It's the thing that defines you — the red curls or the spiky blond 'do or the sun-streaked brown mane — and now it's disappearing...
It’s the thing that defines you — the red curls or the spiky blond ‘do or the sun-streaked brown mane — and now it’s disappearing down the drain.
No, hair loss isn’t life-threatening, and yes, far worse is happening in the world. You know that.
But if you’re a woman, it can be life-altering.
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“My claim to fame was that I had this huge amount of hair,” says Connie Huisken, of Phoenix. “People thought it was exorbitant. It was wiry and curly, and with lots of body. Then it just started falling out.”
Knowing that you’re not alone, that about half the women in the United States deal with some degree of hair loss, doesn’t make it any easier.
Dermatologist Katherine Lim of the Mayo Clinic in Phoenix and Scottsdale, Ariz., says losing 50 to 100 hairs a day is normal. Of the 100,000 to 150,000 hairs on your head, you hardly miss them.
Many factors can contribute to thinning hair, including:
Hereditary female-pattern baldness
Autoimmune disorders, such as alopecia areata
Trauma or severe psychological stress
Hormonal changes, such as childbirth
Medications, such as birth-control pills
Cornrows, braids, tight hairstyles
Within five years, doctors hope they will be able to harvest hair stem cells from an adult’s head, put them in areas of hair loss and generate new hair cells. But for the time being, here are some ways to treat or camouflage thinning hair:
Rogaine (2-5 percent)
Hair transplantation surgery
“But sometimes people lose a lot more,” she says. “It’s fairly common for women, and it’s important that they have the issue addressed.”
With age, follicles produce less quality hair, particularly after menopause. Regardless, dermatologists see just as many women in their 30s and 40s as post-menopausal women, said Dr. Alexander Lewis, a Stanford University adjunct associate professor of dermatology.
Phases of growth, loss
For women, several factors could trigger the loss, including hormonal changes, heredity, stress, aging, underlying medical conditions, iron deficiency and reactions to medicine.
“One very common scenario is that three months after delivering a baby, it seems like all of a sudden your hair is really thinning,” Lim says. “In pregnancy, hormones cause some of the hair to stay in the anagen phase longer, so you’re shedding less then.”
The anagen phase, the first of three in hair’s life cycle, is the growing period, she says. Usually, about 90 percent of the hair is in this stage, growing for two to six years.
In the transitional (catagen) phase, the hair stops growing and shrinks. This phase lasts weeks and involves about 1 to 2 percent of the hair at a given time.
Finally, old hair is pushed out by new hair at the end of the resting (telogen) phase. This months-long period involves about 10 percent of the hair, more in a woman whose pregnancy has caused her scalp to hold on to it longer than usual.
The new hair then enters the anagen phase, and the cycle begins again.
Searching for a cause
Determining what has skewed the cycle is the first step in slowing, stopping or possibly even reversing hair loss, Lim says.
“Sometimes women feel embarrassed to bring it up to their doctor,” she says. “Or the doctor may not have time to talk about it. But there are all sorts of things to decipher.”
www.heralopecia.com: An interactive community and source of support.
www.stophairlossnow.com: Europe’s largest hair-loss Web site, featuring interviews with the world’s experts.
www.womenshairinstitute.com: Women’s Institute for Fine and Thinning Hair, a Pfizer-sponsored site with expert advice and a self-test on hereditary thinning.
www.baumanmedical.com: Bauman Medical Group. Florida hair-transplantation surgeon Alan Bauman, a leading expert whose clientele is 40 percent female. Web site offers video of a woman’s transplant.
www.naaf.org: National Alopecia Areata Foundation, a nonprofit with support groups.
www.dermatology.ucsf.edu: UCSF Hair Research Center. Director Vera Price is a leading researcher and dermatologist specializing in women’s hair disorders, particularly in African Americans.
www.ishrs.org: The International Society of Hair Restoration Surgery, which offers tips on finding a hair-transplant doctor.
• Has your hair become brittle?
• Is the loss patchy or dispersed throughout the scalp?
• Have you been sick?
• Are you taking too much, too little or the wrong medicine or nutritional supplements for an existing condition?
• What is your family’s health history?
• Could you be allergic to your hair-care products?
“It’s common for doctors to just pull the hair and see how many hairs come out, then perhaps look at them under a microscope,” Lim says. “Depending on what we find, we might order a complete blood count and specific tests for conditions we suspect, like lupus or thyroid disease.”
Products and chemicals
Hairstylist Velma Greathouse, co-owner with husband George of Esquire Barber Shop in Phoenix, says many of her African-American clients use relaxers, perms and dyes on their hair.
“If those chemicals aren’t properly applied and your hair isn’t properly maintained, it can be devastating to the hair,” she says. “You can put on a $1,000 dress, but if your hair’s not in good shape, you just won’t feel right.”
Greathouse has had worried clients approach her clutching a hairbrush with five strands in the bristles or pointing to a tiny bald spot.
“Sometimes it’s as simple as saying, ‘Stop using those clippies in your hair,’ ” she says.
Other clients’ situations are more challenging: a young woman who lost lots of weight — and hair — after bariatric surgery; mature women under stress or taking multiple medications for health conditions.
Alan Bauman, a Florida hair-transplant surgeon, performs scalp biopsies and blood tests to rule out medical conditions and usually follows with minoxidil, marketed as Rogaine, the only medicine known to slow hair loss. Oftentimes, he prescribes the 5 percent intended for men, not the 2 percent for women.
“There was some increased facial hair with the 5 percent, so they took it down to 2,” he said. “But I haven’t seen a lot of that in my practice.”
Many who take it stop too soon because it can cause flaking and some initial shedding. But doctors urge them not to.
“You have to give it at least four months,” said Kelly Hood, a Lafayette, Calif., dermatologist.
Cortisone treatments usually follow or are used in conjunction with Rogaine. All treatments work the same way: strengthening follicles to prevent further loss and stimulate new growth.
But when your immune system rejects your hair, strengthening is irrelevant.
Miranda Gardner suffers from alopecia areata, an autoimmune disorder that affects 5 million Americans. The body acts like it’s allergic to the hair, pushing it out in large, circular patches. Gardner, of Concord, Calif., first noticed it two years ago, shortly after giving birth to her son.
Gardner recalls feeling “cold breezes back there,” but she couldn’t see anything. That night, she used a hand mirror to look at the back of her head. There, she found a bald spot the size of a golf ball.
“I cried for three days,” Gardner said.
Surgery could help
But even hair-transplantation surgery is not an option for those with active alopecia areata, because, post-transplant, the body still sees the hair as foreign and ejects it.
But for women with thinning hair and about $5,000, surgery can yield significant results.
“Ten years ago, the grafting was not microscopic enough for women,” Bauman said. “Today, the technology is such that we can graft between follicles.”
In other words, the pluggy look is a thing of the past. Surgeons transplant hair from the lower back of the head to the front and crown. Sessions typically cost $4,000-$7,000, and most women need one or two sessions, said Lewis, who is also a practicing dermatologist and who performs transplant surgeries.
Hormones and heredity
Huisken, 54, has lost hair on several occasions, the first time as she was beginning puberty at age 13. She lost more after the births of her children and again in her 40s.
“I have a feeling it’s hormonal,” she says. “The loss has kind of slowed down now, maybe because menopause is way over for me.”
With a grandmother who backcombed her hair to make it look fuller, Huisken believes heredity plays a role, too.
“I didn’t want that look,” she says. “Who would? Fortunately, my kids have my husband’s hair.”
She has reason to be relieved. Heredity is to blame for thinning hair in about 30 million American women, or 70 percent of women who report hair loss, the American Academy of Dermatology says.
Huisken has consulted with dermatologists, a nutritionist and a homeopathic doctor in search of remedies. She has tried vitamins, Rogaine and Nioxin brand hair-care products with some success. And she has thought seriously about acupuncture, wigs and hats.
“Men who start to go bald can just shave their head, and then they look really nice,” she says. “We can’t do that.”
Information from The Arizona Republic and the Contra Costa (Calif.) Times was used in this report.