For many women, their hair is their crowning glory and a source of great pride. It's the one accessory that you can't take off, and people see it every day. When women experience hair loss, however, it can be a traumatic experience leading to a myriad of questions and tests. Alopecia, the scientific name for hair loss, has multiple potential causes and treatments. And getting information sooner rather than later is critical.
Symptoms
There are about 100,000 hairs on a woman's head at any given time, and typical hair loss is about 50 to 100 hairs a day. Atypical hair loss is considered losing more than 125 hairs a day and no new hair growth to replace them. Women may notice hair loss as the hair begins thinning at the top and side of the head. Handfuls of hair may come out during shampooing, combing or running hands through the hair. When you experience this atypical hair loss, it is time to see a doctor.
Types
Hair loss in women can be permanent or temporary depending on the type and cause. Female-pattern baldness or androgenetic alopecia is where hair thins in the front, side or crown of the head. Scarring or cicatricial alopecia is a rare permanent type in which the hair follicle is scarred by inflammation. Alopecia areata is a temporary type of hair loss characterized by patchy loss areas about the size of a quarter. Telogen effluvium is a temporary type of hair loss after a traumatic event due to changes in the growing and resting stage of hair. Traction alopecia is temporary and results from wearing certain hairstyles. Anagen effluvium alopecia is temporary after chemotherapy.
Causes
There is not a one-size-fits-all cause for hair loss in women. Genetics play a role when the body can't produce new hair. If there is a history of baldness on either side, a woman can be at risk. Sudden or emotional stress can cause hair loss. Severe infections, childbirth, major surgery and crash diets are also culprits. Hormonal changes and damage to the hair follicles are known to cause hair loss in women. Certain medications and medical treatments such as those taken for high blood pressure, gout and chemotherapy or radiation can cause hair loss. For pattern hair loss in women, changes in the level of androgens--male hormones--play a key role.
Tests
A doctor will perform a physical exam and take a complete medical history. Additional tests may be necessary if a cause for hair loss isn't clear after that information is gathered. A pull test is one in which a few dozen hairs are pulled to see how many come out--it is helpful in diagnosing telogen effluvium. Skin scrapings take samples from the scalp to see if an infection is present, causing hair loss. Punch biopsies are performed using a circular tool to remove a portion of the deeper layers of skin to look for causes.
Treatments
The treatment for hair loss in women depends on the cause. For hair loss caused by a medication, the treatment may include changing medicines. Hair loss caused by chemotherapy or radiation may correct itself over time after treatment stops. There is only one medication on the market to treat female-pattern baldness: minoxidil. Minoxidil is a topical treatment you put on the scalp, and you must continue treatment or hair loss may return. Hair transplants, which involves placing tiny plugs of hair in balding areas, are costly but often have successful results. For women whose hair loss is due to an overload of androgens, a medication called spironolactone taken orally can help.
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