For guys, middle-aged hair loss is upsetting, but not something that prompts a doctor’s appointment. A woman that has sudden, unexplained hair loss finds herself in a different situation. While not exactly a medical emergency, it certainly qualifies as an emotional emergency. Yesterday alone I saw 2 patients where the sole reason for their visits was dramatically thinning hair. Fortunately, most causes of hair loss in women are temporary or treatable.
On average a woman loses 75-100 hairs a day as new hair grows in, so if you pull a small wad out of your hairbrush every night, it’s nothing to worry about. A condition called stress alopecia results when a large number of hair follicles inappropriately enter a resting phase, and therefore, fall out at the same time. This diffuse hair loss usually occurs around 3-4 months after a “stressful” event such as a sudden change in hormones from stopping birth control pills or delivering a baby.
Non-hormonal causes of stress alopecia can occur with certain medications, severe dieting, nutritional deficiencies, surgery, a high fever or a stressful event. Yes, going through a divorce can make your hair fall out! You are not going to go bald and there will be a gradual return to normal, but it will take at least 3-4 months. Medical conditions such as anemia or an over-active or under-active thyroid can also cause diffuse hair loss, so it is a good idea to see your doctor for an evaluation.
Male pattern baldness can occur in women during middle age if there is a familial tendency compounded by the increase in androgens, which occur around menopause.
Recently I saw a patient with thick beautiful hair who was upset because the hair around her hairline was thin and broke easily. She wanted to have me check her hormone levels, but it turns out that her tight ponytail was actually the root of the problem. A condition known as traction alopecia occurs when tight hair elastics, hair extensions, or tight braids cause tension and breakage of the hair shaft. Typically, hair loss is at the hairline, part line, or wherever there is a lot of pulling and tugging.
Patches of hair falling out, as opposed to diffuse hair loss, are often an indication of a medical or scalp problem. Dermatologists are the specialists that diagnose and treat conditions resulting in hair loss. The source may be infectious, immunologic, or an indication of a potentially serious medical problem.
Before investing in a wig or a wardrobe of hats, check with your doctor. Your hair-raising debacle may be over before you know it.