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Hair
loss is not just a problem for men alone. One out of every
four women in the United States experiences hereditary hair
loss, and for that one woman, hair loss can feel like a
first class cosmetic disaster.
The causes and symptoms of hair loss in women can be
different than those associated with men. Below, two
dermatologists discuss the differences between male and
female pattern baldness.
How common is hair loss in
women?
NEIL SADICK, MD: The incidence of hair loss in women is
almost parallel to that in men. However, in women, usually
the degree of hair loss is not as extensive as it is in the
male population.
So are they hiding it better
than men?
NEIL SADICK, MD: Luckily, their genes do not express the
trait to the same severe degree as men. There is the same
amount of thinning in terms of numbers of women compared to
men, but the degree of hair loss is usually not as severe as
it is in the male population.
What are the differences in the
cause of hair loss in women, as opposed to men?
MICHAEL REED, MD: Most women lose their hair for the same
reason that men do-genetics. It's called female-pattern
balding, as opposed to male-pattern balding, but both refer
to what is called androgenetic alopecia, which means hair
loss caused by a sensitivity to male type hormones, which
men and women both have. Women are more protected by
estrogen for a period of time, but the cause is the same.
It's just that they have it happen later, it goes more
slowly, and the pattern is such that it's easier to cover it
up than it is for men.
If I lose half my hair and it's on the top of my head,
I'm going to be bald. If I lose half my hair and I'm a
woman, it's diffused all over my head, so it's just going to
be thin hair or "see-through hair".
Are there some myths that women
have about what could cause their hair loss? Washing their
hair too vigorously?
NEIL SADICK, MD: People feel that anything will cause the
hair loss to accelerate-such as emotional trauma, washing
their hair too often, poor diets-but those truly are myths.
How can a woman tell if she's
actually losing her hair?
MICHAEL REED, MD: It's said that we have to lose 50 percent
of our hair in any given area before it starts to be
noticeably thin, but a lot of women notice it long before
then. There are very few people with delusions of hair loss.
They can just tell by the texture, by the body, that it's
not the hair it used to be.
Finally, though, it gets to the point where they begin to
see scalp and not hair. Especially in women, right behind
the hairline they tend to get a round or oval-shaped area
that gets very, very thin, and those women seek treatment.
What is the second most common
cause of hair loss in women?
NEIL SADICK, MD: Telogen effluvium, which is where the hair
goes into a resting or shock phase after any type of insult.
The most common cause of this type of resting hair shedding
is pregnancy. Three to six months after delivering a child,
many women will notice a great degree of hair loss as the
hair cycles into a resting phase because of the physiologic
insult of pregnancy.
This can also occur quite commonly in women who are on
crash diets and lose a great deal of weight over a short
period of time, or after acute illnesses, such as an acute
infection. Anything that puts stress on the body can cause
the body to recycle its hair into a resting phase and cause
acute hair shedding, called telogen effluvium.
Does the body then recover into
a normal growth cycle?
NEIL SADICK, MD: Usually. Because the body is able to
compensate for this insult, usually three to nine months
after the insult, the hair will begin to regrow, and usually
in most cases between 90 and 100 percent of hair regrowth
can be expected.
What is the third most common
cause of hair loss in women?
MICHAEL REED, MD: The third most common cause that we see in
clinical practice is a condition called alopecia areata.
Areata is Latin for "round" or "circumscribed", which means
that people suddenly see bald spots here or there, or
little, tiny short hairs that are broken off. Sometimes it's
noticed by the person cutting their hair. It's often related
to some stressful event, and it's believed to be some type
of immunologic imbalance. The immune system goes after its
own hair for some unknown reason, causing them to go into
the resting phase and slow down their growth so they break
off or come out. A lot of times, it regrows by itself. In
fact, most people who have it don't come to the doctor. It
just goes away by itself.
But a small number of people have very severe problems.
Some people will lose all the hair on their head, and some
people lose all the hair on their body. It's quite a common
condition.
Where can women go to find more
information about hair loss?
NEIL SADICK, MD: People can consult the American Academy of
Dermatology. There's the International Society of Hair
Restoration Surgery. There is the Alopecia Areata
Foundation, and there's also a National Hair Council. So
these are common information sources that patients can look
to for help and support in dealing with their particular
problems.
But the first place to start may
be a dermatologist?
MICHAEL REED, MD: If the hair loss has any unusual
features-suddenly a lot of hair is coming out, if hair is
coming out in a bizarre or unusual pattern, even if it's
very severe, premature general thinning of the scalp, see a
dermatologist. Dermatologists are trained in medical-and
some of them also in surgical-treatment of hair loss.
They're the people to see first. |