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Am Fam Physician. 2003;67(5):1017-1018

Hair loss in women is common and can be very upsetting. It can happen anywhere on the body but most often happens on the scalp. The medical term for hair loss is alopecia. (Say: al-oh-pee-sha)

Types of Hair Loss

There are four main kinds of hair loss. They have different causes.

Androgenetic Alopecia

(Say: an-droh-jen-et-ick al-oh-pee-sha) This is the most common type of hair loss in men and women. The hair loss happens above the forehead and on the top and back of the head. In men, it is called “male pattern baldness.”

In women, the hair loss has a similar pattern but is usually not as bad. Instead of slowly losing all the hair in the areas that men do, women's hair slowly thins in these areas. The hair loss usually starts on the crown of the head and moves forward.

Men and women have both male and female hormones, but in different amounts. A male hormone causes androgenetic alopecia. Most women with androgenetic alopecia do not have more of this hormone than other women. However, they are more sensitive to the hormone.

Alopecia Areata

(Say: al-oh-pee-sha air-ee-ah-tah) This is a patchy type of hair loss. People with alopecia areata might have one or two small bare spots or lose all of the hair on their head.

Both men and women get alopecia areata. It can begin at any age, but often starts in childhood. It happens when, for unknown reasons, the body's immune system attacks the cells that grow hair.

Telogen Effluvium

(Say: tell-oh-jen eh-floo-vee-em) This is a sudden loss of hair. It is usually not permanent. Women with telogen effluvium notice a lot more hair on their hairbrush or shower floor.

Telogen effluvium is caused by stress. It can be emotional stress, such as from a death in the family; or physical stress, such as from an illness or surgery. Some women have hair loss after pregnancy. Also, many medicines can cause hair loss.

In people who have telogen effluvium, a larger than normal number of hair follicles (roots) become inactive. Then the hairs growing from these follicles fall out. After a month or two, the follicles become active again, and new hair starts to grow.

Traumatic Alopecia

Hair care practices, such as braiding hair too tightly, can cause hair loss. Also, twisting and tugging at hair over and over again can cause the hair to fall out.

Diagnosing Your Hair Loss

Your doctor will ask you about your hair loss, recent illnesses, and the medicines you take. Your doctor will also check the pattern of your hair loss. If the cause is not clear, small pieces of your scalp might be removed and tested. This is called a biopsy.


Androgenetic Alopecia

The only recommended treatment is minoxidil solution (brand name: Rogaine). You apply minoxidil to your scalp twice a day for several months. This treatment helps about half of women.

Alopecia Areata

If your hair loss is mild, you may not need treatment. Sometimes alopecia areata gets better or goes away on its own.

If you need treatment, your doctor might inject your bald spot with a medicine called a steroid. Your doctor might also have you apply minoxidil solution, a steroid cream or lotion, or anthralin cream (brand name: Psoriatec). If your hair loss is spreading quickly, you might need to take a steroid pill.

If you have lost more than half of your scalp hair, your doctor might have you see a dermatologist. A dermatologist is a doctor with special training in the treatment of skin diseases. The dermatologist might have you use medicines that could get your hair to grow again.

Sometimes treatment does not improve alopecia areata. Even when the scalp responds to treatment, it may take a few months for new hair to grow.

Telogen Effluvium

It is important to know the cause of your hair loss. If it was caused by a medicine, your doctor might be able to switch you to a different medicine. If your hair loss was caused by stress, your hair should begin to grow back in a few months after the stressful event is over.

Other Measures

If your hair loss doesn't get better with treatment, many types of wigs are available. Mini-graft hair transplants are another option.

Hair Care and Styling

You may wash your hair as often as you wish. Having your hair styled or teased will not make your hair loss worse. Also, hair sprays, hair color, and permanents will not make you lose more hair.

For More Information:

If you have alopecia areata, you can get more information from this group:

National Alopecia Areata Foundation

Information on all kinds of hair disorders is available at this Web address:

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