Hair Loss In Women

Thirty million women in this country experience hair loss. Yet it remains a taboo subject that's not often discussed among family, friends or even with a family doctor. While hair loss can be bothersome to men, for women, it can be psychologically devastating.

Marian Malloy has been losing her hair since she was a freshman in college. Like most women, the 48-year-old did not know she was suffering from a condition known as Alopecia Marginalis--a type of hereditary hair loss pattern affecting the frontal hairline and temples.

"I felt as though it was quite noticable," says Malloy. "I felt everybody was looking at my hair all the time. I was paranoid about my hair."

Malloy hid her receding hairline with different hairstyles for almost a decade before she sought out medical treatment. She opted for a surgical hair transplant.

"I used Rogaine. I also had steroid treatments. I did see improvement," says Malloy. "But in addition to my hair line getting fuller, I also got a beard and moustache, so that wasn't an option for me."

For Malloy and others like her, hair loss is not just a physical condition. In fact, experts say the social stigma of hair loss severely affects a woman's self-image and self-confidence.

"It's a badge of femininity and it has been," says Ellen Rubin, a psychologist. "So, I think hair has a particular place. It's even more difficult than other things women have to manage.

Dr. Robert Bernstein joins us this morning to discuss the issue of women’s hair loss. He is an assistant clinical professor of dermatology at Columbia University and a dermatologist at Columbia-Presbyterian Medical Center in New York City.

1. WHAT CAUSES HAIR LOSS IN WOMEN?
   Women can temporarily lose their hair from pregnancy, prescription drugs, diet and stress. Medications include those for acne such as accutane, blood thinners to control blood pressure, cholesterol lowering drugs, anti-depression drugs and hormonal drugs such as birth control pills.

   
   However, the majority of women with hair loss suffer from ANDROGENETIC ALOPECIA, a genetic predisposition inherited from either side of the family that is exacerbated by aging. It's caused by the effect of androgens, so-called "male" hormones. Women may lose their hair if the level of these hormones is excessive or if they are extremely sensitive to them. It is believed DHT-- a derivative of the male hormone testosterone- causes abnormal hibernation of hair follicles. It comes down to heredity, the effects of hormones and age which cause hair follicles to get smaller and smaller.

   
   

2. IS HAIR LOSS IN WOMEN DIFFERENT FROM HAIR LOSS IN MEN?
   Even though the hormones responsible for hair loss are the same, the pattern is usually different in men and women. Most men experience pattern baldness-- vertex balding and/or a receding frontal hairline. Women usually have diffused thinning over the top of the head or crown while often maintining a frontal hairline. It is very uncommon for women to go completely bald.

   
   

3. WHAT ARE SOME OF THE SIGNS THAT A WOMAN MAY BE LOSING HER HAIR?
   The hair loss process tends to be gradual and therefore often goes unnoticed by others. Typically, a woman sheds between 50 and 100 strands each day. One sign of hair thinning may be noticeable loss of hair volume. Another is when a woman begins to see her scalp. Some dermatologists do what's called a "hair pull," grabbing a few stands in certain sections and see how many loose hairs come. Normally, you should only have two or three.

   
   

4. WHAT KIND OF DOCTOR SHOULD A WOMAN SEE IF SHE'S STARTING TO EXPERIENCE HAIR LOSS?
   Getting a proper diagnosis is extremely important. You should see a dermatologist. Obviously, some are more experienced in hair loss than others, but you should not go to a general practitioner. Each patient is unique so doctors must delve into a woman's medical history before prescribing remedies. Doctors eed to ask about a woman's treatment history, then take a history of her hormonal background, her menstrual cycles to determine which type of hair loss she has and what's causing it.

   
   

5. WHAT ARE SOME OF THE TREATMENTS AVAILABLE?
   It may be as easy as switching or stopping medications or as tricky as manipulating hormones. Depending on the cause of the hair loss! If excessive levels of male hormones are detected, hair loss may be treated with birth control pills or a high blood pressure drug, spironolactone. Others might try using minoxidil, which is sold under the name, "Rogaine." It's the only FDA-approved drug for women hair loss. Doctors believe minoxidil opens up sodium and potassium channels, stimulating sleepy follicles to produce new, finer hair and stopping others from shutting down. A hair transplant is possible, but only for a few women who have the same type of pattern baldness as men. Most women have what's called diffuse hair loss-- overall thinning in all areas of the head.

   
   

6. CAN HAIR LOSS BE PREVENTED?
   The truth is all women after a certain age have scalp hair thinning. So far, the research has not come up with anything that will prevent it. However, there are some studies going on to see if there is a way to turn off the gene that causes hereditary hair loss. Hair loss is a natural sign of aging.

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