Hair Shedding/Thinning: Information Sheet
Types of Hair Loss
It’s estimated that around 1/3 of women will experience excessive hair loss at some point in their lives. ‘Excessive’ is losing significantly more than the average daily loss of 100 hairs a day.
There are many types of hair loss and sometimes it’s not immediately possible to understand the cause, even with a professional assessment. Some forms of hair loss will be obvious but others are more mysterious and might involve a process of investigation. Sometimes a person will be suffering from more than one condition. But ultimately, it’s usually possible to determine the cause with the right help.
There are about 50 different types of male and female hair loss. The three main types of female loss are:
Telogen effluvium – general shedding from all over the head. This is where normal shedding accelerates due to stress, illness, medication, or hormones. Hair generally grows back within six months.
Androgenetic alopecia (or female pattern baldness)– in women, hair generally thins in the top, frontal area, just behind the hair line, but stays thick at the back. The causes are not well-understood but genes seem to play a part, meaning it can be a hereditary condition. In some cases, an enzyme causes conversion of the male sex hormone testosterone to another hormone, dihydrotestosterone (DHT), causing the hair follicles to produce thinner hair until they stop. The person may not notice shedding but over time, they notice a reduction in hair volume.
Alopecia areata – an autoimmune disease that affects up to 2% of the population. It causes round patches of hair loss and can lead to total baldness. In many cases, the hair regrows.
It’s tempting to try and self-diagnose but I would strongly recommend seeing your GP to get a professional diagnosis. They can refer you on to a dermatologist if they think it’s necessary. I wasted years discussing my problems with my GP without realising that dermatologists are the experts in this field and a referral would probably have unlocked some answers. The NHS is under huge pressure to have skin cancer patients seen by dermatologists within a certain time frame so, in the UK anyway, there is possibly a trend towards reserving their time for more serious conditions. Certainly, my GP never offered me this. A common misconception is that dermatologists just deal with skin but their expertise is in skin, hair and nails.
Another option might be to see a trichologist. Warning: It is legal for anyone to set up as a trichologist, with no qualifications, so make sure that they are a member of the Institute of Trichologists. Even then, they are not medically qualified, they cannot treat underlying medical conditions and they cannot make referrals to medics e.g. endocrinologist. They can be expensive.
Whether you see your GPs/ dermatologist/ trichologist, it makes sense to ask for some blood tests as so much can be learnt about hair loss through them:
- Iron (Full blood count and ferritin)
Ask your doctor to do a full blood count and check your ferritin levels as anaemia and/ low iron stores are a super important consideration in the world of hair. Hair loss can occur if you are anaemic or if your stores are low. The reason for this is that when your body is low in iron, it will borrow iron from non-essential tissue, such as your hair bulb, and give it to essential tissue, like your heart. Without enough iron, your hair may shed before it reaches its maximum length.
Research suggests that hair loss may result if ferritin levels drop below 80 ug/L . For general health purposes, your GP will not be concerned unless your ferritin levels drop below 10 ug/L. The ‘normal range’ is 10-291 ug/L. So whilst your GP may not be worried, your scalp might be…
If you’re suffering hair loss, you need to boost your ferritin to 80, some would say to 100 or even 120. This can be done through supplements and diet.
Warning: do this under the supervision of a medic as high levels of iron can be dangerous.
Tip 1: It’s important to take iron supplements in the right way for proper absorption as its possible to be taking it and not absorbing it- see below under ‘Supplements’
Tip 2: I take Ferrograd C, which is a slow release form of iron combined with vitamin c. My poor absorption improved with this brand. I had been saving money with a cheap form of iron and had disappointing results (but I had also been taking with a vat of coffee!) You need to work out what works best for you.
Tip 3: take with vitamin c if not taking iron supplement that’s combined with iron- e.g. with some orange juice. Also, to maximise absorption, take it at the same time as L-lysine (an amino acid important for building iron stores), which can be bought from health food shop.
Tip 3: Iron can cause digestive problems (it often causes constipation) and that can put people off taking. Take magnesium at bedtime (check first with doc).
- Vitamins B6/ Vitamin B12/ Vitamin D/ Zinc
Ask to check these too. A deficiency in these can cause hair loss
Warning: too much zinc can cause hair loss too so be careful
Hypothyroidism and hyperthyroidism can both cause hair loss, as can medication prescribed to correct these conditions. Because the symptoms of these conditions are wide-ranging and may have other causes (e.g. fatigue, weight changes, brain fog), the only way to get a diagnosis is through blood tests. If the thyroid is the cause of the hair loss, the hair should recover once the thyroid problem is treated.
Perimenopausal/ menopausal: If you have experienced changes in your cycle or you think you may be peri menopausal or menopausal, this may be worth exploring as a rise or fall in hormone can cause hair loss.
Polycystic ovaries can also cause hair loss.
The pill: hair loss can be side-effect of taking the pill so this is something you need to speak to your GP about if you are on the pill and you’re suffering hair loss.
Many types of medication, from the contraceptive pill to pain killers, can cause hair loss. If you are taking anything, speak to your doctor about whether that might be a cause. Here are are some medications that can cause hair loss:
- Contraceptive pills
- Beta blockers
- Angiotensin-Converting Enzyme Inhibitors
- Gout medications
- Hormones (male and female)
- Vitamin A
This list is not exhaustive- research/check anything you are taking
As seen above, minerals and vitamins are essential to the health of your hair and blood tests will reveal deficiencies. It can take up to 10 weeks for nutritional changes to take effect and it can take number of months to see a difference in your hair so need to be patient.
We also need to take any supplements at the optimum time, in the optimum way. This means:
-not within an hour of caffeine, which can destroy up to 80% of their goodness
– ideally, in the morning. The body absorbs and uses supplements better the earlier in the day that you take them. This can cause a conflict with that morning cuppa! If you like a tea or coffee first thing, take your pills an hour later.
There are various blends of supplements for hair/nails which might give you a general boost (e.g. Well Woman). There are also some very expensive programmes of pills that claim to help hair loss e.g. Nourkin. I would advise talking to your GP before using these and focus on boosting specific deficiencies.
There are some medically approved supplements (topical and oral) such as Rogaine, the market leader. These are sold over the counter but they might not be appropriate to your specific hair problem so be careful about taking advice before buying. If it’s is appropriate, something like Rogaine can be a very effective treatment in the right circumstances or it could be a big waste of money.
- multi vitamin: might be a good idea to boost you generally
- Biotin: this boosts the structure of your hair and aids hair growth
This is a really important aspect of your lifestyle to assess.
- Protein: is essential for your hair as hair is made of a protein called keratin. It’s particularly important to eat protein as part of your breakfast and lunch, when your body makes best use of it.
e.g.. eggs, meat, fish, cheese, lentils, chickpeas, quinoa- these sorts of foods are some of your hairs best friends!
- Iron rich foods are also very important- see below for more info re iron
eg. green leaves, red meat, beans (pinto/kidney)/ lentils/ dried fruits e.g. raisins and apricots/ fortified cereals. Eat vitamin c rich food alongside to aid absorption- e.g. broccoli, oranges and strawberries
- Complex carbs: without these, your body will start turning muscle into energy and this can put strain on the liver and kidneys, which can then lead to hair loss. Diets such as Atkins are not conducive to hair growth- they might provide the protein but an imbalance in your diet can lead to problems for your hair.
e.g.. Good sources: oatmeal, brown rice/pasta, whole grain breads and cereals, peas, baked beans, jacket potatoes with skin
- Biotin: strengthens the hair’s structure
e.g. Good sources: Eggs, almonds, oily fish, dairy, oats
- Regular eating: It’s important to eat something every 4 hours. The liver stores glucose for max of 4 hours and research suggests that after this time energy to hair follicles will reduce, which is bad news for growth and maintenance. If worried re weight, snack on chopped veg and low-fat crackers. These will do the job!
- Water: Drink lots and lots of water- view your hair as a plant on top of your head! Water it regularly.
- Crash dieting: this will put the body into survival mode. It may then dispense with non-essentials like hair and nails, which are usually the first things to get overlooked by the body.
Stress can cause hair loss. There are 3 main types of stress-related hair loss. The shedding often happens 6 to 12 weeks after the start of the stress. Good news it can self-correct once stress reduces. So the lesson is to keep stress to a minimum! In a way, this is pointless thing to say as stress is often beyond our control but it does have a massive impact on our well-being and hair. Cut out/reduce stressful things if that’s an option. Find ways to relax every day! Easier said than done…
Basic rule: resist the temptation to deal with your hair in short term ways like extensions, drastically lifting hair colour to bulk it. So tempting but this will almost always worsen situation.
Avoid hair extensions- short term gain but can destroy fragile hair you have
Keep straightening (very evil!) and blow drying to minimum. Always have the hair dryer on a low temperature setting and at a distance of 6 inches form your hair. Ideally stop before your hair is fully dry.
Use a comb when your hair is wet and at its most fragile and a paddle brush to style
Avoid dragging hair back into tight pony tail/ bun. If you’re self-conscious about your hair, you may be wearing it up all the time so this is an important consideration as it will put hair under strain. Use well covered hair ties to avoid breakage.
Colour- use least destructive option e.g. only go one or two shades lighter, only colour roots where can get away with it.
Hair pieces- these are a useful, temporary, versatile and hair-friendly way of making the most of what you have and giving yourself that glamorous feeling on a night out. Many of them simply fit on to your own hair with a hair claw, clips or combs. They range in price depending on whether you want synthetic hair or real.
It’s easy to fall waste money on ‘miracle cure’ products. Be would be wary unless recommended by reliable source.
Tip: I have tried Nioxin and I think I noticed an initial I improvement but then my hair shedding became so significant I couldn’t see a difference. But it has good reviews so might be worth a try. Need to select correct type as variety of categories.
Tip 2: for styling, VIP Volume in Powder is effective if you use a small amount. You spray it in like a hairspray but too much will make it a static mess so go easy!
Tip 3: Good old-fashioned hairspray. Give your hair a shot of Elnette and ‘fluff’ it up a little with your hands to add some volume.
Depending on where you live, the water you wash in may not be helping the condition of your hair. In the middle east, for example, tap water is desalinated. In other words, it’s salt water that has been treated to remove the salt but in the process, chlorine and lime are added, which dries out hair and can cause breakage. Even in the UK, the minerals in hard water can cause it to dry, cause colour to fade and make it harder to style.
Tip: Various ways round this-
-Some people wash hair in bottled water- one option. Fiddly.
-A less labour-intensive solution is to shower as normal, then do a final rinse over the bath with some bottled water. You can buy an enormous plastic jug vey cheaply from the supermarket for this or just buy a large bottle of water specifically for the bathroom!
-For a more long-term solution, there are attachments that you can buy for your shower that filter out some of the nasties. For approx. £50, you can buy a shower filter (such as the Aqua Elegante) on Amazon. These say they filter 95% of free chlorine, heavy metals, nitrates, nitrites, silver, aluminium, arsenic, cadmium, iron, zinc, lead, chromium, barium, hydrogen sulfide, radon, selenium, trihalomethanes, manganese, mercury, chloroform, and trichlorethane.
Chlorinated water again, which can cause breaking.
Tip 1: Wash hair in fresh water first (but that might be chlorinated too!) or wear swim cap/tie hair up
Tip 2: Clean with anti-chlorine shampoo afterwards. Boots does an own-brand. I actually use this all the time now to combat the chlorine in the regular water. Not sure if this helps…
Do a weekly protein conditioning treatment. I use Philip Kingsley’s Elasticizer (designed for Audrey Hepburn after too much styling/processing on set, it’s supposed to moisturise dry, damaged hair). Available online but there are many alternatives in the shops.
Sadly, some of what we’re experiencing may be age-related. That’s something we have to embrace or at least accept.
Useful resource: https://www.philipkingsley.co.uk
A final thought:
Proverbs 31: ‘A good woman… is worth more than rubies… She is clothed with strength and dignity; she can laugh at the days to come.’
Remember you are beautiful, regardless of your hair.
- Iron (over 80)
- Vitamin B6
- Vitmaon B12
- Vitamin D
- Polycystic ovaries
- The contraceptive pill
Check anything you are taking for side effects that include hair loss
Caring for yourself & your hair
- Multi vitamin/biotin/ specific vitamins to tackle any deficiencies
- Take care how and when you take them
- Protein/iron-rich foods/ complex carbs/biotin-rich foods/fresh fruits and veg
- Regular eating (4 hours)
- Lots of water
- Careful if dieting
- Reduce if possible!
- Avoid extensions/overly or aggressive colouring/straighteners
- Take care blow drying/use comb when hair is wet and paddle brush to style
- Don’t drag hair back too tightly/ careful re hair ties
- Desalinated water
- Might want to consider using bottled water to wash/ do final rinse
- Try to keep your hair away from the water with cap/tying it up
- Conditioning Treatments
- Try and use a weekly protein conditioning treatment