Female hair loss can be a difficult subject to talk about. Despite how common it is (estimates suggest that around six million women in the UK are affected), it is so often seen as a male misfortune, female sufferers can feel a sense of isolation or even shame.
It is easy to see why thinning hair might take its toll on a woman’s confidence. Given that our society places such a premium on youth and beauty, a full head of hair can become a real touchstone for self-esteem. For many women in this position (particularly younger women), hair loss is a condition to be hidden at all costs, if it cannot be redressed.
As a woman in my early 30s, who has been experiencing progressive hair loss for around a decade, my typical approach to the problem has been to fluctuate between denial and despair.
On a good day, when I’m feeling ready to take on the world, I can tell myself nobody notices anyway. But all it takes is a photo taken from an awkward angle, or a run-in with an oddly angled mirror, to puncture that illusion. From time to time, this has left me reluctant to socialise, loath to date, and worried that those I encounter are looking at my hairline, not my eyes. (On the plus side, I own a collection of hats and headbands that would put your average branch of Accesorize to shame.)
GPs aren’t always well informed
I had been to the GP several times before, but without much success. The first GP simply looked at me and barked “stress”, before suggesting a cure – not being stressed. The second time, I was sent off for blood tests, but the receptionist failed to properly explain the results, and I felt too despondent to follow up.
Both doctors gave me the impression I was wasting their time, as though my concerns were spurred by vanity rather than by genuine distress or by worries about my health.
This being the case, I was relieved to attend a consultation with Iain Sallis, a consultant trichologist at the Hairmedic Clinic. He not only diagnosed me on the spot, but reassured me that I wasn’t crazy: hair loss isn’t just something I need to grin and bear, but rather something that bears analysis. While it can be a frustratingly difficult condition to pin down, it often signals health issues that need addressing.
Hair loss can be complicated
There are many different types of hair loss, each with their own causes and prognosis. These include alopecia areata (characterised by the sudden appearance of round bald patches) and alopecia totalis (which leads to the complete loss of hair from the scalp). My own condition is less dramatic: diffuse hair loss all over my scalp, particularly on top, with my parting having grown ever wider over the last few years.
According to Iain, my problem likely stems from a few factors: chronic telogen effluvium coupled with possible androgenic alopecia and an underlying genetic disposition. While it is unlikely I will ever have thick hair again, he is confident some regrowth is possible. This will involve taking a closer look at each piece of the puzzle.
Telogen effluvium is very common
In normally growing hair, each hair goes through a cycle of growing and shedding, lasting around three years. Acute telogen effluvium occurs when there is some kind of ‘shock to the system’ – for instance, an emotional trauma, a serious illness or childbirth. In this instance, the normal growth cycle is disrupted, pushing a large number of hairs into the shedding phase simultaneously. Typically, the hair loss is temporary.
In chronic telogen effluvium, however, the excessive hair shedding lasts longer than nine months and can be gradual in onset. The hair cycle shortens, and the hair thins slowly over time. While the causes vary, there is often a persistent trigger factor – it can be linked to nutritional deficiencies (particularly an iron deficiency), thyroid disorders, or certain medications.
The good news, says Iain, is that this part of the problem is very common and largely correctible. I will need blood tests to check for any underlying medical issues, and once the trigger is identified, it can hopefully be resolved.
Hair loss can be linked to hormones
The second part of the issue might be a bit more complicated. Iain says that my pattern of hair loss is often seen in women with hormonal disorders such as PCOS. If that is the case, it could be that my body produces more androgens (male hormones) than normal for a woman, or that my hair follicles are particularly sensitive to testosterone even in the normal range.
Given that I also have slightly irregular periods – another common sign of PCOS – I’ll be pushing to get a diagnosis. If a blood test does confirm raised androgen levels, Iain suggests taking an anti-androgen contraceptive pill like Yasmin or Zoely. With any luck, this will return my hormone levels to normal and prevent any further hair loss.
Where to go from here
After the consultation, Iain wrote me a letter to give my GP, outlining the problem and explaining which blood tests I need. He also gave me some Hairjelly protein capsules (a nutritional hair loss supplement formulated for fine and thinning hair) and a bottle of Minoxidil (a medication promoting hair growth in people with androgenic alopecia). The Minoxidil, also marketed as Regaine, isn’t a magic cure, but it often makes a real difference.
At the time of writing, I am waiting for the results of my blood tests, and will proceed from there. Because this is not a simple problem, there is unlikely to be a simple solution, but information is always power. I feel heartened that, if I attack the issue from several angles, I will maximise my chances of seeing improvements. And while ‘stress’ seems too facile a diagnosis, keeping my stress levels in check and generally being good to myself surely can’t hurt.