There are many causes of falling hair in women including hormonal disturbances brought about by pregnancy and some endocrine diseases; psychological stress and disorders; crash dieting; infections (fungal or bacterial); skin diseases like seborrhea and psoriasis; systemic illnesses like cancer and lupus erythematosus; drugs like some anti-cancer medications; physical and chemical trauma to the scalp as in excessive hair brushing or chemical burning of the scalp during a visit to the beauty parlor; and, alopecia areata, a condition of unknown cause that is characterized by well-circumscribed patches of baldness. But the most common—and this is most probably what causes your problem—is androgenetic alopecia, a hereditary condition that is more pronounced in men than in women that is why it is otherwise called male pattern baldness.
Androgenetic alopecia is caused by genetic sensitivity of hair follicles to androgens or male hormones, which becomes more pronounced as one ages. Androgens are hormones that are produced by the testes (in males) and adrenals (in both sexes). Testicular androgens are more physiologically active than adrenal androgens, thus, baldness is more common in men. However, the androgens produced by the adrenals of women have the same effect, albeit to a lesser degree, on hair growth as testicular androgens. It is thus not uncommon for women to experience thinning hair as they age. In fact, about 10 percent of women have significant hair loss by the time they are in their 40s. At sixty, 40% of them have cosmetically noticeable hair loss—a few even go completely bald.
Many cases of hair loss in women need no treatment. Hair loss caused by trauma, pregnancy or psychologic stress often resolves spontaneously over a period of many months. Baldness due to drugs like some anticancer preparations, as a rule, also resolves spontaneously.
The treatment for hair loss that requiresone depends on the cause. For example, fungal and bacterial infections are treated with antifungal and antibacterial medications, respectively, while anti-dandruff shampoos or lotions are applied for seborrhea.
In so far as androgenetic alopecia is concerned, two drugs, minoxidil and finasteride, have demonstrated positive results in re-growing or preventing loss of scalp hair.
Minoxidil topical solution can be tried in all cases of hair loss, so you can try it too. When applied regularly on the scalp, it reportedly leads to some amount of hair re-growth in as many as 40 percent of patients.
Finasteride, on the other hand, which is taken orally, is reportedly more effective than minoxidil, but you cannot use this drug because it is only for men. It is not prescribed to women because of its potential adverse effects.
Another treatment modality that may help you involves devices that emit low-energy laser light that may stimulate hair growth. These devices are available in some dermatology clinics, but their long-term safety and effectiveness are still unknown.
Hair transplantation is another possible treatment that is open to you. This procedure involves moving hair to thinning scalp areas from donor sites. Only problem is, female pattern baldness causes thin hair all over, so good donor sites may be limited.
Incidentally, wearing a wig is a safe and relatively cheap option you should also consider. After all, among women, wearing a hair piece is not only acceptable but also fashionable.
By EDUARDO GONZALES, MD