Hair loss, especially when severe, often profoundly affects the lives of those afflicted. Severe hair loss evokes not only cosmetic concerns but may also evoke feelings of vulnerability (nakedness), loss of self-esteem and alterations in self-image.
Each hair follicle produces hair in phases. There is a growing (anagen) phase, which lasts from 2 to 6 years, a resting (catagen) phase which lasts for about 3 months, and finally the shedding of the hair (telogen) phase which allows the follicle to begin pushing a new hair to the surface.
Most modern medical research leans toward the position that a predominantly male hormone called dehydrotestosterone (DHT), which is converted from testosterone, binds to sites on hair follicles and is a primary instigator of hair loss. DHT appears to make the follicles go into their “resting” phase faster which in turn starts to cause the hairs produced by those follicles to become thinner and thinner with each growth cycle.
Female pattern baldness usually begins about age 30, becomes noticeable around age 40, and may be even more noticeable after menopause. It is usually an overall thinning rather than a bald area on top of the head, though women may have a receding hairline, too. It is thought that about 15% of American women have such hair loss. As in males, hair follicles simply shut down, with hormones playing some role in the process.
By far the most common form of hair loss in women is due to hormone changes. It is estimated that around 30% of Caucasian females are affected before menopause. Women rarely lose their hair due to a genetic predisposition; instead it is usually caused by hormonal imbalance and other cyclical shifts. Other causes include, harsh commercial shampoos, perms, hair color, bleach, blow-drying, improper combing/brushing, high fevers, and scalp infections.
One plausible theory to explain some of the difference between men and women is based on the angle of follicles and resultant sebum build-up. The angle at which hairs come out of a female scalp allow the sebum (oil produced by the scalp) to “run off” whereas the angle of hairs on a male scalp (straight up) can lead to oil blockage.
Most doctors agree that if you have a oily scalp with thinning hair, frequent shampooing is advised. shampooing can reduce surface sebum, which contains high levels of testosterone and DHT that may reenter the skin and affect the hair follicle.
Specific foods or vitamins don’t regrow hair, although good nutrition is essential for healthy hair.
Telogen effluvium is a form of nonscarring alopecia characterized by diffuse hair shedding, often with an acute onset. A chronic form with a more insidious onset and a longer duration also exists. Telogen effluvium is a reactive process caused by a metabolic or hormonal stress or by medications. Generally, recovery is spontaneous and occurs within 6 months. The interval between the inciting event in telogen effluvium and the onset of shedding corresponds to the length of the telogen phase, between 1 and 6 months.
Signs, symptoms & indicators of Female Hair Loss
Absence of unusual hair loss
Risk factors for Female Hair Loss
Lupus, SLE (Systemic Lupus Erythromatosis) / Risk
Alopecia occurs in 27 to 50% of patients. Typically manifested as reversible hair thinning during periods of disease activity, it is demonstrated by the ease with which hair can be plucked from the scalp and the development of “lupus hairs” (i.e. short strands at the scalp line). Following an acute attack of SLE, usually with fever, patients may experience much generalized hair loss. This results from a period of arrested hair growth during the acute episode.
Hyperthyroidism
Hyperthyroidism can cause hair loss. Hair loss associated with thyroid disorders is easily treated.
Mercury Toxicity / Amalgam Illness
Mercury toxicity can cause hair loss.
Hypothyroidism
In rare cases, diffuse hair loss may be the only symptom of hypothyroidism, but in many people with hypothyroidism the hair is not affected. Once thyroid hormone is administered, regrowth of hair occurs in approximately 2 months.
Hypothalmus / Pituitary / Pineal Function
Any condition that upsets the ovary, adrenal or pituitary gland may result in hair loss.
Birth Control Pill / Contraceptive Issues
Women starting or stopping birth control pill use have experienced hair loss.
Stress
Severe stress can cause hair loss.
Vitamin A Toxicity
Vitamin A toxicity symptoms include skin that has a rough and dry appearance, hair loss and brittle nails.
Zinc Requirement
See the link between Hair Loss and Manganese.
Manganese Requirement
Mineral metabolism of 19 patients with hair loss was examined and the analysis showed manganese deficiency in all. Eighteen patients showed considerable problems with calcium absorption, and twelve patients had problems with their zinc metabolism. Specific nutritional and mineral therapy resulted in improved hair growth after 2-3 months of treatment. [Blaurock-Busch, E. Wichtige Nahrstoffe fur Gesunde Haut und Haare, Kosmetik Internat. 3/87]
Vitamin B6 Requirement
Especially if associated with birth control pill use.
EFA (Essential Fatty Acid) Requirement
Essential fatty acid deficiency can results in dry, brittle hair and hair thinning or loss.
Iron Requirement
Iron deficiency anemia can in some cases contribute to hair loss.
History of severe hair loss
Possible Pregnancy-Related Issues
The hormone changes occurring at childbirth can cause hair loss.
Female Hair Loss suggests the following may be present
Stress
Severe stress can cause hair loss.
Vitamin A Toxicity
Vitamin A toxicity symptoms include skin that has a rough and dry appearance, hair loss and brittle nails.
Recommendations for Female Hair Loss
Evening Primrose Oil / GLA
In his book, “Solved: The Riddle of Illness,” Stephen Langer, M.D. points to the fact that symptoms of essential fatty acid insufficiency are very similar to hypothyroidism, and recommends evening primrose oil – an excellent source of essential fatty acids – as helpful for people with hypothyroidism. The usefulness of evening primrose oil, particularly in dealing with the issues of excess hair loss with hypothyroidism, was also reinforced by endocrinologist Kenneth Blanchard. According to Dr. Blanchard:
“For hair loss, I routinely recommend multiple vitamins, and especially evening primrose oil. If there’s any sex pattern to it – if a woman is losing hair in partly a male pattern – then, the problem is there is excessive conversion of testosterone to dihydrotestosterone at the level of the hair follicle. Evening primrose oil is an inhibitor of that conversion. So almost anybody with hair loss probably will benefit from evening primrose oil.”
Grape Seed Extract / Resveratrol
A mouse study has shown improved hair growth with the use of topical procyanidins (grape seed extract). [J Invest Dermatol 1999 Mar;112 (3): pp.310-6]
The active ingredients of Revivogen are natural compounds proven to inhibit of 5-alpha-reductase (the enzyme that produces DHT), block the androgen receptors and stimulate hair growth. These active ingredients include Gamma Linolenic acid (GLA), Alpha Linolenic acid (ALA), Linoleic Acid, Oleic Acid, Azaleic acid, Vitamin B6, Zinc, Saw Palmetto Extract, Beta-Sitosterol and Procyanidin Oligomers.
Animal/Saturated Fats Avoidance
Researchers in one study noted that Japanese hair was thick and healthy, with a small gland and little scalp oil, until large amounts of animal fat crept into their diet after World War II.
Conventional Drugs / Information
Hundreds of different drugs have been linked to hair loss. Anesthetics, chemotherapy, bromocriptine – used to inhibit lactation, beta blockers, ACE inhibitors, amphetamines and anticholesterol agents are examples.
Test / Monitor Hormone levels
There have been several reports that supplemental DHEA has accelerated hair loss in susceptible men and women. Hormone level testing is advised prior to hormone use.
Test Mineral Status
See the link between Female Hair Loss and Manganese Requirement.
Test Iron Stores (Ferritin)
Iron deficiency can cause hair loss in women. Laboratory evidence of such a deficiency may show up on a complete blood count, serum iron or serum ferritin.
Reading List
Breaking the Silence on Women’s Hair Loss: A Proactive Guide to Finding Help by Candace Hoffmann. This book includes sections on the causes of women’s hair loss, hair loss myths, possible treatments, and a range of hair care options. It will be a valuable resource for anyone who is coping with this problem, and for everyone who wants to understand and assist women who are dealing with hair loss.
Key
| Weak or unproven link |
| Strong or generally accepted link |
| Very strongly or absolutely counter-indicative |
| May do some good |
| Likely to help |
| Highly recommended |
| May have adverse consequences |
Glossary
Hormones
Chemical substances secreted by a variety of body organs that are carried by the bloodstream and usually influence cells some distance from the source of production. Hormones signal certain enzymes to perform their functions and, in this way, regulate such body functions as blood sugar levels, insulin levels, the menstrual cycle, and growth. These can be prescription, over-the-counter, synthetic or natural agents. Examples include adrenal hormones such as corticosteroids and aldosterone; glucagon, growth hormone, insulin, testosterone, estrogens, progestins, progesterone, DHEA, melatonin, and thyroid hormones such as thyroxine and calcitonin.
DHT
Dihydrotestosterone - a highly active form of testosterone, which influences many aspects of manly behavior, from sex drive to aggression. The conversion from testosterone to DHT is driven by an enzyme called 5-alpha reductase, which is produced in the prostate, various adrenal glands, and the scalp.
Testosterone
The principal male sex hormone that induces and maintains the changes that take place in males at puberty. In men, the testicles continue to produce testosterone throughout life, though there is some decline with age. A naturally occurring androgenic hormone.
Menopause
The cessation of menstruation (usually not official until 12 months have passed without periods), occurring at the average age of 52. As commonly used, the word denotes the time of a woman's life, usually between the ages of 45 and 54, when periods cease and any symptoms of low estrogen levels persist, including hot flashes, insomnia, anxiety, mood swings, loss of libido and vaginal dryness. When these early menopausal symptoms subside, a woman becomes postmenopausal.
Sebum
The oily liquid covering the skin surface.
Alopecia
Loss of hair.
Acute
An illness or symptom of sudden onset, which generally has a short duration.
Chronic
Usually Chronic illness: Illness extending over a long period of time.
Insidious
A symptom or condition of gradual onset or development.
Metabolism
The chemical processes of living cells in which energy is produced in order to replace and repair tissues and maintain a healthy body. Responsible for the production of energy, biosynthesis of important substances, and degradation of various compounds.
Hyperthyroidism
An abnormal condition of the thyroid gland resulting in excessive secretion of thyroid hormones characterized by an increased metabolism and weight loss.
Thyroid
Thyroid Gland: An organ with many veins. It is at the front of the neck. It is essential to normal body growth in infancy and childhood. It releases thyroid hormones - iodine-containing compounds that increase the rate of metabolism, affect body temperature, regulate protein, fat, and carbohydrate catabolism in all cells. They keep up growth hormone release, skeletal maturation, and heart rate, force, and output. They promote central nervous system growth, stimulate the making of many enzymes, and are necessary for muscle tone and vigor.
Hypothyroidism
Diminished production of thyroid hormone, leading to low metabolic rate, tendency to gain weight, and sleepiness.
Pituitary
The pituitary gland is small and bean-shaped, located below the brain in the skull base very near the hypothalamus. Weighing less than one gram, the pituitary gland is often called the "master gland" since it controls the secretion of hormones by other endocrine glands.
Vitamin A
A fat-soluble vitamin essential to one's health. Plays an important part in the growth and repair of body tissue, protects epithelial tissue, helps maintain the skin and is necessary for night vision. It is also necessary for normal growth and formation of bones and teeth. For Vitamin A only, 1mg translates to 833 IU.
Manganese
An essential mineral found in trace amounts in tissues of the body. Adults normally contain an average of 10 to 20mg of manganese in their bodies, most of which is contained in bone, the liver and the kidneys. Manganese is essential to several critical enzymes necessary for energy production, bone and blood formation, nerve function and protein metabolism. It is involved in the metabolism of fats and glucose, the production of cholesterol and it allows the body to use thiamine and Vitamin E. It is also involved in the building and degrading of proteins and nucleic acid, biogenic amine metabolism, which involves the transmitting of nerve impulses.
Mineral
Plays a vital role in regulating many body functions. They act as catalysts in nerve response, muscle contraction and the metabolism of nutrients in foods. They regulate electrolyte balance and hormonal production, and they strengthen skeletal structures.
Calcium
The body's most abundant mineral. Its primary function is to help build and maintain bones and teeth. Calcium is also important to heart health, nerves, muscles and skin. Calcium helps control blood acid-alkaline balance, plays a role in cell division, muscle growth and iron utilization, activates certain enzymes, and helps transport nutrients through cell membranes. Calcium also forms a cellular cement called ground substance that helps hold cells and tissues together.
Zinc
An essential trace mineral. The functions of zinc are enzymatic. There are over 70 metalloenzymes known to require zinc for their functions. The main biochemicals in which zinc has been found to be necessary include: enzymes and enzymatic function, protein synthesis and carbohydrate metabolism. Zinc is a constituent of insulin and male reproductive fluid. Zinc is necessary for the proper metabolism of alcohol, to get rid of the lactic acid that builds up in working muscles and to transfer it to the lungs. Zinc is involved in the health of the immune system, assists vitamin A utilization and is involved in the formation of bone and teeth.
Essential Fatty Acid
(EFA): A substance that the human body cannot manufacture and therefore must be supplied in the diet.
Iron
An essential mineral. Prevents anemia: as a constituent of hemoglobin, transports oxygen throughout the body. Virtually all of the oxygen used by cells in the life process are brought to the cells by the hemoglobin of red blood cells. Iron is a small but most vital, component of the hemoglobin in 20,000 billion red blood cells, of which 115 million are formed every minute. Heme iron (from meat) is absorbed 10 times more readily than the ferrous or ferric form.
Anemia
A condition resulting from an unusually low number of red blood cells or too little hemoglobin in the red blood cells. The most common type is iron-deficiency anemia in which the red blood cells are reduced in size and number, and hemoglobin levels are low. Clinical symptoms include shortness of breath, lethargy and heart palpitations.