carnivores and people of average body weight. Also, smokers have a higher chance of balding than non-smokers.

Stress and certain medication (even some types of birth control) can contribute to hair loss in women. Contributing factors can also include imbalances of thyroid hormones, pregnancy, disease, quick and dramatic weight loss, and an excess of Vitamin A.

Androgenetic alopecia, or male or female pattern baldness, is caused by dihydrotestosterone (DHT), a derivative of the male hormone testosterone. DHT shrinks hair follicles and prevents hair from growing.

Both men and women experience the hormonal process of testosterone converting to DHT. Even though women have far less testosterone than men, even low levels of DHT can trigger hair loss in women.

Another cause of hair loss in women is traction alopecia. This condition results from tight braiding of the hair and scalp for a long time, creating permanent hair loss. Thankfully, this condition is very treatable.

Associated Medical Conditions of Hair Loss in Women

Polycsystic Ovary
This condition causes hair loss as the ovaries secrete excessive hormones which ultimately lead to excess DHT in the scalp. We are continuing to learn more about both the primary condition and the associated hair loss.

Thyroid
Both low and high thyroid conditions may be associated with hair loss. Most importantly, an endocrinologist should be managing the thyroid hormone levels. After, this, several options exist for both retarding the hair loss and regaining body.

Anemia
Women with anemia, either thru excessive menstruation, poor diet or other associated medical conditions may have hair loss associated with the anemia. Once the anemia is treated, the options for treating the hair loss improve.

Diagnosing Hair Loss in Women

Hair loss in women can be more difficult to diagnose than hair loss in men. About 90% of all cases of men’s hair loss are caused by hereditary male pattern baldness.

But women’s hair loss can be triggered by a much wider variety of conditions and circumstances.

Preliminary blood work checks to see if the thyroid gland or an auto-immune disease is causing har loss.

Your hair restoration doctor will also check your medical and family history. He’ll also examine your scalp under magnification to check for varying sizes of hair follicles.

In healthy scalps, shedding hair follicles are replaced by hair equal in size. But female pattern hair loss causes new hairs to be finer and thinner because the hair follicles are shrinking.

Sudden hair loss in women is likely to be caused by a medical condition, such as pregnancy, thyroid disorders, anemia, auto-immune diseases, polycystic ovary syndrome (PCOS), and skin conditions such as psoriasis and seborrheic dermatitis.

It’s not clear whether there is a direct connection between menopause and hair loss in women.

Tests for Hair Loss in Women

A qualified and board-certified hair restoration doctor can perform any or all of the following tests to get an accurate diagnosis for women’s hair loss:

• Hormone levels (DHEA, testosterone, androstenedione, prolactin, follicular stimulating hormone, and leutinizing hormone)
• Serum iron, serum ferritin, and total iron binding capacity (TIBC)
• Thyroid levels (T3, T4, TSH)
• VDRL (a screening test for syphilis)
• Complete blood count (CBC)
• Scalp biopsy: A small section of scalp is removed and examined microscopically.
• Hair pull: The doctor may lightly pull a small amount of hair to determine if there is excessive hair loss. The normal range is one to three hairs per pull — anything more would be a sign of hair loss in women.
• Densitometry: This handheld magnification device is used to check for miniaturized hair shafts.

The Ludwig Scale and the Savin Scale are female hair loss density scales used by hair restoration experts.

Eight crown density images are shown in the Savin Scale below. They range from no hair loss to severe hair loss. The highest density is extremely rare. Also illustrated is frontal anterior recession (bottom row, far right), and this is also uncommon.

Women’s Hair Loss Treatments

Based on an accurate diagnosis, hair loss in women can be treated using medications, Biocapillation™, hair transplants, or wigs and hair pieces.

Drugs & Medications

Drug treatments for women’s hair loss are more difficult than for men because they tamper with women’s androgen levels.

Physicians will often use topical treatments, applying medications directly to the scalp.

There is currently only one FDA-approved medication for female pattern hair loss, although others are used.

We’ll explain your options during your free hair loss consultation.

Female Hair Transplant

Female hair transplants are most often recommended for women with androgenic alopecia, also known as female-pattern baldness.

Wigs & Other Styling Techniques

This is a very common solution and for many people very effective. The hair is either synthetic, or is purchased from a hair donor (frequently from India where women are rewarded for growing their hair long and selling it as wigs. Several options exist for attaching the new hair, none medical or surgical and usually involve glue, weaving or mechanical clips.

Eyebrows & Eyelashes

Both of these areas may thin and they are both imminently treatable with transplants. Other options such as tattooing exist.

© 2012, John Frank, M.D.