Sudden Hair Loss in Women Patients


Sudden Hair Loss in Women Patients is a growing problem, we often associate hair loss with men, but it can be equally prominent in many females, and lead to severe anxiety and stress. You may notice patchy hair loss, or patterned type of shedding similar to male-pattern balding. There are different causes from stress, to Autoimmune conditions. We will discuss the causes and provide some patient stories from different women.

What is a Pull Test?


A doctor will grasp an area of hairs and gently pull on the hair with the thumb and index fingers. If this test produces more than 3 - 5 hairs it would be considered a Positive Pull-test. This may indicate a patient has androgenetic alopecia, alopecia areata or even scarring alopecia, however more tests would need to be done to confirm this diagnosis.

Angrogenetic Alopecia:


This is one of the more common causes of hair-loss, even though it is more commonly seen in men, women can also be affected. It is also known as Male-pattern balding and over half of women over 80 will be affected. Angrogenetic Alopecia is less common in asian's, and African Americans and is most common in white men.

This pattern of hair loss in women is steady thinning over the crown which slowly widens as shown in the image below. Eventually, the entire top part of the scalp may be affected. There are different low cost products including hair building fibres, scalp thickeners, hair pieces which can help camouflage hair loss.


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Medical treatment is also possible, with 5% Minoxidil being shown to be effective. Finastaride is a synthetic steroid that reduces DHT production and limits hair loss. Female pattern baldness can be very stressing for women, and studies have shown that women become extremely upset by hair loss as compared to men.

Studies have shown that baldness in Women can also be linked to having your father being bald, as well as having a mother who carried a similar gene, would give you a much higher risk of developing baldness.

Hypothyroidism and Hyperthyroidism


There are conditions which affect the thyroid, namely Hypothyroidism (underactive thyroid) which may result in hair loss and dryness. Another cause may be Hyperthyroidism (overactive thyroid) which can also cause hair thinning. It is important to visit your doctor so that they can measure the amount of
  • thyroxine
  • and TSH in your blood.

    Fortunately, once the thyroid hormone levels are corrected - hair growth should return to normal

    Telogen Effluvium:


    Telogen Effluvium would cause Hair loss all over the scalp, so the pull test would, so the pull-test would be positive in many areas. It is often caused by stress, or a serious illness or surgery. Once the cause of the stress is eliminated hair should grow back. TE can also be caused by low iron, thyroid problems, taking certain medications. It is advisable to check with your doctor if you suspect you have large amounts of hair loss.

    Anagen Effluvium:


    This is one cause of hair loss, that affects both men and women. It is mainly linked to a side effect of chemotherapy but is is also caused by toxic chemicals and results in sudden and severe hair loss. Anagen Effluvium can also cause hair thinning in other areas like eyebrows, eyelashes and body hair. It is often possible to diagnose this condition by looking at the hair under a microscope which shows the end's of the hair tapered, and narrow.

    Chemotherapy
    Since chemotherapy uses strong drugs like daunorubicin, doxorubicin, and methotrexate, it can cause toxicity in the hair follicles, and increased loss within 3 weeks of chemotheraphy. It is important to realize that hair will grow within a few months of ending chemotherapy. Minoxidil 2% has also been successfully proven to shorten the period of baldness following chemotherapy.


    Alopecia Areata:


    Alopecia Areata is an autoimmune condition that creates inflammation at the hair follicle which can trigger hair shedding. It generally affects 1 - 2% of the world population and occours in both genders equally, and mostly occours between the ages of 20 - 40. Althought the exact cause is difficult to determine, patients have been found to have an increased amount of hair destroying antibodies. In this condition the immune system attacks the hair follicles.

    In general, sudden hair loss starts with one or more circular patches that can overlap. In General, the cause is not known, but genes appear to play a role, or some kind of enviromental trigger may lead to Alopecia Areata. There is also a chance that the hair will grow back again, however this varies from person to person.

    Lichen Plano Pilaris


    This is a rare inflammatory condition which often affects younger women and usually results in permanent hair loss on the scalp. Redness develops around the hair follicle and they can be easily pulled out. Some patients report having burning, itchiness, and tenderness. Fortunately, this disease is usually slow to progress, and early treatment can help releive symptoms.

    Lichen Plano Pilaris is almost 3 times more likely to affect women, and is mostly seen in Caucasians, in generaly the average age of onset is mid 40s. People suffering from this will have a smooth texture at the areas where hair follicles have been destroyed, and it is usually patchy in appearance.

    DLE Alopecia:


    DLE is also known as discoid lupus erythematosus, which can commonly cause hair loss especially in women. This is an autoimmune disease that leads to scaly patches of skin, scarring, and eventually hair loss. Any change to the scalp can result in permanent scarring, and irreversible alopecia although it does responnd well to corticosteroids.

    Studies have shown that using topical tacrolimus cream can often result in Hair regrowth in some patients.

    Female hair loss Stories



    A 26 year old patient noticed hair thinning in her early 20s, and it got worse when she turned 26. After visiting her doctor, who did some tests, they could find no real cause. She started using Rogaine which contains 2.5% Minoxidil, she has seen some good results. "I was often in tears at night and not many of my friends could relate, after using Rogaine for a while, my hair appears fuller.".

    In general, you can get a 6 month supply of Minoxidil for around $18 - $20, it may also be worth asking your doctor about Finasteride, even though it is mostly used by men. Some doctors suggest seeing an endocrinologist, since some female hair loss disorders are hormonal in nature.

    Another 23 Year old women reports losing her hair, and general thinning and widiening around her scalp. Her hair loss is believed to be stress related since she just lost a parent 2 years ago. She also used to twist the ends of her hair during stressful periods. It is believed she could be suffering from Trichotillomania, with causes compulsive hair pulling and hair loss, resulting in bald patches on the scalp.

    The patient also appears to be suffering from grief following the loss of her loved-one, this can lead to alopecia areata, or Telogen Effluvium. For more information about stress and hair loss, read our full article here http://www.hairlossgone.com/Blog/View/hair-loss-from-stress-its-kinda-common-id5

    Another patient reports having hair thinning: "I started taking 5mg of biotin in the mornings, and noticed a large reduction of hair on my brush, it does not appear to be growing faster but it appears to be staying in at least"

    Doctors also see another young women who suffered blood loss during an operation, she was given Iron tablets as a precution following surgery. "Actually, I didnt take the tablets and noticed my hair was thinning, I didnt know it was related to my iron levels. A doctor did a test and found my ferretin levels to be at 12"

    Another female patient reports, "I started using Rogaine 5% and saw my bald spot dissapear, however I also noticed unwanted facial and body hair".

    A patient lacking vitamins: "I was tested and found to be Vitamin D deficient, I have been taking supplements and notice some regrowth, will see how it goes from here"

    A patient notices hair loss during a shower: "I have more than normal hair loss coming out when I shower, What can be done about this" Some would suggest going to your doctor, and getting your thyroid levels tested. If you have recently had a baby, this could be caused by post-partum hair loss. There could even be a Vitamin D deficiency, or some kind of auto-immune condition causing hair loss, therefore it is very advisable to see your doctor.

    A stressed out female with hair thinning, "I have been very stressed out and notice my hair looks very weak, fragile, and tends to fall out more, what could be causing this?" - In general, without seeing a doctor we cannot make a diagnosis, we can only present some facts, stress does cause many conditions of the scalp including Telogen effluvium which forces more hairs into resting phase which eventually leads to more hairs falling out.


    References:
    https://www.researchgate.net/publication/26807794_Hair_loss_in_women
    https://www.researchgate.net/publication/256101039_Anagen_effluvium
    https://www.researchgate.net/publication/259170692_Alopecia_areata_A_review
    https://www.dermnetnz.org/topics/discoid-lupus-erythematosus/




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