Female hair loss sucks just as much as men’s

Listen, it’s no fun for anyone, but hair loss seems to be viewed as more normal — or at least more expected and therefore more talked about — when it happens to dudes. That stops now.

By Genevieve Monsma
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Why does hair get thinner with age?

Thanks to a dip in estrogen, a number of hair follicles start spending more time being dormant (translation: doing no work)—and when they are working, they produce thinner, more fragile strands and fewer of them. So, if you started perimenopause in, say, your mid-forties, by your mid-fifties you may have “up to a fifty percent decrease in hair density,” says Michelle Blaisure, a certified trichologist and consultant for Bosley haircare. 

How apparent that decrease is will be dependent on how much hair you had to start (Blaisure says those with fine hair typically notice sooner)—as well as how diffuse the loss is. If it’s all over your scalp, the thinning will probably be less obvious than if the hair loss is concentrated in one area. More concentrated loss is rarer and usually found in “the 20 percent of women who are genetically predisposed, like some men, to hair loss,” says Blaisure, who adds that genetic female pattern hair loss usually occurs on the top of the head, from the crown to the forehead.

Environmental causes of hair loss: How we compound the problem

In addition to age-related hormonal fluctuations (and, for some, a genetic predisposition), “there are number of environmental factors I believe are exacerbating female hair loss,” says Gary Goldenberg, MD, a dermatologist in New York City. “In the last twenty years, hair loss in women has skyrocketed, and it now makes up a quarter of my dermatology practice. Normal aging and hormone fluctuations are part of the cause, but I think external factors like consuming extra hormones in our diets, deficient nutrition, and chronic stress aren’t helping.”

Dietary causes of hair loss

Dr. Goldenberg points to the prevalence of hormones in meat and dairy as possible culprits. As for the role of poor eating, he cites “crash diets, too many processed foods, and not enough of the real stuff—plus the fact that perimenopausal and menopausal women frequently try to control weight gain by restricting their calorie intake.” Remember, if the body is deficient, it will shuttle nutrients to vital organs first, leaving little to nourish the hair follicles.

Hair loss due to stress and anxiety

As for stress, “When itis consistently high, we overproduce the hormone cortisol, which can cause an imbalance that impacts your hair follicles,” explains Blaisure, who also thinks an out-of-whack microbiome could contribute to hair thinning and loss. “We’ve been talking a lot lately about microbiomes and the need for balance between good and bad bacteria in our guts and on our skin. Well, this is true on the scalp as well. When the microbiome of the scalp is disrupted by UV exposure, pollution, harsh products, or even improper cleansing, this can impact the health of the hair follicle and the strands they produce,” she explains. 

So, what can I do about thinning hair?

Eat thoughtfully Instead of trying to pin down specific foods that cause hair loss (or growth), focus on having a generally healthy diet. Consuming balanced meals and trying to minimize intake of foods laced with hormones is one common-sense strategy. Neal Schultz, MD, a dermatologist in New York City, also recommends his patients take a nutritional supplement like Viviscal to ensure hair follicles aren’t getting short-shrift on the days you’re not on your eating A game. Other supplements to try: Better Not Younger Hair Fortifying VitaminsNutrafol, and Hum Hair Sweet Hair

Reduce stress You already know the oft-suggested ways to reduce stress: meditation, yoga, exercise, sleep, spending time with friends. For these activities to help lower cortisol levels though, you have to actually dothem. Regularly. You may also consider taking an adaptogen supplement (sprinkle it in your coffee or pop an ashwagandha pill with breakfast). There is some evidence that these herbal supplements can help control cortisol spikes. Check with your doctor though, especially if you have a pre-existing health condition or are taking other medications.

Cleanse with care As we age, our hair also gets more dry and gray. As a result, many of us try to stretch time between shampoos to maintain hydration levels and salon color. This isn’t, however, great for scalp skin (or hair follicles) — a week’s worth of dry shampoo plus environmental grime, do not a balanced scalp make. Sonsoles Gonzalez, founder of the Better Not Younger haircare line for women over 40 and a former haircare executive at Procter & Gamble and L'Oréal, adds that scalp skin is more delicate than most of us realize. 

“Scalp skin ages faster than skin elsewhere and becomes thinner, dryer and more vulnerable earlier than skin on your face. Then, we make it worse by being hard on our scalps, using permanent color and layers of dry shampoo, and then not washing for days. You’d never apply makeup, not wash at night, then apply more makeup the next morning. But that’s what we do with dry shampoo,” she explains. “All that buildup can cause scalp inflammation, which will impact the productivity of your hair follicles,” Gonzalez says.

A better strategy. “Cleanse your hair two or three times a week,” says Gonzalez. And when you do wash your hair, give your scalp a good, deep massage so you loosen the product buildup, enabling it to rinse away. Consider using a deep cleanser or scrub once or twice a month too, to facilitate stubborn buildup removal. Try Bosley Bos-Renew Scalp ScrubBetter Not Younger Activated Charcoal Scalp Cleanser, or Christophe Robin Cleansing Purifying Scrub with Sea Salt. Finally, consider scaling back on the dry shampoo. “Once or twice between shampoos should be your maximum,” says Gonzalez.

Treat your hair like a designer dress, not an old pair of jeans Part of the reason hair feels thinner with age is that individual strands become smaller in diameter. And skinnier strands are more fragile and apt to tear and split. Thus, try to be mindful of your hair’s vulnerability when you’re styling, e.g. never rake a brush through root to ends to pull out snarls, minimize heat styling if you can, and try to vary the height of your ponytail so you aren’t routinely cinching the exact same spot with a tight elastic. 

Also, consider using treatment masks one or twice a month to boost hydration and improve elasticity (elastic hair is less apt to snap). Try Briogeo Don’t Despair, Repair! Deep Conditioning MaskLiving Proof Restore Mask Treatment, or Better Not Younger Hair Redemption Restorative Butter Masque.

Get growing: home remedies for hair growth and thickness

There are a number of “scalp-stimulating” serums that aim to boost blood flow (and thus better nourish sickly follicles), inhibit production of an enzyme that has been tied to hair loss, and quell inflammation (which can negatively impact follicle productivity). Quite a few of these formulas also contain minoxidil, an ingredient clinically proven to help promote more robust growth by keeping hair in the growing phase longer; Minoxodil is also the ingredient doctors most often recommend. You can find it in Rogaine for WomenBosley Hair Regrowth Treatment, or Nioxin Hair Regrowth Treatment for Women. It is worth noting that most over-the-counter Minoxidil treatments for women contain 2% Minoxidil; using more than that concentration (men’s Minoxidil is typically 5%) may cause hair to grow on a woman’s face.

For those who prefer not use blends with Minoxidil, there are plenty of options free of it that use botanical ingredients to coax new or more robust growth: Try Oxilogica Drop for Intense Hair Loss or Better Not Younger Superpower Fortifying Hair & Scalp Serum.

Dr. Goldenberg also occasionally prescribes Spironolactone to female patients. This medication is typically used to combat fluid retention and/or high blood pressure, but it is also analdosterone receptor antagonist (a fancy way of saying it blocks the production of certain male hormones), and thus may help keep male hormones from outnumbering female ones. This return to hormonal homeostasis, for some, may help temper hair loss.

What can a dermatologist do for hair loss?

Finally, a number of dermatologist’s offices are now offering PRP (platelet rich plasma) therapy for the scalp. How it works: Your doctor draws a sample of your blood, places it in a centrifuge and spins it to separate the platelets, which are rich in growth hormones. The platelets are then injected into the scalp, and the growth hormones the platelets release stimulate scalp tissues to heal themselves. This regeneration is believed to help boost hair follicle productivity. Dr. Schultz says most patients will see about a twenty percent improvement in density, but “many perceive it to be more than that because you’re not just getting more hair. Your strands are also thicker than they were before PRP so your hair feels noticeably fuller,” he explains. Dr. Goldenberg typically prescribes three PRP treatments, spaced about a month apart (average cost of a treatment is $1200). After that, patients may come in once or twice a year for a touchup treatment.

Dr. Goldenberg has also found success pairing stem cell injections with PRP treatments. (The stem cells come either from umbilical cords or from the patient’s own fat, removed via liposuction.) “PRP acts like the foundation, then I inject the stem cells into the scalp. The stem cells are pluripotent, which means they can change their function, depending on where they are placed in the body. In the scalp, they become new hair follicles. We’ve seen some excellent hair regrowth results with this combination,” he says.

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