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Female pattern hair loss: ‘The hairdresser asked if I’d been stressed’

The i 3 days ago Elisa Bray
a person standing in front of a building: Elisa Bray says hair loss among women has soared in the pandemic (Photo: Elisa Bray) © Provided by The i Elisa Bray says hair loss among women has soared in the pandemic (Photo: Elisa Bray)

Of all the things that women in their thirties might start anxiously looking out for – crows’ feet, stretch marks, grey hairs, wrinkles – hair loss doesn’t usually make the top five. That’s supposed to be a problem that befalls men, isn’t it? Especially if we are to let male-targeted adverts for hair-loss treatment shampoo, be our guide. So I was shocked to discover, last summer, that where I had once had a surplus of thick dark hair there was a large thinning patch. Suddenly, the ever-blocked bath plug made sense.

“Have you suffered anything traumatic during the past few months or been stressed?” asked the concerned hairdresser at my first post-lockdown appointment, as she cut my tresses into a volume-boosting shoulder-length style. Haven’t most people? Spending several months of the past year homeschooling two young children while working during the various lockdowns might just be a factor.

More helpfully, she recommended seeing a trichologist, who diagnoses and treats hair and scalp problems. Under their professional eye, blood test results are inspected for deficiencies and health issues which can lead to extra shedding, and the thinned areas are examined under a microscope.

Crash diets

My diagnosis is female pattern hair loss (androgenetic alopecia ). I’m surprised when the sympathetic trichologist who’s looking at my sparse crown tells me this, as it’s a genetic condition yet no one in my family is known to have had it. I’m relieved when they assure me that daily application of a topical anti-androgen solution should replenish some of my crop with time.

a person looking at the camera: Elisa Bray lost hair on her crown (Photo: Elisa Bray) © Provided by The i Elisa Bray lost hair on her crown (Photo: Elisa Bray)

It turns out that hair loss is less rare among women than I’d thought. Perhaps the most common culprit among premenopausal women is low ferritin (stores of iron that help to extend the hair’s growing phase), which often goes undiagnosed and yet is easily treatable with supplements. Crash diets, too, can starve hair of the right ingredients for growth.

Wear a wig

Discussions with friends reveal that one who had suffered low iron, and had been grieving a parent, developed hair loss during the summer, while another had to wear a wig on her wedding day to conceal the bald patches. Anna recalls discovering it when washing her hair on holiday, after a period of stress and lack of protein in her diet. “When I looked down it was like there was a small animal, a guinea pig, in the bottom of the shower, there was so much hair. It was horrendous.”

As our lifestyles have become increasingly busy and stressful, shedding can be an unfortunate side-effect, and sometimes it’s noticed late, when as much as 30 per cent has been lost.  Susie Hammond, a trichologist at Philip Kingsley, blames the emotional stress around Covid-19 for triggering the extra hair fall. But she is also seeing excess shedding as a side-effect in those who have contracted Covid.

While it is normal to lose up to 100 hairs a day, telogen effluvium (a form of wide-spread, non-concentrated hair loss) – commonly caused by trauma or short-term illness – can result in three times as many being shed, although it usually resolves itself in three months, once the issue is fixed. “However, with Covid-19 we have seen severe telogen effluvium often associated with high temperature,” she explains. “Recovery could be longer than in usual cases as the patient may remain sick for a long time.” Even before the pandemic, the vast proportion of people seeking help were women: 78 per cent. Yet, it still feels like a stigma for women; a subject not discussed and often dismissed.

“It has been harder for women to talk about hair loss,” agrees Hammond. “While it’s common to see men with shaved heads or receded hairlines, this is not the case for women.”

She points out that the psychological significance should not be underestimated; hair loss can have a huge impact onself-esteem. “But images of women with bouncy hair pervade the media and female hair is traditionally linked to sexual attraction, making women’s hair loss a more emotive subject,” she says. “My female clients are often very upset when they come to us. Hair loss in women is far more common than is thought, but it’s becoming increasingly acceptable to talk about it.”

Tress test

There are many reasons why women lose their hair. Other than an unpleasant side-effect of chemotherapy, it’s caused by thyroid disorders; stress; low iron, vitamin D, vitamin B12 or zinc; some medications; and a condition known as female pattern hair loss (androgenetic alopecia), the female equivalent of male balding at the top of the head, which is genetic.

Genetically predisposed follicles gradually grow sensitive to normal levels of androgens (male hormones testosterone and dihydrotestosterone), leaving hairs in the affected area to become shorter and finer until growth stops altogether.

During the pandemic, hair loss has been more prevalent, according to experts at Philip Kingsley who have seen a raft of new and existing clients reporting extra shedding, and a surge in sales of their Trichotherapy products.

Since it launched virtual consultations when the clinic closed for lockdown, enquiries rose 20 per cent – and among the clients seen over the period, 90 per cent were women.

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