Hair loss affects women of all ages. Here's why it happens—and what you can do about it.

By Melanie Rud
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It’s not just men who have to deal with thinning hair. Here experts weigh in on what’s causing your strand shedding, plus discuss the best, most effective treatments to help combat this pesky problem.

Image courtesy of Getty.
Image courtesy of Getty.

Why Is My Hair Falling Out?

Let’s start with the basics. In a nutshell, the answer is any one of a multitude of different things. Hair loss in women is complicated, and a huge number of factors can come into play, says hair biologist Dr. Dominic Burg, Chief Scientist for Evolis Professional. Hormonal changes are among the most common: “Hormones carry out an ‘order’ from the genes to attack the hair follicles from which hair grows,” explains Lars Skjoth, Founder and Head of Research & Development for Harklinikken hair clinic. “This ultimately causes the follicle to shrink, resulting in gradually thinner hair.”

Credit those hormonal changes for postpartum hair loss. As many women who have had a baby will tell you, the serious shedding post-baby is no joke. Hair loss during perimenopause and menopause is also common. Dieting—specifically yo-yo dieting and a lack of nutrients—can play a role, Dr. Burg adds, as does that dreaded ‘S’ word: stress. And as with anything, genetics come into play, too. While age doesn’t help matters, this isn’t just an aging problem, notes Dr. Burg. Hair loss is a problem that affects women of all ages.

What Happens When Your Hair Falls Out?

It’s important to first understand the hair cycle, which has three phases: the growth (anagen) phase, the transition (catagen) phase, and the resting (telogen) phase. When one of the hair loss causes mentioned earlier disrupts this cycle, the growth phase gets shortened. “A good anagen phase lasts six to eight years, while a shortened one can be as short as only a year or two,” explains Dr. Burg. That’s why, along with actual hair loss and shedding, the length of your hair can also be an indicator that something is going on; if you can’t seem to grow it past your shoulders, something may be disrupting your hair growth cycle, he says.

Ultimately, this cycle is controlled by the follicles on your head.  There are over 150,000 of them, and when something (think stress, hormonal changes, age) throws them off, it disrupts the signals they’re sending to your hair telling it to grow, explains Dr. Berg. And while hair loss in men often starts across at the top of the head, female hair loss typically starts at the temples and the part, says Skjoth. “It first starts as hair miniaturization, which is the shrinking of the hair strand. It’s thinner, more transparent, weaker, and cannot grow as long. A woman will typically start to notice her temples receding and/or her part getting wider, because the hairs that are growing there are less dense,” he explains. 

What Are the Most Effective Hair Loss Treatments?

Now for some good news. There are plenty of types of hair loss treatments out there, including inexpensive over-the-counter options and pricier, in-office procedures and medications. Each one has its own set of pros and cons, making it important to talk with your dermatologist or doctor about what potentially may be causing your hair loss and how to best address it. Regardless of the treatment route you take, this is one instance where patience is most definitely a virtue. “Generally speaking, you need to give any hair loss treatment at least three months to work,” says New York City dermatologist Dhaval Bhanusali, M.D., who adds that you’ll typically start to see results in a few phases. First up, less shedding, which you may notice as soon as six weeks after starting a treatment protocol, he says. After that you’ll start to see tiny new baby hairs pop up, and finally, you’ll notice an actual improvement.

Here are a few of the hair loss treatments experts agree are the most effective.

Minoxidil

One of the most well-studied topical hair loss treatments, this drug was initially used as a blood pressure medication that just happened to come with the side effect of causing excessive hair growth. It’s readily available over the counter in both two and five percent concentrations. Dr. Bhanusali says you can either use the lower concentration twice a day or the higher concentration once a day. The one sticking point with minoxidil is that you need to keep using it in order to maintain the effects. So, once you start and it begins to work, you’re probably not going to want to stop.

Other Topical Treatments

While minoxidil may be the best known, there are plenty of others, available both over-the-counter and prescription. Evolis is a new range of products (including hair loss shampoo, conditioner, and scalp treatments) that works by blocking FG5, a protein known for eliciting signals that shorten the anagen (growth) phase of the hair. Doctors often also prescribe spironolactone; this commonly used oral medication for acne can be used topically or orally to help with hair loss, too. Another prescription option is HairStim, a combination of minoxidil, spironolactone, plus anti-inflammatory and antioxidant ingredients such as turmeric and resveratrol, says Dr. Bhanusali. At a cost of about 60 dollars per month, it’s an affordable option that delivers good results, he says.

Supplements

Vitamins for hair loss get a lot of buzz. A lot. The experts we spoke with agree that while they may be beneficial in instances where hair loss is caused by a specific nutrient deficiency, there’s not a lot of clinically backed data to prove their efficacy, just largely anecdotal evidence. Still, they can’t hurt (just be sure to check with your doctor before taking one), though Dr. Bhanusali does point out that it’s not just the buzzed-about biotin that is an option. Dr. Burg agrees, citing both vitamin D and zinc as more-essential nutrients to help with the hair growth cycle. The bottom line: Vitamins and supplements aren’t a miracle hair loss cure, but they may have some beneficial effects.

Lasers

With both in-office and some at-home options available, lasers are a potentially promising hair loss treatment. “The wavelength of the light stimulates the mitochondria (your cells’ energy powerhouse) to kick hair into the growth phase,” says Dr. Burg. This is a pricey treatment option and needs to be done correctly and with the right type of laser in order to yield any kind of results.

PRP Injections 

Protein rich plasma (PRP) injections are another effective option, though an admittedly somewhat invasive, costly, and time-consuming one. Your blood is drawn and spun to remove the platelets, which are then injected into the scalp. “The injection causes a controlled injury in the epidermis, which causes cells to create new cells,” explains Dr. Bhanusali. The plasma that’s being injected triggers the cells to create more hair follicles and delivers the growth factors that promote hair growth, he explains. Keep in mind that you’ll need three to four treatments spaced four to six weeks apart. The price varies based on where you live, but Dr. Bhanusali points out that each treatment can cost anywhere from $750 to $1,000 dollars.

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