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Women and Hair Loss: The Causes

According to the American Academy of Dermatology, hair loss for women is a growing problem, affecting some 30 million women in the United States and being seen in increasing numbers. But what exactly causes air loss for a woman? To understand, it's important to know a little something about hair growth.

Experts say hair usually grows at the rate of about one-half inch per month -- with each hair strand having a growth phase of two to six years. At that point the hair "rests" for a period of time, then falls out -- and the follicle from which it sprang soon starts growing a new strand. And the cycle continues, usually well into our senior years. For some, however, hormones called androgens interferes with this natural process. According to dermatologist Michael Reed, MD, a clinical associate professor of dermatology at NYU Medical Center, androgen hormones include testosterone, androsteinedione, and dihydrotestosterone (DHT) -- all of which are made in men's bodies in large amounts, and in women's bodies in small amounts. In those who are genetically susceptible to hair loss, when testosterone comes in contact with hair cell enzymes, it is converted into the more potent androgen DHT, which binds with receptors deep within the hair follicle. "Over time, an excess build-up of DHT in the follicle causes it to begin shrinking. This in turn alters the natural resting and growth phases of the hair," says Reed. Some of the follicles will die, while others become incapable of producing or maintaining healthy hair growth. The end result is hair loss and a condition that is medically known as androgenic alopecia.

For years, doctors believed that androgenic alopecia was the primary cause of balding in both men and women. Today they know this is not true for women. The term 'androgenic alopecia' is not used for women anymore -- instead it is called female pattern hair loss -- a broader term that encompasses many possible causes, some of which some are likely linked to an excess of testosterone, and some of which are not, according to Daly. He says that while the science of female balding is still largely misunderstood, there is evidence that many other types of enzymes, as well as hormone receptors and blockers, may be the cause in women. One clue that there is a true difference between male and female balding is the pattern in which the hair loss occurs.

"Female pattern balding goes around the whole top of the head, whereas men lose it on the temple, the crown, the bald spot in the back," says Daly. The hormone and enzyme receptor sites are also different in varying areas of the scalp -- another reason doctors now believe the loss patterns are caused by different factors. Another important difference is that balding in men is almost always the result a genetic predisposition coupled with age, in women, it can happen at any time. Also, underlying medical conditions can also be the cause of hair loss, even when true androgenic alopecia is the diagnosis.

"Often women also suffer with polycystic ovary syndrome, [a common hormonal problem in women], and sometimes hair loss is the only obvious sign," says Ricardo Azziz, MD, director of the Center for Androgen-Related Disorders at the Cedars Sinai Medical Center in Los Angeles. In addition, he reports that certain types of autoimmune disorders result in a slightly different and often less dramatic hair loss problem known as alopecia area, an inflammatory condition that causes hair to come out in clumps or patches. Still others can develop a temporary hair shedding problem known as telogen effluvium, a change in the natural hair growth system that often follows childbirth, crash dieting, surgery, or a traumatic emotional event. He adds that thyroid disorders, anemia, even chronic illness or the use of certain medications can also cause hair loss in women that is often undiagnosed. For these reasons, specialists say it's vital for all women to get at the "root" of their hair loss before seeking treatment.

The No. 1 rule of treating hair loss in women is getting the correct diagnosis to determine if there is an underlying physical problem. This can preclude the need for additional hair loss treatment. Women are advised to see a doctor who specializes in female pattern balding to check for possible underlying medical conditions via blood tests, or a scalp biopsy. Diagnosis is often made by excluding what problem isn't there -- but it's essential to do the complete workup.

Medical Hair Restoration Source: Colette Bouchez, WebMD Featured Article