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Dr. Sue-Ann Chan
Resident Dermatologist
Dr. Simmy Kaur
Resident GP
Have a question about female hair loss?
Our Resident General Practitioner Dr Simmy Kaur and Consultant Dermatologist Dr Sue Ann Chan have the answer.
Types of hair loss
Non-scarring hair loss
Scarring hair loss
Causes & Treatments
COVID-19 hair loss
How hair grows and falls out
Help & Support
Scalp & Hair Health
Opening up the conversation
Types of hair loss
Non-scarring hair loss
Scarring hair loss
Causes & Treatments
COVID-19 hair loss
How hair grows and falls out
Help & Support
Scalp & Hair Health
Opening up the conversation
There are two main types of hair loss, ‘scarring’ and ‘non-scarring.’ The vast majority of people will experience non-scarring hair loss. However it’s important to bear in mind that other medical conditions can also cause hair loss.
Below are the most common forms of non-scarring hair loss.
This is a genetic type of hair loss which can be encountered by women who are in their 30s and older, but most frequently occurs with menopause. It happens when the hair’s growth phase slows down and the hair follicles shrink. It usually takes the form of diffuse thinning, starting from the crown of the head, but unlike male pattern hair loss, it doesn’t result in complete baldness. It can’t be ‘cured’ but its symptoms can be lessened by a healthy diet, cutting out smoking and limiting sun exposure.
This hair loss condition often happens when the body goes through stress and shock. Hair loss from the condition is identifiable by bald patches appearing throughout the scalp and otherwise patchy hair loss. However, there is a good chance that, for four out of five people complete regrowth will occur within a year without treatment. Medical treatments include steroid creams, while using gentle hair treatments with scalp nourishing ingredients.
This is the only form of hair loss that is completely avoidable and caused by lifestyle. It’s caused by extensive wear and tear of the hair follicles due to tight hair styles such as braids and cornrows or wearing hair extensions, as well as using harsh chemicals that can irritate the scalp. All of these can damage the root, causing scarring and hair loss. Bald patches are normally localised around the areas that experience the most tension. A good scalp care regime can help to rebuild damaged hair follicles, reduce scalp irritation and create an ideal environment for healthy hair growth.
Telogen Effluvium occurs when more hair follicles than usual enter the hair’s resting phase (telogen phase). It’s characterised by excessive hair shedding – which can lead to thinning and bald patches – and often occurs after pregnancy or taking medications. However, normal hair growth tends to resume once the body goes back to normal.
Diffuse hair loss is where there is general hair thinning over the whole scalp and can be attributed to a number of factors such as nutritional deficiencies or illnesses. Stress is another key factor – the stress hormone called cortisol regulates the normal functioning of our hair follicles. When cortisol is present at high concentrations, it causes cells in the hair follicles to undergo apoptosis (i.e. die) prematurely by up to 40%, resulting in hair loss. As well as taking measures to reduce stress, a healthy diet, rich in iron, biotin, selenium, zinc, and folic acid should help also keep symptoms at bay.
This is an anxiety condition which occurs when patients have a strong urge to persistently rub or pull out their hair. This can also lead to scarring alopecia, where the pulled out hair doesn’t always grow back.
Scarring hair loss is rare and presents as localised bald patches. Unfortunately in scarring alopecia the hair does not grow back as there are no hair follicles present in the skin. Examples of this type of hair loss include discoid lupus, lichen planopilaris, folliculitis decalvans and central centrifugal cicatricial alopecia.
Female pattern hair loss is caused by a combination of genetic and hormonal factors. It can also be caused by Polycystic ovarian syndrome and going through the menopause. Female pattern hair loss usually starts from the crown of the scalp (vertex of the scalp) and gradually moved forward and backwards. Male pattern hair loss can start both from the temples of the scalp or from the crown of the scalp and in some cases on both areas.
Female hair loss can sometimes occur due to common conditions such as thyroid problems or even anaemia. Female pattern hair loss is something we see a lot in practice as is telogen effluvium. Childbearing (telogen effluvium) and chemotherapy related hair loss seem to be commonly seen in clinical practice.
The treatments for hair loss depend on the cause. Therefore, it’s important to speak to your GP or dermatologist if you are experiencing symptoms. Treatments generally consist of oral medications, shampoos and topical solutions to use on the scalp. Some women find that hair accessories and camouflage products can be really beneficial in helping to boost confidence. For female pattern hair loss, consider using a caffeine-based shampoo to stimulate hair growth. If this is inadequate, consider using topical minoxidil 5% lotion twice a day on the scalp. You would only start seeing results in three to four months. Once you observe hair growth, do not stop the treatment as you may experience rebound hair loss if you do so. If topical treatment is insufficient, consider taking medications which can be prescribed by a dermatologist in some severe cases. In recent years there has been lots of interest in newer, more innovative treatments for hair loss, such as laser, micro-needling, hair transplantation and fat transfer - the results of which are very promising.
The root of the hair isn’t the ‘live’ part of the hair which grows. The hair shaft itself however is essentially dead so is more prone to breakage.
Taking a multivitamin and vitamin D can be helpful. Biotin, iron, folic acid, b12, vitamin C, zinc, and collagen supplements have also been associated with good hair growth but it’s equally important to have a good healthy, balanced diet with lots of fruit and vegetables, healthy fats and protein. It’s also really important to make sure that you get enough sleep and have time to relax and recoup. When we don’t sleep well or we are stressed, excess concentrations of the stress hormone ‘cortisol’ can cause the cells of the hair follicles to age prematurely, resulting in hair loss. Make sure you allow time for relaxation techniques if you have a busy lifestyle.
Some forms of hair loss have been associated with smoking - therefore kicking the habit is recommended! Watching your alcohol intake is a good idea too - the current recommendation is to not drink more than 14 units of alcohol per week, no more than 3 units in any one day and to have at least 2 alcohol free days per week.
Hair care practices such as colouring, perming or relaxing and the use of heat can cause damage to the hair follicles resulting in significant effects on hair quality. Therefore, avoid chemical treatments wherever possible and keep the use of heat to a minimum!
A good tip is to keep a symptom diary so that you can quantify and identify any patterns. This is a useful thing to do while you are ‘watching and waiting.’
Below are the four main ingredients to look out for that have been scientifically proven to help: Caffeine / caffeine extract Pumpkin seed extract Rosemary Leaf oil Panthenol B5 Whilst the evidence for essential oils are not strong for combatting hair loss, there are evidence to support their use in reducing stress levels and promoting relaxation. You can start by using a really good quality, silicone and sulphate free shampoo and conditioner like MONPURE’s Strengthening Silk Protein Shampoo and Essence-Conditioner. In addition to this, using regular treatments such as MONPURE’s Nourish and Stimulate Scalp Mask and Follicle Boost Hair Density Serum can help to ‘feed’ the hair follicles with the essential vitamins and nutrients that they need to flourish and grow to their optimum. MONPURE’s Follicle Boost Hair Density Serum contains ingredients such as pumpkin seed extract which can help to prevent hair loss and AHA’s & retinol which help to re-surface the scalp skin to help speed up cell rejuvenation.
Yes absolutely, however I think this is the case for anyone actually. We treat the skin on our faces with care by regularly exfoliating and moisturising - we should be doing the same with our scalps!
Not necessarily, many women report that their hair looks better than ever during pregnancy! During pregnancy there is an increase in circulating oestrogen which is a ‘hair friendly’ hormone. It helps to keep hair in the growth or ‘anagen’ phase for longer which quite often results in fuller, nourished and shiny hair. Unfortunately for some women, pregnancy and childbirth – like with any other significant stress on the body – can result in a condition called ‘telogen effluvium.’ This occurs when there is increased hair shedding due to a disturbance of the normal hair cycle, which is triggered by a stressful life event. The good news is that hair does normally grow back with this kind of hair loss in around 3-6 months.
Telogen effluvium (TE) is a common type of hair loss. It presents as diffuse hair loss following a significant stress on the body. This can occur as a result of stressful life events, drugs, following major surgery, hormonal abnormalities and even some nutritional deficiencies. TE typically occurs around one to three months after a major stress to the body and most people with it notice a general thinning of the hair. Covid-19 can place a great deal of stress on the body and therefore it can cause hair loss in the form of TE.
The good news is that unlike some other types of hair loss, TE is almost always temporary and for most people the hair does grow back. Most people notice that the hair is ‘back to normal’ around 6 months after the hair loss. In some cases the hair unfortunately doesn’t grow back, but this is very rare.
This depends on the type of hair loss. Androgenetic alopecia is largely genetically inherited, exacerbated by external stimuli such as dietary habits, hormonal changes and stress levels. While hair loss due to alopecia areata (brought on by illness or stress) can be unpredictable and hard to prevent. The key is to look after and strengthen the hair that you already have. The other thing to do is to seek help early if you are feeling that you are losing an unusual amount of hair as treatments can quite often be more effective when used in the early stages of hair loss.
According to the American Association of Dermatology, it's normal to shed around 50-100 hairs per day. However in reality, hair loss can vary tremendously from person to person. As a general rule of thumb - if you notice thin or bald patches, a visible scalp, a sudden increase in hair fall, or a gradual decline in the thickness of the hair, seek help from your doctor.
The rate at which the hair grows or ‘the anlagen phase’ is dependent on many factors to include genetics, age, ethnicity, health, the time of year and diet. Interestingly, studies have shown that females of Asian descent tend to have faster rates of hair growth. Researchers have also found that hair tends to grow at a faster rate in the Summer months. The key to doing everything you can to prolong good hair growth is to eat well, reduce stress, avoid over-styling, avoid using excessive heat and to use good products on the hair.
Yes, potentially. This can be achieved quicker with treatment – for example topical steroid lotion, steroid injections and Dyphencipherone (DCP) treatment in the Dermatology department
Seek help early! If you are feeling that you are losing an unusual amount of hair and worried - see your doctor, as treatments can quite often be more effective when used in the early stages of hair loss.
It’s useful to take a clear log or hair loss diary with you to your GP appointment so that they can gauge if you are losing an unusual amount of hair. They will examine your scalp and possibly do a blood test to differentiate (in some circumstances) the type of hair loss that you have. In some uncommon cases they take skin scrapings to help make a diagnosis. Once a diagnosis is made, which may in some cases take a little time, a treatment can be given.
The process is simple - GPs and dermatologists listen to the history of the problem, examine, do tests if required and then treat.
In the NHS, GP’s are restricted to 10 minute consultations which means that quite often they can’t speak to you extensively at the time that they see you - even if they want to! They can however signpost you to local organisations that can help with things like talking therapies. These resources vary from area to area so it’s good to visit your GP to see what they can do. Alopecia UK is a great resource, here you’ll be able to find a support group near you. There are so many people out there in the same situation as you that feel the same way as you do. Patients of mine have found that talking about the issue can be really cathartic and beneficial for the psychological healing process when dealing with such a life changing condition.
A dermatologist is a doctor who specialises in the diagnosis and treatment of skin disorders. Dermatologists can sub-specialise in trichology. A trichologist is somebody that has a diploma in trichology, by definition trichology is the study and treatment of the hair and scalp.
The best way to prevent the hair from becoming dull and unhealthy is to really look after it in the first place by using good quality, clean products. We do this with the skin on our faces - we exfoliate, cleanse, moisturise and do a face mask every now and again. We should be doing exactly the same with our hair! Good hair requires care, time and nourishment.
An unhealthy scalp can lead to dryness, irritation, itching, scaling, ageing and even hair loss.
You can start by using a really good quality, silicone and sulphate free shampoo and conditioner like MONPURE’s Strengthening Silk Protein Shampoo and Essence-Conditioner. In addition to this, using regular treatments such as MONPURE’s Nourish and Stimulate Scalp Mask and Follicle Boost Hair Density Serum can help to ‘feed’ the hair follicles with the essential vitamins and nutrients that they need to flourish and grow to their optimum. MONPURE’s Follicle Boost Hair Density Serum contains ingredients such as pumpkin seed extract which can help to prevent hair loss and AHAs and retinol which help to exfoliate resurface the scalp skin to help speed up cell rejuvenation.
It’s the opposite actually, foam is created when foaming agents such as sulphates are added to shampoos. Sulphate-free shampoos are gentler on the scalp, as sulphates can strip it of its natural oils, leaving the scalp and hair feeling dry and brittle. Sulphates can be particularly troublesome in those with coloured or chemically treated hair.
Over-cleansing the scalp or the skin can result in it being stripped of its natural oils which can result in damage to the root.
Ideally hair shouldn’t be cleansed more than every 2-3 days - this may sound a bit gross but with some persistence you will notice that your hair will look fuller and healthier if you have a normal or dry scalp. If you have a oilier scalp naturally, you may require more frequent shampoos. Always look for scalp friendly ingredients.
Losing your hair can have huge consequences on your confidence. So, it’s really important to open up and talk about how it’s affecting you. The hardest part is reaching out and looking for help in the first place - your GP or dermatologist will be able to guide you to therapies and support groups where you can talk to other people with similar experiences. We’re seeing more and more women coming forward on social media and in the limelight with hair loss which brings us a step closer to combating the negative stigma that hair loss has attached to it. I think talking is the key to normalising female hair loss and MONPURE’s #itsnotjusthair campaign is a great example of that. Just remember - you’re not alone.
