Hair loss (alopecia) is common these days and it is not just a guy thing as many of you would think. Women also lose Hair like men. Thinning hair in women could be a result of genetics, hormonal imbalance, the normal aging process, or some medical conditions. Fortunately, some lifestyle modifications, preventive measures, and medical treatments can address this issue.

The present article is an attempt to discuss several causes of hair thinning in women, preventive measures, and the recommended treatments available.

18 Common Causes of Thinning Hair in Women

Some common causes of thinning hair in women include;

1.Genetics (heredity)

This reason is a tricky one. In this case, hair-fall/thinning happens because you are born with it. Female-pattern hair loss which occurs due to genetics (a hereditary condition that happens with aging) is termed androgenic alopecia.

In most cases, females unlike males do not experience bald spots or receding hairline but they do notice hair thinning along with the crown of the scalp.

2.Aging

Hair fall/thinning after a certain age is a natural phenomenon. As women age, the hair growth slows down, hair follicles shrink due to hormonal changes, hair becomes less dense and the scalp may become visible (Trüeb, Rezende, & Dias, 2018).

3.Menopause

Estrogen and progesterone hormone are primarily responsible for keeping the hair in the growing (anagen) phase. These hormones also help hair grow faster.

During menopause (a natural weakening or cessation of a women’s reproductive system when she enters her 40s or 50s) in women, there is a decline in the production of estrogen and progesterone hormones. As a result, hair follicles shrink, hair becomes too thin and hair growth is stalled (Blume-Peytavi, Atkin, Gieler, & Grimalt, 2012).

4.Radiation therapy to the head

Hair lose/hair thinning caused by radiation therapy may be temporary or permanent. At lower doses, hair loss is often temporary, but at higher doses and in the case of the radiation doses to the scalp or the brain, hair loss can be permanent.  The hair may not grow back the same as it was before.

5.Hairstyles and chemical hair treatments

Excessive hairstyling or styling your hair vigorously such as tight ponytails, tight braids, hair weaves, cornrows, or pigtails can trigger a type of hair loss termed as traction alopecia – a condition where hair loss/hair thinning is triggered by repeated pulling of hair.

Hair dyes used for coloring hair contain chemicals that cause damage to hair follicles and lead to thinning of hair and even permanent hair loss. Other treatments like hair perming, curling irons, hair straightening treatments, hot-oil hair treatments also can cause hair to fall out. If scarring happens, hair loss/damage could be permanent (Dias, 2015).

6.Lack of protein in the diet

Hair needs nutrition in the form of proteins. To have healthy and thick hair, it is important that you eat a protein-rich diet like fish, eggs, kidney beans, lean meat, lentils, nuts, chia seeds, oats, quinoa, soy cheese, and much more.

Hair is primarily composed of keratin, a protein that serves as a building block for hair. The absence of a protein-rich diet leads to hair shedding and thus hair thinning (Goluch-Koniuszy, 2016).

7.Certain medications

Blood thinners (heparin and warfarin), antidepressants (Prozac, Jani mine, Tofranil, etc.), and blood pressure drugs (captopril and lisinopril) may trigger hair thinning and hair loss in some women.

Drugs such as methotrexate used for rheumatoid, acne medications containing vitamin A (retinoids), cholesterol-lowering drugs (simvastatin (Zocor) and (atorvastatin) Lipitor), NSAIDs, and lithium for bipolar disorder may result in thinning of hair in women as well.

8. Anabolic steroids

Women athletes using anabolic steroids (anabolic-androgenic steroids (AAS)) to increase their muscle mass may experience hair thinning/hair loss.

According to the ADD – American Academy of Dermatology, these steroids can affect the body of a woman in a similar fashion as PCOS (polycystic ovary disease) does, triggering hair thinning from the scalp. However, once the consumption of these medications is stopped, the hair will regrow and hair health should show some improvement (Glaser, & Dimitrakakis, 2013).

9.Trichotillomania

It is a medical condition also termed as “hair-pulling disorder”. It is an impulse control disorder in which people experience an irresistible urge or compulsion to pull their hair aggressively.

This condition is more common in women. This constant and recurrent hair pulling may result in bald patches in the scalp, thinning of hair, and excessive hair loss (Cisoń, et.al., 2018).

10.Alopecia areata

This is a medical condition that results in immunity disorder. It results in irregular hair thinning/hair loss because of an overactive immune system.

The body’s immune system mistakenly attacks hair follicles ((the part of your body that makes hair) as foreign items. This triggers sudden and dramatic patchy hair loss most often on the scalp. This can be treated with medical consultation and drugs like Rogaine.

11.Lupus

Women who experience Systemic Lupus Erythematosus (SLE), experience non-scarring alopecia (hair loss). It is another autoimmune disorder in which hair follicles are attacked by immune system cells, triggering dramatic hair-thinning/hair loss.

12.Drastic weight loss

Sudden and tremendous weight loss can lead to myriad health issues, with hair loss being one of them. Drastic weight loss is a kind of physical trauma that can cause havoc on hair health and thickness.

Due to sudden weight loss, there is a huge reduction in essential nutrients needed by the body. As a result, there are mineral and vitamin deficiencies triggering hair shedding, thinning, and falling.

13.Physical stress

Physical stress that includes accidents, injuries, surgeries, and chronic illnesses results in physical trauma that may trigger hair thinning/hair loss. This condition is called Telogen effluvium. In this condition, there is excessive shedding of resting or telogen hair because of some sudden shock (accident, injury).

The significant stress pushes a big amount of hair follicles into a resting phase. After some time, the impacted hair might just fall out suddenly while combing.  Hair loss because of physical stress is usually temporary and after a certain period of time, the hair becomes healthy again (Peters, et al., 2017).

14.Emotional stress

Emotional stress churns the body and affects the hormones in unexpected ways. One effect is hair thinning and hair loss. A healthy diet, good sleep, and leisurely walks help to combat stress.

15.Polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is a common hormone disorder experienced by women. In this, women produce an increased level of androgens (male hormones) in their bodies. These extra androgens result in more hair on the body by thinning the hair near the front of the scalp. This is termed androgenic alopecia or female pattern hair loss.

This condition is treatable with certain medication and lifestyle modifications.

16.Hypothyroidism

Hypothyroidism is a condition prevalent in older women in which the thyroid gland does not produce enough hormones required for normal functioning of the body, growth, and development.

Severe and prolonged hypothyroidism can result in thinning of hair and hair loss. The hair loss is diffuse and does not involve hair loss in the discrete regions but the entire scalp. The hair appears uniformly sparse. Medical treatment of this condition helps in the regrowth of the hair (Vincent & Yogiraj, 2013).

17.Iron-deficiency anemia

Women who have low iron levels are anemic and it is one of the major causes of hair thinning and hair loss. Iron is stored in the hair follicles in the form of ferritin.

When the body has low iron levels, it starts using the iron which is stored in ferritin form in your hair follicles. As a result, hair becomes damaged, thin and the hair growth is stalled.

However, iron-deficiency anemia can be reversed by having more foods containing iron (red meat, fish, greens, lentils, etc). Even iron supplements are helpful (Park, et al., 2013).

18. Vitamin B deficiency

Vitamin B is an important element for healthy hair and scalp. Foods like nuts (almonds), whole grains (brown rice, barley, millet), legumes (beans, lentils), fruits (bananas, avocados), meat (red meat, poultry, fish), eggs, and legumes are rich in Vitamin A.

When women do not eat a vitamin B rich diet and there is a deficiency, leads to hair thinning/hair loss.

This is reversible. Consumption of foods rich in vitamin B can improve hair health. (Almohanna, et al., 2019). 

Thinning Hair in Women Treatment

Fortunately, several medical treatments are available to prevent hair loss and promote hair growth. However, it is always advisable to consult your doctor before taking any of these treatments.

1. Minoxidil

Minoxidil (brand name Women’s Rogaine) is an over-the-counter (OTC) drug approved by FDA for topical use. It works by extending the duration of the growth phase of the hair follicles. FDA recommends that women use minoxidil 2% to encourage hair growth and prevent hair thinning/loss.

2.Estrogen therapy

Hormone replacement therapy (Estrogen therapy) can be beneficial in treating female pattern baldness (androgenic alopecia). This therapy involves supplying adequate hormone estrogen to make up for the reducing levels in women. Minoxidil is more effective and is considered as the treatment of choice.

3. Spironolactone

Also named Aldactone is a weak androgen receptor inhibitor. This medication is effective in treating hair thinning/hair loss by binding to androgen receptors and reducing the body’s processing of testosterone.

4. Tretinoin

Topical tretinoin, also termed as Retin-A, when used in combination with 0.5 percent minoxidil is beneficial in treating hair loss/thinning or female pattern baldness (androgenic alopecia) in women. It comes in the form of serums, tretinoin creams, and lotions.

5. Corticosteroids

Women who experience hair thinning/hair loss because of alopecia areata (patchy hair loss triggered by immune system attacks on the hair follicles) may consider treatment with corticosteroids (immune system suppressors) injected at several sites in the impacted areas. Improvement in hair health is visible in 4 weeks.

6. Iron supplement

Iron deficiency (medically known as anemia) is the cause of hair thinning and hair loss in some women. Such women who experience anemia should consult their doctor. The doctor will prescribe iron supplements which will fix the low iron in the body issue.  The supplement will help in stopping hair loss.

7. Anthralin

In women, anthralin has been reported to have an immunomodulating effect on alopecia areata (patchy hair loss). It can be applied to the scalp at home and then the scalp should be washed with cool water and mild shampoo.

Anthralin encourages hair regrowth and new hair strands may sprout up in 2-3 months after using it.

8. Takeaway

Hair thinning in women can be treated with lifestyle modifications. Nutritious food, workout, yoga, and good sleep can address the issue of hair loss and hair thinning depending on the cause.

Thinning Hair in Women Prevention

• Consider changing your lifestyle and have protein-rich and hair-friendly foods. Reduce sugar and processed foods, trans fat, and foods containing preservatives and artificial flavors.
• Quit smoking and avoid heavy alcohol consumption
• Exercise more to reduce stress, sleep well and do a little bit of yoga for emotional and physical well-being
• Women who experience hair thinning/hair fall due to thyroid disorders should consult their GP. The doctor will prescribe thyroid medication to address the issue and bring the thyroid hormone levels back to normal. Once the prescribed medicines start working, the hair will start regrowing.
• Eat an iron-rich diet that includes chicken. Lean red meat, fish, leafy veggies, soy products, chia seeds, and lentils. If the iron levels in the body are normal, the hair will also remain healthy.
• Never starve your body and ensure that you eat a good diet. A starving body may starve your hair too. If you want to lose excess weight, make changes in foods that you consume instead of eating less. Eat nutrient-dense foods and avoid processed and fat-rich foods.

References:

Almohanna, H. M., Ahmed, A. A., Tsatalis, J. P., & Tosti, A. (2019). The role of vitamins and minerals in hair loss: a review. Dermatology and therapy, 9(1), 51-70.

Atkin, S., Gieler, U., & Grimalt, R. (2012). Skin academy: hair, skin, hormones, and menopause–current status/knowledge on the management of hair disorders in menopausal women. European Journal of Dermatology, 22(3), 310-318.

Cisoń, H., Kuś, A., Popowicz, E., Szyca, M., & Reich, A. (2018). Trichotillomania and trichophagia: modern diagnostic and therapeutic methods. Dermatology and therapy, 8(3), 389-398.

Dias, M. F. R. G. (2015). Hair cosmetics: an overview. International journal of trichology, 7(1), 2.

Glaser, R., & Dimitrakakis, C. (2013). Testosterone therapy in women: Myths and misconceptions. Maturitas, 74(3), 230-234.

Goluch-Koniuszy, Z. S. (2016). Nutrition of women with hair loss problems during the period of menopause. Przeglad menopauzalny= Menopause review, 15(1), 56.

Park, S. Y., Na, S. Y., Kim, J. H., Cho, S., & Lee, J. H. (2013). Iron plays a certain role in patterned hair loss. Journal of Korean medical science, 28(6), 934.

Peters, E. M., Müller, Y., Snaga, W., Fliege, H., Reißhauer, A., Schmidt-Rose, T., … & Kruse, J. (2017). Hair and stress: A pilot study of hair and cytokine balance alteration in healthy young women under major exam stress. PloS one, 12(4), e0175904.

Trüeb, R. M., Rezende, H. D., & Dias, M. F. R. G. (2018). A comment on the science of hair aging. International journal of trichology, 10(6), 245.

Vincent, M., & Yogiraj, K. (2013). A descriptive study of alopecia patterns and their relation to thyroid dysfunction. International journal of trichology, 5(1), 57.

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