Hair Loss in Women: More than Meets the Eye

At least half of women in the U.S. will experience some form of hair loss by the time they are 50 years old. The most common types often occur with greatest frequency at a time in life when women are experiencing other life stressors such as menopause, empty nest syndrome and the aging of their parents.

Hair loss can be frightening for women since it is often unclear how much hair will be lost when it begins. Hair may cease being a "crowning glory" for the affected woman and may require an adjustment in how she perceives herself and how she presents herself. Fortunately, help is available through an appointment with a dermatologist, a physician trained in the diagnosis and treatment of hair loss.

Speaking today at the 64th Annual Meeting of the American Academy of Dermatology, dermatologist Elise A. Olsen, M.D., professor of medicine/dermatology at Duke University in Durham, N.C., discussed the three most common types of hair loss in women.

"Women are generally unclear as to why they are experiencing hair loss and often go to the Internet searching for remedies, most of which are ineffective and unnecessarily expensive," stated Dr. Olsen. "Women need to see a dermatologist when they develop hair loss to make sure that it is not coming from an undiagnosed medical problem and a dermatologist can educate them on ways to minimize or reverse hair loss."

Hair Loss in Caucasian Women

Different ethnic groups experience different types of hair loss. One of the most common types of hair loss in Caucasian women is telogen effluvium, which is characterized by increased shedding of hair over the entire scalp. Hair is lost when combing, brushing and washing the hair. This type of hair loss may be caused by thyroid, hormonal, nutritional or age-related factors, as well as medications being taken or underlying disease. This also is the type of hair loss that pregnant women experience following the birth of their baby. "The treatment and cure for telogen effluvium is to find the underlying problem which initiated the hair loss," said Dr. Olsen.

Another common type of hair loss experienced by Caucasian women is female pattern hair loss. This condition can begin early (teenage years to the early 20s) or late (early 40s to 50s) and is characterized by the loss of hair on the top of the scalp, but not the back of the scalp. The hair becomes finer because the individual hairs are smaller or "miniaturized." The overall density may decrease so dramatically that women may notice that their ponytail is smaller or that they can now easily see their scalp when they style their hair. Some women with female pattern hair loss also have hirsutism, which is the growth of hair in the beard or moustache area, or persistent acne or irregular menstrual cycles.

Some women with female pattern hair loss, particularly those with other medical conditions, may have androgen -a male hormone such as testosterone- sensitivity causing these problems. Women with this pattern of hair loss should be evaluated with special blood tests to determine their androgen levels. In some cases, female pattern hair loss may be the first sign of an underlying type of diabetes that is more frequent in women with elevated androgens in the blood. "Women with female pattern hair loss should see a dermatologist to determine if their hair loss is associated with underlying hormonal or endocrine problems," said Dr. Olsen. "If these are present, then the hair loss will require addressing these problems first."