Hair Loss in Women

Almost every third woman experiences hair loss at some point in her life. The distress is significant. However, hair loss can be targeted and treated, but not with retail products – rather with the right therapy.

Hair constantly renews itself in humans. After a certain period, they stop growing and fall out, making way for new hair to grow. Thinning hair with age is also normal. If hair loss lasts for several weeks and more than 100 hairs fall out daily, or bald spots appear, it's considered hair loss. With the right diagnosis, hair loss can be treated with medication, but over-the-counter products from retail stores don't always deliver on their promises.

Causes of Hair Loss in Women

The potential causes of hair loss are varied:

- Hereditary factors
- Stress
- Hormonal disorders/changes
- Infections
- Side effects of medications
- Attack of the immune system on hair follicles

Hereditary hair loss is common

Hair loss appears in various forms: Hereditary hair loss (androgenetic alopecia) is the most common cause of hair loss, even in women. Hair roots are likely sensitive to male sex hormones (androgens). During menopause, this can lead to hair loss in some women, mostly along the central part of the scalp. The front area of the scalp can also be affected, resulting in a receding hairline. In younger women, a decrease in hair density could be due to conditions like Polycystic Ovary Syndrome (PCOS), which leads to excessive testosterone production.

Circular Hair Loss due to Autoimmune Disease

Circular hair loss, also known as Alopecia areata, can occur at almost any age. The hair falls out in painless clumps. This condition can affect not only scalp hair but also other body hair. If all hair is lost, experts refer to it as Alopecia areata universalis. Alopecia areata is an autoimmune disease, where the immune system attacks the hair follicles, disrupting their growth and causing them to fall out. The exact causes are still unknown.

Diffuse Hair Loss with Many Causes

Diffuse hair loss is a common form of hair loss where hair falls out evenly across the entire scalp. The causes are diverse. Possible triggers include thyroid disorders, certain medications, chronic illnesses, autoimmune diseases, severe infections like the flu, malnutrition, or chemotherapy. Even birth control pills can trigger diffuse hair loss, and many women experience it after giving birth.

Eczema or Fungus as Causes of Hair Loss

Certain scalp conditions, such as severe scalp eczema or fungal infections, can lead to temporary or permanent hair loss. Scar formation can result in permanent hair loss in these cases.

Hair Loss due to Pressure and Traction

Pressure and traction on the hair can also lead to hair loss. Alongside compulsive hair pulling (trichotillomania), constantly wearing tight hairstyles like ponytails can cause hair loss.

Diagnosis: Pluck Test, Trichogram, and Blood Test Can Help

During the examination, the doctor asks the patient about their medical history, prior tests and treatments, and symptoms. For women, changes in menstrual cycles, pregnancies, or birth control pill use also play an important role.

Then the hair is examined under magnification to check for fragility. A pluck test determines how easily the hair comes out. Subsequently, the hair root is examined. A trichogram shows which growth phase the hair is falling out in. Computerized hair analysis can provide further insights. A blood test or scalp tissue samples might also be necessary for diagnosis.

The Right Therapy for Hair Loss

The sooner appropriate treatment is initiated, the higher the chances of success. However, the exact cause of hair loss must be determined first before a doctor can create an individualized treatment plan. If a specific medication is responsible for hair loss, an alternative might be tried. If conditions like hyperthyroidism or malnutrition are causing hair loss, they need to be treated to stop hair loss. It's important to note that not all hair loss requires treatment, and sometimes hair can naturally regrow on its own.

Possible additional treatments include:

Medications: Two active ingredients can effectively counteract hair loss. The blood pressure medication Minoxidil can stimulate the growth of new, stronger hair in some cases of hereditary hair loss. The local application of cortisone or dithranol can help with circular hair loss.
Anti-androgens: For hormonally-induced hair loss, dermatologists prescribe tablets containing anti-androgens. These medications block the effects of male hormones on hair roots, improve scalp circulation, and stimulate hair growth.
Hair Transplantation: Hair is extracted from the back of the head. The doctor makes micro-incisions at bald spots and transplants the hair grafts. They also determine the density and direction in which the hair should grow. This process requires meticulous work. Like any procedure, there are risks of side effects, including swelling and graft loss.

Can Over-the-Counter Products Help?

Whether oils, serums, or ingestible powders: many retail products claim to halt hair loss. Some products suggest they can "actively combat" hair loss with natural ingredients like bamboo or basil. Manufacturers often back up their products' efficacy with their own studies. However, experts doubt the significance of these often small-scale studies conducted over short periods. Comprehensive scientific studies that could provide substantial evidence of the products' effectiveness are lacking, according to the experts.

Dietary supplements can also promise high efficacy against hair loss. These products often contain vitamins as well as trace elements or extracts, sometimes in high doses. While these are not inherently harmful, buyers should scrutinize the dosages of the contained vitamins before purchasing. An excess of vitamin A, for example - whose daily requirements are fully met by some vitamin capsules - cannot be eliminated by the body and accumulates instead. Long-term excessive intake of vitamin A can lead to dry skin and hair loss. Pregnant women should be particularly cautious: overdosing on vitamin A can result in malformations in the unborn child.

Individuals experiencing hair loss should seek an expert's opinion from a dermatologist. Retail products should be treated with caution. Their efficacy is often unproven - what's certain is that some of their ingredients can be harmful, particularly in excessive doses.