By Marci O’Connor
When I started losing my hair three years ago, I was mortified. I starting wearing baseball hats (never a good look) and avoided cameras. Every day became a bad hair day. It never occurred to me to go to the doctor. I assumed there was no cure for this sudden “shedding” — if there was one, somebody would be a millionaire, right? — but mainly I just didn’t want to draw any unnecessary attention to my lack of hair. Turns out time spent hiding my condition would have been better spent at the doctor’s office. Losing hair isn’t just a guy thing. There are more than a hundred causes of hair loss for women, and according to Jeff Donovan, a dermatologist and hair loss specialist at Sunnybrook Health Sciences Centre in Toronto, nearly all women will experience some type of hair loss in their lifetime. Determining whether you’re losing an abnormal amount of hair can be tricky since we shed anywhere between 50 to 100 hairs daily. But if you’re leaving clumps in your hairbrush or waking up to a pillowcase strewn with hair, book a visit with your doctor. When I finally did, I was diagnosed with a thyroid condition and started taking medication. It helped curb the hair loss, but I never did get back all my curly locks. In the end, I was fitted with a postiche, a custom hairpiece that clips onto the hair.
The technical term for hair loss is alopecia. It can appear as anything from an overall thinning to complete baldness.You can lose hair for any number of reasons, like low iron levels, polycystic ovarian syndrome or lifestyle triggers like excessively restrictive diets. Getting checked by a doctor is the only way to rule out more serious underlying diseases like lupus or anemia. However, if a cause isn’t found by your GP, you should get a referral to a dermatologist.
The three most common types of hair loss are androgenetic alopecia (genetic hair loss), telogen effluvium (an umbrella term describing excessive hair shedding with various causes, including stress) and alopecia areata (an autoimmune disease).
We’re used to seeing androgenic alopecia in men – the typical receding hairline and balding crowns. In women it appears as a widening hair part, and could become overall thinning in later stages. If your mother was affected, your chances increase.
Telogen effluvium can be caused by a traumatic event, like childbirth or a period of extreme anxiety. People usually notice this type of loss as an overall thinning of hair anywhere from one to three months after a difficult experience.
After the birth of her daughter, Jennifer Campbell* noticed that she was losing abundant pregnancy hair, but with a new baby, hair styling wasn’t a priority, and she knew some minor postpartum shedding happens to most women. “I had my hair up a lot. It was only when I was in the shower that I noticed lots and lots falling out.” She hoped her hair loss would abate after she stopped nursing, but when it didn’t, she went to her doctor and was diagnosed with postpartum telogen effluvium. In Campbell’s case, it took almost two years before her thinning hair started to rebound, but most of the time the excess shedding stops within six to nine months.
Alopecia areata is an autoimmune disease where – for unknown reasons – the immune system starts attacking hair roots. An inflammation develops, and the hair roots become inactive and shrink in size. It usually starts with losing a patch of hair around the size of a loonie and can sometimes end with total hair loss. This disorder strikes two percent of the population, but doctors can’t predict if and when hair will grow back, and if it does, how permanent it will be.
Regardless of diagnosis, losing your hair can heartbreaking. “Hair is important to women, and losing it can lead to loss of self-esteem, anxiety and depression,” says Donovan. There are online groups like hairlosstalk.com and womenshairlossproject.com where you can find support from people in similar situations. Additionally, the Canadian Alopecia Areata Foundation (canaaf.org) offers in-person support to those affected by alopecia areata.
“The only thing harder than dealing with hair loss as a woman,” say “Y”, the anonymous founder of the Women’s Hair Loss Project, “is thinking you’re the only one this is happening to.”
So what to do if you’ve suddenly become the anti-Rapunzel? Seeking out treatments can be overwhelming and there’s a lot of snake oil, like “hair growth” shampoos, being peddled.
“You should seek out evidence-based medicine, and not just what worked for somebody’s uncle,” says Dr. Lisa Kellett, a Toronto dermatologist. “There really is a lot of hope for all of the most common causes of hair loss.”
The most successful treatments are ones that deal with the underlying problem when possible. If hair loss is a result of low iron levels, iron supplements can be prescribed. If it’s a result of a fungal infection, the problem will be addressed with medication. Occasionally, certain medications like antidepressants or beta blockers can cause hair loss. If so, substitutions can usually be made by your doctor. For androgenetic hair loss, topical minoxidil (a common brand is Rogaine) may be prescribed. This can stop hair loss 30 to 40 percent of the time, and may even improve hair density. Other treatments include oral antiandrogen pills or hair transplants. There may not be a “cure” for this type of hair loss, but these options can help prevent further shedding.
If hair loss is due to alopecia areata, common treatments include steroid injections, diphencyprone (a topical treatment) and sulfasalazine pills, cyclosporine pills or methotrexate pills.
These medications stop the inflammation that causes this type of hair loss.
But even with the right treatment, you may still end up with some version of hair loss. Wigs and other non-surgical hair systems are practical solutions, and these aren’t your grandma’s wigs either. You can buy clip-on systems like a postiche (starting at $2,200) or a hair integration system, where your own hair is pulled through a cap and integrated with hairs that match yours (starting at $3,500, with maintenance fees to consider). A less-proven alternative is laser therapy. Though not all doctors are convinced f its effectiveness, low-level laser therapy is used on hair over a long period of time to stabilize hair loss, and in some cases, has been known to restore some hair growth.
As a single mom, Jennifer was very aware of her missing locks when she re-entered the dating scene. “I had such gorgeous hair and losing so much of it changed the way I felt as a woman at first. But I’m not letting it define how I feel about myself. I guess we just work with what we have – luckily I have a killer smile.”