Women joke about tearing their hair out when they’re stressed, but for those dealing with real hair loss, it’s no joke.
Hair loss can be frustrating, surprising and downright disheartening, and according to the American Hair Loss Association, women represent 40 percent of those with hair loss in the United States.
In order to treat or even prevent hair loss, it’s essential to understand why hair is falling out in the first place. TODAY Style sought out the experts to explain how to tackle hair loss with confidence.
What causes hair loss?
Hair loss doesn’t happen overnight. Typically, there’s some kind of trigger that leads up to it.
“There are numerous causes of hair loss from such causes as hormonal issues, certain types of hair styling that can cause hair loss over time, systemic diseases such as thyroid gland problems, lupus and others,” said Dr. Alan Parks, board-certified dermatologist and founder of DermWarehouse.
Extreme mental or physical stress (childbirth, surgery and illness) and certain medications or nutritional deficiencies can also cause hair loss.
What is alopecia?
Alopecia is basically a fancy medical term for hair loss and, like many conditions, no two types of alopecia are the same. “There are a number of different types of alopecia and they are generally characterized by thinning hair or complete loss of hair,” said cosmetic dermatologist Dr. Sejal Shah of New York City's SmarterSkin Dermatology.
Although several types of hair loss exist, the two most common are androgenetic alopecia (female pattern hair loss) and telogen effluvium (excessive daily hair fall), according to Anabel Kingsley, a trichologist (a hair and scalp expert) for Philip Kingsley hair care.
“Androgenetic alopecia is a slow and progressive reduction in hair volume,” Kingsley said. “It occurs when you have a genetic predisposition that causes hair follicles on your scalp to be sensitive to normal levels of circulating androgens (male hormones).”
In other words, your hair follicles gradually shrink and produce hairs that are slightly finer and shorter with each passing hair growth cycle. Even though this type of hair loss is mostly reliant on genes, Kingsley said other factors can influence it as well. For instance, certain contraceptives and hormone-replacement therapies that effect hormone levels can aggravate the problem if there's already a genetic predisposition to follicle sensitivity.
Telogen effluvium, on the other hand, is characterized by excessive daily hair fall with more hairs falling out when women shampoo or brush/style their hair. It can take 8-12 weeks for hair to fall out after a triggering event. “It is a reactive alopecia, triggered by an internal disruption,” Kingsley said. “As hair is non-essential tissue, it is very sensitive to fluctuations to general health.”
Certain vitamin deficiencies — like Vitamin D, iron and ferritin (stored iron), for instance — and other factors like crash dieting, thyroid issues and pregnancy (postpartum hair loss) can also trigger telogen effluvium.
Alopecia areata, another type of alopecia typically diagnosed by a dermatologist, is an autoimmune condition that affects as many as 6.8 million people (approximately 3.5 million women) in the U.S. Basically, the immune system mistakes the normal cells in the body as foreign invaders and attacks these cells.
To spot the condition, dermatologists will examine hairs that have fallen out and look to see if they resemble exclamation marks with their bulbs still attached, according to Gary Sherwood, director of communications for the National Alopecia Areata Foundation.
"They also examine the scalp to see whether there are white spots where the hair used to be," Sherwood said. "Additionally, they will ask whether there is a history of autoimmune conditions in the family as that could (but not always) play a role."
Is my hair loss normal?
Whether it's from combing or shampooing (or just standing still, to be honest), every woman loses a bit of hair on a daily basis. "On average, women lose 100 hairs per day; some people lose more and other less," Shah said.
If a bit more hair is coming out for a few months after a stressful event — for instance, a death in the family or major surgery — it's totally normal and usually corrects itself, according to Parks. Also normal? Increased hair loss in the winter (due to a dryer scalp) or hair loss due to scratching and an inflamed scalp. This type of issue can easily be treated with products like Ducray Kertyol PSO Shampoo. Thinning hair as you get older is also normal.
So, at what point does normal hair loss turn into a cause for concern? If you're losing more than 100 hairs per day or finding bald patches on your scalp, you should probably consult your dermatologist.
"As a rule, you should always notify a doctor if you believe something is wrong with your body or your health in general. If you notice bald patches the size of small coins, you should notify your doctor or dermatologist," Sherwood said.
How to prevent hair loss
If you’re genetically predisposed to hair loss, it's not always preventable. But certain types of hair loss are avoidable; take traction alopecia, for instance.
“Traction alopecia, which is primarily due to a pulling force (for example, tight hairstyles that pull at the root), is potentially preventable if the hair is not subjected to this pulling force,” Shah said. That means you should try to keep your hair loose and avoid constricting styles like tight braids for long periods of time.
Eating a well-balanced diet and keeping your stress levels in check can also ease hair loss. Kinglsey recommends anti-androgenic scalp drops for those with a genetic predisposition to follicle sensitivity.
Vitamins for hair growth
If you’re hoping to grow back healthy locks after experiencing hair loss due to a certain deficiency, vitamins can help. Parks recommends Ducray Anacaps Dietary Supplements and Shah suggests iron, vitamin D and zinc if you’re deficient in them.
At the same time, vitamins aren’t a miracle cure for hair loss. “Nutritional supplements can be very beneficial if you are losing your hair due to a nutritional deficiency,” Kingsley said. “However, if your hair loss is unrelated to diet, nutritional supplements will not remedy it.”
The bottom line? Vitamins won't hurt, but don't rely on them to treat all types of hair loss.
Treatments for hair loss
When it comes to treating hair loss, there’s really no "one size fits all” treatment, but you do have some options.
“Treatments vary depending on cause but can include OTC Rogaine, intralesional steroid injections for certain types of inflammatory or autoimmune conditions, oral medications and treating underlying diseases,” Parks said.
For androgenetic alopecia, in particular, treatments include minoxidil, platelet-rich plasma and low-level laser therapy. Telogen effluvium, Shah said, has a whole different set of treatments.
“In the majority of cases, telogen effluvium resolves spontaneously, so treatment may not be necessary unless a treatable underlying cause is identified, such as thyroid disease or nutritional deficiency, then that would of course be treated,” she said. “Autoimmune or immune-mediated alopecias usually require treatments that can mediate the immune response.”
It's not always easy to find a legitimate solution for hair loss, but you can definitely arm yourself against false claims.
"It's first important to identify the type of hair loss and then choose treatments that are FDA-approved, FDA-cleared or have supporting data behind them," Shah said. "As we are still discovering new things about hair loss, there are some lesser-studied therapeutic options that may help some people. Generally, if a treatment promises overnight results or seems too good to be true, it's probably not legit."
In general, the only FDA-approved products for hair growth are Rogaine (for both women and men), and Propecia for men, according to Parks. Sherwood also cautioned that there are currently no treatments for alopecia areata that are approved by the FDA, but dermatologists may recommend some topical treatments after seeing success with other patients.
"There are a lot of product touted as treatments for hair loss out there, and it can be difficult to tell what's legit. It's important to keep in mind that many of these treatments are supplements or hair care products (shampoos, topical serums, etc.), so not necessarily subjected to FDA regulation," Shah said, since the FDA doesn't regulate skin care and beauty products.
Dealing with hair loss? There are plenty of products that help make hair appear thicker or (sometimes) encourage growth. Try some of these expert-approved solutions.
After giving birth to her children, Shah experienced a bit of hair loss herself. She started taking these nutrient supplements (they contain Biotin and AminoMar) to thicken her hair, and was amazed with the results.
This leave-in treatment for hair growth is one of Parks' favorites! It encourages optimal hair growth and helps with microcirculation to hair follicles.
These anti-androgenic, stimulating scalp drops — one of Kingsley's favorites from the brand by which she's employed — address reduced hair volume and hair loss by targeting hair follicles and protecting them from the damaging effects of male hormones.
When your scalp is healthy, it's also pretty! In the name of overall scalp health — and minimal hair loss — Shah recommends this purifying scrub to detoxify and soothe sensitive or oily scalps.
Parks swears by this hair lotion that strengthens locks and stimulates growth. The best part? It comes in a mess-free spray applicator.
Topical drops containing Minoxidil can be effective in slowing down loss, Kingsley said. And at $30, these drops from Keranique are a bargain!
This clarifying shampoo is the perfect treatment to keep your scalp in tip-top shape, according to Shah.
Want to tackle hair loss? Park loves this scalp therapy that she says is ideal for both women and men at various stages of hair loss.
Nutritional supplements containing Biotin can help promote a healthy hair growth cycle, according to Kingsley. These Biotin vitamins from Nature's Bounty will definitely do the trick!