Hey my loves! I recently opened up about my struggle with endometriosis and PCOS, and I was so overwhelmed by your love and support. As a result of both of these issues, I have struggled with hair balding since my 20s. I know I’m not alone in this, so I really wanted to be open about my hair loss issues with you guys, as it’s not often spoken about.
Most recently, I had a really scary incident where I discovered a bald spot at the top of my head. This was created by wearing a super tight and heavy ponytail that caused damage to the hair follicle, which meant all the hair here fell out. It’s called traction alopecia and it’s quite common when you wear very tight hairstyles or heavy extensions.
But the truth is, there are so many different causes of hair loss, so I wanted to reach out to some amazing experts to help you guys understand why you may be experiencing hair loss and the different treatments and remedies you can try. Mostly, I think it’s important for us to talk about it because it’s not something we should feel ashamed of.˙
In fact, Marc R Avram MD, hair loss specialist and Clinical Professor of Dermatology at Weill Cornell Medical school in New York City, told us that male and female pattern hair loss is a lot more common than you might think: “About 50% of men and 30 to 50% of women will have it. We do not know the exact genes that cause it but we know it comes from both our parents.” So actually, most of us will experience hair loss, we just don’t talk about it. It also means it’s definitely worth knowing and understanding the signs so that you can treat any hair loss from the first symptoms.
Shanthi Colaço, MD, FAAD, a board-certified cosmetic and general dermatologist who provides long-term hair loss treatments says “The most common type of hair loss in women is the same as it is in men: androgenetic (hereditary) alopecia, also known as female (or male) pattern hair loss (FPHL or MPHL).
“Women often see diffused hair thinning and/or a widening part, whereas men see a receding hairline and/or a bald patch at the crown of the scalp. Luckily, women rarely become bald. In both sexes, hair loss from androgenetic alopecia occurs because the growing phase (anagen) of the hair cycle shortens causing the hair shaft to get thinner and thinner over time until eventually it falls out and doesn’t regrow.”
Dr. Colaço also says that female pattern hair loss can start any time after the onset of puberty, “But is most commonly seen around menopause, which supports an additional hormonal cause. Women normally produce some androgen or male hormone (i.e. testosterone) as this has important functions in both sexes. But when there is excess androgen activity, hair loss can occur.”
Hair Loss Causes, Symptoms, and Prevention:
Common Causes of Hair Loss
There are so many possible reasons for hair loss, which means it’s crucial to see a doctor as soon as possible. Dr. Colaço outlines some other causes:
- Hypothyroidism – Low thyroid hormone levels.
- Low blood counts due to iron deficiency.
- Traction alopecia caused by tight hairstyles continuously pulling on the hair shaft damaging hair follicles, which can eventually leading to permanent hair loss.
- Telogen effluvium – Physical or emotional stress to the body such as surgery, childbirth, death of a loved one, which causes about 30% of hairs to shift from the growth phase (anagen) into the resting phase (telogen) where they are more likely to fall out.
- Alopecia areata – When your own immune system attacks your hair follicles.
- Inflammation, for example, psoriasis.
- Infection, sometimes caused by fungus.
- Trichotillomania – Pulling out your own hair, often to relieve stress.
- Medication side effects, like chemotherapy.
What Lifestyle Factors Can Cause Hair Loss?
Stress: “Chronic stress and the resulting inflammation is linked to a wide variety of medical problems, including hair loss. Physical and/or emotional stress shifts hair from the growth cycle to the resting cycle, in which it is more likely to fall out,” Dr. Colaço tells us. She also mentions that for this type of hair loss there are no targeted treatments.
Poor diet: Another cause for hair loss can also be related to your diet, and Dr. Colaço stresses that “A balanced diet is necessary for strong, healthy hair. When you don’t get the vitamins, minerals, protein, and other nutrients that your body needs, it can cause hair to fall out. For example, iron deficiency is one of the most common causes of hair loss in women.”
Extreme weight loss: So, while diet deficiencies, including iron, can be a cause, Dr. Avram also says “If your diet or weight is not stable or if you have a chronic medical disease, that can affect the absorption of vitamins in our bowels and vitamin supplements may be needed.” However, he says this is often quite rare in comparison to the other causes of hair loss. Finally, extreme weight loss, for example, if you were to lose 15 to 20 lbs in a short amount of time, could also contribute to some hair loss.
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Why Do Hormone Disorders Like PCOS And Thyroid Disorders Cause Hair Loss?
Thyroid: “The thyroid hormone is important for the development and maintenance of hair follicles. Both under and overproduction of thyroid hormone can result in hair loss, but usually only if severe and prolonged,” Dr. Colaço tells us. Although, fortunately, she also says that “Hair loss is temporary and regrowth is expected with the treatment of the underlying thyroid disorder, although this may take several months.”
PCOS: Polycystic ovary syndrome is a common hormone disorder and while it usually causes excess facial and body hair (hirsutism), in some cases, although less common, PCOS can cause scalp hair loss. Dr. Colaço explains that “Since PCOS causes excess androgen activity, patients may experience female pattern hair loss (FPHL). Hairs lost due to PCOS will not grow back without treatment. The anti-androgen medication, spironolactone, is often prescribed in combination with oral contraceptive pills (also lowers androgens) with moderate success.” Find out more about polycystic ovary syndrome here.
My experience with hair loss and how I fixed it:
What is Traction Alopecia and What Causes It?
In most cases, traction alopecia can be avoided, as it’s caused by wearing tight hairstyles or styles – like weaves, extensions, and tight braids – that put significant stress on the hair follicles. Dr. Colaço explains that “The constant pulling on the hair shaft can result in permanent damage to the hair follicle and a type of hair loss called traction alopecia.”
How to avoid traction alopecia: Dr. Colaço suggests that “If you are planning on getting weaves or extensions, opt for the sewn-in kind. Braided styles should be kept in for no more than two to three months.”
Signs of traction alopecia and how to prevent it: “The first signs of hair thinning due to traction alopecia can be broken hairs at the front of your hairline, a receding hairline, or patchy hair loss where hair is tightly pulled. If you notice any of these signs, it goes without saying that you should stop pulling on your hair immediately to prevent scarring of the hair follicle and irreversible hair loss! Looser, natural hairstyles are the key to both treatment and prevention of traction alopecia,” Dr. Colaço warns.
In fact, one of our lovely Huda Beauty team members experienced irreversible hair loss from traction alopecia due to scraping her hair back into a ponytail during her school years. She just recently underwent forehead reduction surgery to conceal the permanent loss of hair at the front of her scalp.
What Causes Bald Patches?
“Bald patches are most commonly seen on the crown of the scalp in male pattern hair loss. There is also a condition called alopecia areata in which your own immune system attacks your hair follicles causing circular, patchy hair loss. Hair loss in alopecia areata is most often seen on the scalp, but can also occur in the eyebrows, eyelashes, beard, and other hair-bearing areas,” Dr. Colaço tells us. Dr. Avram also adds that “Chronic persistent traction alopecia can result in bald patches.”
Causes: While doctors still don’t know exactly why this happens, genetics and stress are thought to be key factors.
Treatments: Dr. Colaço says that “Although this is a self-limited condition, monthly corticosteroid injections by a dermatologist into the bald patches are very effective in reducing inflammation around the hair follicle and helping hair to regrow faster.”
What Should I Do If I See Signs of Hair Loss?
Hair loss has SO many different causes, so if you notice any unusual hair loss, it’s really important to see your doctor. The sooner you understand the problem, the sooner you can get started with a treatment plan or feel reassured that what you’re experiencing is only temporary.
To determine the cause, Dr. Colaço explains, “A dermatologist will take a thorough history of the hair loss, including family history, check for signs of inflammation or infection, and order blood tests to investigate other possible causes of hair loss, including hypothyroidism and iron deficiency. If there are signs of excess androgen activity (such as menstrual irregularities, acne, and excess facial and body hair), a hormonal evaluation can be performed. A scalp biopsy is useful in some cases, especially if scarring alopecia is suspected.”
My short-term hack for hiding thinning hair partings with eyeshadow:
The Best Hair Loss Treatments and Remedies:
Once you and your doctor have determined what is causing your hair loss, your dermatologist will tell you if treatment is necessary or whether the hair may grow back by itself.
Dr. Colaço outlines some of the most effective treatments for hair loss that can be combined for even better results:
Minoxidil (Rogaine®): “The 5% solution is a safe and effective treatment for hair loss and it is the only topical treatment FDA-approved for female pattern hair loss. I recommend at least a nine-month trial before deciding whether or not it’s helping you and if it is, you must keep using it to maintain the benefit. If you stop using Rogaine, hair loss returns within a few months.” Dr Colaço also warns that you should avoid letting the solution drip onto areas other than the scalp, like your cheeks or forehead, to avoid any unwanted hair growth!
Rogaine is definitely at the more affordable end of the spectrum; the Women’s Rogaine® 5% Minoxidil Unscented Foam costs $27.50.
Laser for at-home use: “Red light therapy (RLT) or low-level laser therapy (LLLT) in theory could thicken hair follicles. One very small study revealed that people who received RLT had improved hair density compared with those in a placebo group, [however] only a few studies have looked at these devices, the results are promising and require as little as 20 minutes of use twice a week. The downside is that the devices are expensive, do not work for everyone, and more research needs to be done to see if new hair growth is sustainable in the long term.”
In our experience, combining red light with derma-rolling and serums has helped to more quickly regrow hair on areas that have been damaged due to traction alopecia.
Hair transplant: “If you have an area of thinning or balding due to male or female pattern hair loss, a hair transplant can be an effective and permanent solution. Keep in mind that hair transplants are very expensive, not covered by insurance, and not everyone is a good candidate.”
Platelet-rich plasma (PRP) injections: “This in-office treatment has become very popular in recent years and for good reason! There is mounting scientific evidence to support that it is a safe and effective treatment for hair loss and also, as natural as it gets! PRP is obtained by drawing a small amount of your blood and using a machine to spin it down and isolate the platelets, which contain lots of your own natural growth factors. It is then injected back into your scalp at the level of the hair follicles in areas of hair loss. We recommend monthly injections for the first three to four months and then once every three to six months thereafter for maintenance.”
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Finasteride (Propecia®) and dutasteride: “These medications are FDA approved to treat male pattern hair loss. I recommend at least a six-month trial before deciding whether or not it’s helping you and if it is, you must keep using it to maintain the benefit. In addition, finasteride and dutasteride are sometimes used off-label to treat hair loss in post-menopausal women.”
Spironolactone: “For pre-menopausal women who have FPHL, this anti-androgen medication is often used. Studies have shown that ~40% of women who take this medication for a year will experience improvement in hair loss. As it can cause birth defects, an oral contraceptive pill is often prescribed with it.”
Biotin, iron, protein, and/or zinc: “These supplements are recommended if your clinical history or blood tests reveal that you have deficiencies.”
If treatment is needed, Dr. Colaço says “It’s important to remember that not one treatment works for all types of hair loss and often the best response is achieved by using multiple treatments. A positive response to treatment can be seen as new hair growth, thickening of existing hairs, and/or reduction of hair loss.”
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Can Supplements Improve Hair Loss?
The answer to this is yes and no, and some supplements are more effective than others. Iron supplements are only helpful for those who have iron deficiencies. For androgenic alopecia (male or female pattern hair loss) an oral anti-androgen like those listed above – finasteride, dutasteride, and spironolactone – are the most effective.
However, if you don’t want to take oral medication, supplements can be helpful. Dr. Colaço suggests, “Look for ingredients like Biotin and Saw palmetto. Biotin is a B vitamin that is essential for healthy hair and nails. Products should contain at least 2500 mcg of Biotin and no more than 5000mcg. Saw palmetto can block the hormone DHT (dihydrotestosterone), the active form of testosterone and the main target of anti-androgen medications like finasteride.
“Nutrafol, which I use in my practice, is a nutraceutical product containing Biotin 3000 mcg and Saw Palmetto as well as other proprietary botanicals with potent anti-inflammatory, anti-stress, antioxidant, and DHT-inhibiting properties. A research study published in the peer-reviewed Journal of Drugs in Dermatology showed statistically significant improvement in hair growth, density and quality, albeit in a small number of patients.”
Nutrafol supplements are another more affordable treatment for hair loss with some impressive science to back them up. A month’s worth of Nutrafol supplements cost $79, and you should stick with it for up to six months to see impressive results. We’re also big fans of the Viviscal hair supplements, which are also hugely popular among celebs and have extensive research and science-backed results. You can get a three-month subscription for $40 per month here.
Are There Any Natural Remedies That Stimulate Hair Growth?
Unfortunately, Dr. Colaço told us “There are no specific natural ingredients or oils available for home use that have been clinically shown to grow hair on their own.”
Dr. Colaço’s Tips for Managing Hair Loss
Dr. Colaço was kind enough to share her top tips for keeping your hair healthy at home:
1. Gentle hair care: Use gentle, sulfate-free shampoos and conditioners. A conditioner that is too thick can weigh hair down and decrease volume.
2. Limit heat: Try to limit use of hot tools or use the lowest heat settings: this includes hot-oil treatments, blow dryers, curling irons, straighteners etc.
3. Limit chemical treatments: Coloring, perming, straightening, relaxing and other chemical treatments should be limited and preferably done by a professional.
4. Avoid pulling: Wearing your hair in tight hairstyles (sleek buns, ponytails, braids, etc.) and use of extensions, weaves, etc can cause hair loss over time. Loose, natural hairstyles are safest.
5. Stop smoking: Smoking causes inflammation throughout the body, which makes so many things worse, and hair loss is no exception.
6. Eat healthy: Eating too few calories every day can cause hair loss and so can not getting enough nutrients, such as iron or protein.
Let us know if you have any questions or stories you’d like to share in the comments below.