Most people fail to realize that about 50% of women over the age of 50 suffer some amount of hair loss. Unfortunately, some women start well before that. Still, the way that women lose their hair differs a great deal from men. While men generally have male pattern baldness that leaves permanent hair on the back and sides of the head, women’s hair tends to thin all over, including the back and sides. Women often keep more of their hair at the hairline, however.
The reasons for these differences between the sexes are primarily hormonal, although if you’ve read the page about hair loss in men, you’ve learned that the process is quite complex and not entirely understood.
If a woman has lost enough hair to merit a hair restoration procedure, the process is also quite different from that performed on men. The surgeon must understand these differences and be trained in how to treat women with hair loss in order to achieve an excellent result. We keep these differences very much in mind – not only from a medical perspective but also in terms of how women want to look.
Doctors can test for hair loss by pulling the hair to see how many hairs come out easily. Hairs can also be magnified to test their density to see which hairs have shrunk/miniaturized in size. That test is called densitometry.
Types of Hair Loss in Women
Women have different types of hair loss. Below are three of the main types:
Diffuse Hair Loss (Diffuse Unpatterned Alopecia)
This is the most common type of hair loss in women, in which the hair thins to some degree all over the head. Balding does not occur, but there is hair loss and hair miniaturization.
Unfortunately, hair restoration methods do not always work for this type of hair loss because any donor areas are also affected. Despite this, hair transplantation can decrease the frontal scalp visibility that is more bothersome to most women. Medications may also be effective to some degree for this condition.
Patterned Hair Loss
Patterned hair loss in women usually consists of one of two possible patterns. The first pattern is more common, in which the hair thins behind the hairline and continues to thin on the sides and back. Women with this pattern can usually be very successfully treated with hair restoration.
The second, less common pattern is similar to male pattern baldness in that the hair thins in the front and is fuller on the sides and back. This also can be very successfully treated with hair restoration.
Localized Hair Loss
This condition is called Alopecia Areata and is usually the result of a genetic, autoimmune disease in which the hair falls out in round patches. Corticosteroid injections are the usual treatment for this type of hair loss in women. Lupus is one cause, but radiation used to treat cancer can also cause this type of hair loss outside of a genetic disease situation.
This kind of hair loss may also occur as a result of trichotillomania, a psychological condition in which the person pulls out the hair compulsively. If this continues enough, the hair may not grow back properly, and hair restoration procedures can often be used to correct the effects of the condition.
Hair loss in women is even more affected by hormones, illnesses (particularly skin conditions), and stress than hair loss in men. Like men, women have hereditary hair loss as well, and the genes can come from either parent. The hormonal component is quite different, however.
Women do have testosterone in their bodies, but much less than men. The enzyme 5-alpha reductase plays a large role in male pattern baldness, but women have only about half as much of this enzyme in their bodies as men. Women also have more of an enzyme called aromatase, which blocks formation of the hormone, DHT – another major player in male pattern baldness.
Like men, common hair loss in women is called Androgenetic Alopecia. The genes that could cause hair loss will only “express” themselves and actually cause that loss when acted upon by hormones called androgens. So, excess androgen is often the reason for the expressivity of genes that leads to hair loss in women.
Disease and Medications
While diseases and medications can cause hair loss in men, women are more prone to these causes. Most of these conditions cause diffuse hair loss and include thyroid issues, gynecological conditions, autoimmune disorders (as already mentioned), malnutrition (sometimes caused by dieting), anemia, endocrine system problems, and stress.
Medications for the thyroid, contraception, blood pressure, depression, blood thinning, cholesterol, and inflammation are among those that sometimes cause hair loss in women. Recreational drugs can also be a culprit.