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Hairloss in Women

By Dr Raghu Reddy

How do I know I have a problem and it's not just natural hair loss?

There are number of factors to explore and consider if you are experiencing hair loss. Firstly, genetics play a big part. Just like men, women can inherit genes from the maternal or paternal side, which leave them predisposed to hair loss.

However it is important to note that, unlike baldness in men, hair loss in women is almost always caused by an underlying medical condition so your first step should always be to seek the advice of your GP or a hair loss specialist. They will be able to help determine whether there is an underlying issue or whether you are simply going through a natural change.

Is it a normal part of getting older?

To some degree, yes. It is likely that as you grow older, you will experience some level of hair loss but the extent of the problem will differ depending on your age, genetic makeup and lifestyle.

One of the most common causes of hair loss in women is a change in hormone levels, so if you are post-menopausal then it is likely that you will experience some natural thinning of the hair. Women with higher than normal levels of testosterone, such as women who have been diagnosed with PCOS for example, are also more likely to experience patterned baldness.

Are more women in their 30s and 40s presenting with hair loss? Why do YOU think it is?

I am not convinced that hair loss in women has become more common but I think now there is a better awareness of the problem and more women are choosing to seek help. There is also greater awareness of the potential treatments available and the topic is perhaps discussed more openly now than ever before.

I think it is also apparent that a greater number of women are suffering with hair loss because of over-styling and even the over-use of hair extensions. Both of these things can lead to permanent damage and we are certainly seeing a growing number of younger women suffering in this way.

What medical conditions might be causing it? If I get these treated will it stop?

Hair loss can be a symptom of a number of possible underlying medical conditions such as: an underactive thyroid, anaemia, hormonal disorders including oestrogen disorders, an ovarian tumour, or even lupus. Lupus is a skin and connective tissue disorder, which causes the body’s own immunity to fight against hair growth.

If you are diagnosed with one of these underlying medical issues (and the earlier the diagnosis, the better) then in many cases you will be able to seek treatment and the hair loss, as a result, can be reversed.

Could something lacking in my diet be to blame?

Hair is made up of Keratin, which is a natural protein. Making sure your diet is high in protein can therefore help to keep hair strong, looking shiny and healthy. Try to incorporate meat, fish and eggs in your diet and you may gradually notice an improvement.

What about my lifestyle? Too much swimming or washing?

There is a common misconception that washing the hair frequently is bad. On the contrary, hair needs to be washed regularly to keep it clean and healthy. Evidence suggests that using an SLS (Sodium Lauryl Sulphate - a common chemical found in shampoos) free shampoo, like aloe vera, can play a role in preventing hair loss. Regular conditioning is also good for the hair as it will make it softer, but try to make sure you apply it to the hair shafts and not the scalp.

Exercise caution when using hair dyes and if you wear hair extensions, try not to use these excessively, as they will pull the hair and weaken it. If you continue to cause stress to the hair by over-styling, braiding or using hair extensions, then this could lead to traction alopecia, which is a condition brought about by environmental damage done to the hair.

Try not to scratch your scalp with your fingernails either, as this will also traumatise the hair.

Can chlorine/swimming/exercise have an impact?

Use of Chlorinated water has been shown to affect hair. It is advisable to wear a swimming cap. There is no correlation between exercise and hair loss.

Is there blood test I need, say for a deficiency that I could ask my doctor for?

It is best to see your GP and get detailed medical history and examination. In general, some of the tests that might be useful are full blood count, Urea & electrolytes, Thyroid function tests and tests for auto-antibodies if there is evidence of auto-immune disease.

It's been so much worse since I have been laid off work - does stress play a part?

Stress can cause hair loss in different ways; in particular it can lead to the build up of acid-free radicals, which contribute to gradual hair loss. Prolonged periods of stress can lead to changes in hormonal levels, which can also lead to hair loss.

There is a condition called Telogen Effluvium, whereby accelerated hair loss is noted as part of prolonged periods of stress. Also, conditions such as trichotillomania (pulling of the hair) are associated with stress. There have been a number of examples of celebrities who have publicly discussed their battles with this condition in the past.

How about supplements like Nourkin? Is it - or anything else such as Regaine - effective?

Topical minoxidil (commonly known as the product ‘Regaine’) can be prescribed in certain cases where the hair is thinning and this can be an effective method of increasing the density of the hair. They also have a formula specifically for women. However you should seek expert advice before using any hair loss product.

If you’re looking to reduce the natural process of hair loss then a drug called Propecia could also help and again, this can be prescribed by a specialist if it is deemed suitable for you.

How else can I fix my thinning hair? Help?

If you are able to rule out any of the above underlying medical conditions, but you are still experiencing hair loss, then there a number of steps you can take.

Reducing the use of hair extensions, avoiding over-styling and not restricting the hair by wearing it in very tight braids will help. There are also certain products that can increase hair density but, again, you should always seek the advice of an expert first before taking these.

If hair loss has reached the point where it is permanently damaged, and where no underlying medical condition has been diagnosed, then surgical restoration may be an option.

The 3G FUE hair transplant process involves taking individual hairs from the back of the head, where the hair is strong and plentiful, and replanting them in the thinning area to restore the natural looking, fuller head of hair. The treatment is carried out under local anaesthetic and once the hair is transplanted it will grow as normal. For cases where the hair has been lost permanently then a transplant is the only solution that will result in successful re-growth. There are very few practitioners who specialise in the FUE hair transplant process so anyone suffering from hair loss should pick their practitioner wisely.

I have small bald patches and have been diagnosed with alopecia areata - what do you recommend?

Alopecia areata is an autoimmune condition. The good news is that it is self-limiting and usually heals by itself. No medical attention is needed in most cases of Alopecia areata.

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