Hair loss in women
Martina Feichter studied biology with an elective subject pharmacy in Innsbruck and also immersed herself in the world of medicinal plants. From there it was not far to other medical topics that still captivate her to this day. She trained as a journalist at the Axel Springer Academy in Hamburg and has been working for since 2007 - first as an editor and since 2012 as a freelance writer.
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Hair loss in women can cause feelings of shame and seriously scratch self-esteem - often more than in men with thin hair. What are the different causes of hair loss in women? What can be done about it? You can read the answers here!
Hair loss in women: causes
There are different forms and causes of hair loss in women. Here you will find the most important:
Hereditary hair loss in women
In most cases, hereditary hair loss in women (and men) is the reason for hair thinning. For a long time it was believed that an excessive production of testosterone (the most important male sex hormone) is the reason for the increased hair loss in the affected women. But this is only the case occasionally, for example with polycystic ovarian syndrome (PCO syndrome).
In most women with hereditary hair loss, however, no elevated levels of male sex hormones (androgens) can be detected. Rather, they seem to be triggered by a reduced activity of the enzyme aromatase and a genetic hypersensitivity of the hair follicles to androgens:
Aromatase converts male into female sex hormones (estrogens) on female hair follicles. The reduced enzyme activity in the case of hereditary hair loss in women means, on the one hand, that the concentration of male sex hormones on the hypersensitive hair follicles increases. On the other hand, fewer female hormones (estrogens) are formed locally, which are said to have a beneficial effect on hair growth. Overall, this results in hair loss.
In the women affected, the hair loss manifests itself in a general thinning of the scalp hair, mainly in the crown area. As a result, the scalp shimmers more and more. In some women, hair loss also tends to affect the front of the head, leading to a balding forehead (as in men with this type of hair loss).
Circular hair loss in women
Instead, some women get circular, bald spots on their heads or other hairy parts of the body. Then there is circular hair loss (alopecia areata). It has other causes. If it is severe, all body hair can fall out completely (alopecia areata universalis).
The exact reasons for this type of hair loss in women, men and children are not known. However, various factors play a role in the development of the disease, for example an autoimmune reaction: Antibodies of the immune system mistakenly attack the body's own healthy tissue - in this case cells in the hair roots. This disrupts hair growth and ultimately leads to hair loss. Genetic predisposition and other factors can also contribute to the development of the disease.
The circular hair loss manifests itself particularly in the 2nd and 3rd decade of life. Menopause, or in general the 5th decade of life, is also often accompanied by this form of hair loss.
Diffuse hair loss in women
Diffuse hair loss results in hair loss evenly all over the head. There are many possible causes for this. Here are the main ones:
Certain medications are often the trigger for excessive hair loss. These include, for example, cytostatic drugs (anti-cancer drugs), anti-thyroid drugs (anti-thyroid drugs), beta blockers (for heart disease), lipid-lowering drugs (for increased blood lipid levels), anticoagulants (anticoagulants), vitamin A preparations and the gout drug allopurinol. Particularly important for women: Diffuse hair loss is often triggered by the pill (ovulation inhibitor).
In other cases, diffuse hair loss in women (and men) is due to a metabolic disorder. This can be a protein or iron deficiency, for example in the context of malnutrition. Hyperthyroidism and hypothyroidism can also be the reason for excessive hair loss.
In some cases, diffuse hair loss is caused by poisoning, such as with thallium or arsenic.
Chronic infections (such as tuberculosis) can also be the cause of diffuse hair loss. Even after an acute, severe infection with a high fever like the flu, your hair can temporarily fall out. The same is true after operations.
Many women complain of increased hair loss after giving birth. You can read more about this in the article Hair Loss After Pregnancy.
Mechanically induced hair loss in women
Persistent or frequent pulling on the hair roots can lead to the affected hair falling out prematurely. This can be observed, for example, in women who very often wear a tight ponytail: Here, hair loss primarily affects the area of the forehead and temples. Doctors speak of traction alopecia here.
Scarring hair loss in women
In women (and men) with inflammatory skin diseases or skin damage, hair loss is sometimes caused by damage to the hair roots or scarring on the scalp. This can happen, for example, with lupus erythematosus, lichen planus (lichen planus), scleroderma (a connective tissue disease) or local infections with fungi or bacteria.
Hair loss in women: treatment
Treatment for hair loss in women depends on the cause. For example, if certain medications cause diffuse hair loss, those affected should speak to their doctor. It may be possible to reduce the dose or switch treatment to an alternative that is less harmful to hair growth. If not, the hair loss usually normalizes on its own after the drug therapy has ended.
If diseases (such as hyperthyroidism, tuberculosis, etc.) or poisoning are the trigger for hair loss, these must be treated professionally. This can often stop hair loss as well.
The treatment of scarring hair loss is difficult and tedious. In the case of lupus erythematosus, for example, cortisone and other active ingredients can be prescribed to treat the inflamed areas of the scalp, which stop the inflammatory processes and thus the hair loss. Hair that has already been lost does not grow back because the hair follicles are irreversibly damaged.
Mechanically induced hair loss in women can be prevented by avoiding excessive tension on the hair roots. This means, for example, just tying a ponytail loosely or wearing your hair open more often.
Temporary hair loss in women after childbirth, after operations or infections usually does not require any therapy, but rather normalizes on its own.
Treatment of hereditary hair loss in women
Minoxidil is considered to be the most effective remedy for hereditary hair loss in women. It is used as a two percent hair tonic twice a day locally on the areas that are becoming lighter. This can stop the progression of hair loss and sometimes even trigger new hair growth. The exact mechanism of action of minoxidil is not known. It probably stimulates blood flow in the small blood vessels.
Sometimes doctors also prescribe tablets containing antiandrogens (such as cyproterone acetate) for hereditary hair loss in women. These are substances that neutralize the effects of male sex hormones. Before menopause, antiandrogens are used in combination with estrogens as contraceptives. Pregnancy must be avoided during treatment: in a male fetus, the antiandrogens would interfere with genital development.
If a hormonal disease such as polycystic ovary syndrome is behind hereditary hair loss in women, the focus is on treating the underlying disease.
Extreme hair loss in women (and men) can often only be concealed with a hairpiece (toupee, wig). Some sufferers also opt for a hair transplant.
Treatment of Circular Hair Loss in Women
There are various options available for treating circular hair loss in women (and men). These include, for example, local applications of cortisone or dithranol (cignolin, anthralin). Cortisone inhibits the immune system. Dithranol is a skin irritant that is said to stimulate new hair growth.
Topical immunotherapy can be tried for larger bald areas. In the process, an allergic contact dermatitis is specifically triggered on the affected areas of the skin, which is intended to “divert” the misdirected immune system from attacking the hair root cells.
The chances of success of the individual treatment options for circular hair loss in women (and men) are overall rather modest. There are also frequent relapses.
In some cases, the circular hair loss in women (as well as men and children) heals on its own.
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