Causes of Hair Loss and Baldness in Women

The common term for hair fall is “Alopecia”, which is defined as the absence or loss of hair in hair-bearing areas like the scalp, and when the hair fall is severe for a prolonged time, it may result in balding. Balding is a term that, more often than not, is associated with men, but women can be affected by this condition as well. According to dermatologists, balding in women is as common as it is in men. There are various factors that can attribute to hair fall, which results in male/female patterned hair loss. It is normal to lose about 25-100 hair follicles per day, which gets replaced by growing hair follicles, and thereby, normal hair density and length are maintained. But, when the lost hair follicles are not replaced by new ones, thinning of hair occurs initially, and over time, it leads to patterned baldness. 

What are the types of hair loss( alopecia)? 

The most common type of hair loss seen in both men & women is androgenic alopecia, which results in patterned baldness. This condition develops primarily due to the increased sensitivity of hair follicles to the circulating androgens. In men, androgenic alopecia presents as a receding hairline that gradually moves back and forms an “M” and gradually a “U” shape of baldness on the scalp, whereas in women, hair thinning occurs on the top and crown of the scalp, which is at the partition of hair. Another common type of alopecia is telogen effluvium, in which there is an abrupt shift of the growth phase (anagen phase) of the hair’s life cycle into the telogen phase (shedding phase), leading to sudden and excessive hair fall, which, over time can rest in baldness. Alopecia can also be due to chronic immune mediated diseases like alopecia areata, which is due to the abnormal immune system activity that targets the hair follicles, resulting in bald patches on the scalp/ eyebrows/ moustache/ beard areas. Various other causes of hair fall include tractional alopecia seen in women who wear tight hairstyles. Due to the extreme pulling force on the hair shafts and follicles, localized hair fall is observed. Trichotillomania is an impulse- control disorder where the patient repetitively pulls out the hair strands, resulting in bald patches. 

What are the causes of Hair loss? 

There are various reasons for hair loss, such as the following: 

1. Hereditary Factors

Hair loss and baldness may be carried in the genes we inherit, and individuals with a family history of baldness are more likely to experience baldness in themselves. In individuals with strong hereditary factors, balding may begin at an earlier age and presents with early thinning of hair, the presence of short and brittle hair, receding hairline, and the development of bald patches on the back of the head. The presence of hereditary factors does not always mean that balding will begin at a younger age, and in some, it becomes more apparent as the individual ages. 

2. Medications and Treatments

The medications that are used in various medical conditions, such as high blood pressure, acne, high cholesterol, heart disease, cancer, gout, autoimmune diseases, and depression, birth control pills can have many side effects, one of which is the development of hair loss and balding. Hair loss can also occur after chemotherapy and radiotherapy, a part of cancer treatments. 

3. Pregnancy

Pregnancy is a physiological condition that causes severe physical and emotional strain on a woman’s body, resulting in post-partum telogen effluvium hair fall. Additionally, the stress of pregnancy and childbirth can also result in hair loss and balding in some women. 

4. Hormonal Causes

The life cycle of the hair is dependent closely on the delicate balance of various hormones that play a vital role in the growth, sustenance, and shedding of hair follicles. Conditions such as hypo/hyperthyroidism, PCOS, menopause, etc., which inherently are caused by the disruption of hormones, have a huge impact on normal hair growth and cause increased shedding and decreased growth of the hair, resulting in hair thinning and baldness. 

5. Hair Styles and Hair Products

Certain hairstyles, such as braids and tight and high ponytails, can cause a lot of traction and pressure on the hair follicles, resulting in evulsion and damage to the hair along the hairline. The use of heat styling can also damage the protective covering over the hair shaft and leave the cuticle open to damage from external factors, which in turn increases the risk of hair follicle damage and hair loss. The use of harsh chemicals in hair care products, coloring agents, and styling products can, over time, cause irreparable damage to the hair shaft and follicles, leading to thinning and balding. 

6. Diet and Nutritional Deficiencies 

Diet has a huge impact on hair, and the presence of nutritional deficiencies, especially of iron (the most common), zinc, and vitamins A, B, C, D, and E, can lead to problems with normal hair growth. The protein deficiency in the diet can also affect normal hair growth and lead to excessive hair fall. It is important to note that hair loss due to nutritional deficiencies is, in most cases, reversible, and hair growth is seen when supplementation is done. Hair loss is also seen to accompany sudden, severe weight loss and crash diets, as these are seen to upset the natural metabolism of the body, which in turn affects hair growth and the hair life cycle. 

7. Stress

Stress is often termed as the silent killer, and not only does it play a role in hurting our overall health and leading to the development of problems such as diabetes, high blood pressure, heart disease, etc., but it also contributes to the development of hair loss and balding. Stress can be either physical, as seen due to pregnancy, trauma, surgical procedures, etc., or it can be mental or emotional, as seen in individuals with psychiatric issues such as anxiety, depression, chronic stress, insomnia, etc. 

8. Autoimmune Diseases and Other Infections

The immune system is an essential component of the human body designed to protect it from harmful invaders in the form of bacteria, viruses, fungi, cancerous cells, etc. Still, in some individuals, the immune system might start attacking normal tissues and cells within the body, including the hair follicles. This can lead to steady and gradual destruction of the hair follicles, leading to hair loss and balding. Alopecia areata, alopecia totalis and alopecia universalis occur due to the body’s underlying immune-mediated reaction targeting against the hair follicles. Infections of the scalp, such as ringworm (Tinea capitis), furunculosis (boils), etc, can also lead to hair loss and balding, especially if the condition is not diagnosed and treated properly. 

9. Bad Lifestyle is an Enemy To Your Hair

Lifestyle with an irregular sleep schedule, regular smoking and alcohol consumption, excessive sugar consumption and a stressful, sedentary lifestyle can cause increased hair shedding and slow down the growth phase of your hair cycles, resulting in early balding. Seek help from a dermatologist and get treated at the earliest for your hair fall. It can reduce your hair fall and reverse hair growth to a larger extent. Always make sure to consult a National Medical Council (NMC) board certified dermatologist for your hair, skin and nail concerns.