Women's Health Community

Dear alex: One of the common causes of hair loss occurs when many of the hairs are suddenly synchronized in the loss, or shedding phase.

For example, during pregnancy many women experience more fullness in their hair volume. This arises when the hormones of pregnancy artificially keep the hair in the resting ("telogen") phase—avoiding normal rates of shedding. Then, up to three months after delivery, much of the hair which did not shed during pregnancy begins to be lost all at once.

A similar pattern can occur with birth control pill use, or after stopping the Pill. Other medications (e.g., amphetamines, Accutane, Coumadin, Depakote, lithium, vitamin A, etc.) might be linked to hair loss. Even emotional stress or a severe illness (e.g., high fever) can induce this pattern of diffuse hair loss.

Fortunately, this type of hair loss ("telogen effluvium") generally improves on its own after three to six months, but it can take up to eight months. If there is a known trigger (e.g., a specific medication), it should be eliminated.

The second kind of hair loss commonly seen is caused by either increased levels of male hormones ("androgens") or an increased sensitivity to the effects of male hormones. Because of links to male hormones, it is referred to as "androgenic alopecia" The gene which increases one's susceptibility can come from either the maternal or paternal side. It can begin in adolescence, but is most likely to be present as women age.

Among younger women with polycystic ovarian syndrome ("PCOS") the increased levels of male hormones can prompt increased facial hair, acne, and thinning hair over the crown of the head. While this is often referred to as "male pattern baldness" it does not progress to the usual shiny bald head one sees in men. Rather, the involved hair follicle replaces a lost long hair with a much shorter, finer hair. This can give a fuzzy appearance with the scalp clearly visible.

Low thyroid, and uncontrolled diabetes are two endocrine diseases which can be linked to hair loss. Anemia, specifically low ferritin stores, can prompt hair loss. Secondary syphilis, where hair loss does not onset until well after the initial chancre has healed, is not commonly seen. Yet with each of these medical conditions some simple blood tests can establish a diagnosis. By treating the underlying cause, hair growth should normalize after treatment.

Autoimmune problems such as Systemic Lupus Erythematosus (SLE) can be linked to female hair loss. Other autoimmune conditions which may involve hair loss include lichen planus, and scleroderma. Some autoimmune disorders can also be linked to joint pain.

Alex, you really need an accurate diagnosis. I do not know which of these causes might be your culprit. Your best bet may be to seek a dermatologist who specializes in female hair loss if your hair loss becomes more pronounced. You can also start with your family MD to check thyroid and ferritin blood levels.

Yours,
Jane