Hair loss is an emotionally distressing issue for many women, going far beyond mere aesthetics. Especially when more hair than usual suddenly falls out while combing or washing, the worry becomes significant: "Will it stay like this forever?"
Feminine hair loss is a widespread problem that is far too rarely discussed. In this article, you will learn what feminine hair loss means, what the underlying causes can be, and what options are available to strengthen your hair again.
The most important points in brief
Over 95% of women with hair loss suffer from hormonally related loss, often due to hypersensitivity to male hormones.
Circular hair loss affects individual areas of the scalp, usually due to autoimmune reactions, while diffuse hair loss thins the entire hair, often due to stress or nutrient deficiency.
Adequate intake of vitamin D, iron, folic acid and B vitamins can promote hair growth in cases of nutrient deficiencies – however, a medical evaluation is important.
What is female pattern hair loss?
The daily loss of 60 to 100 hairs is completely normal. This natural hair cycle, which lasts about seven years, ensures that new hairs grow back as old ones fall out. Hair loss (effluvium) is defined as a significantly higher loss of hair and a visible thinning of the hair. Visible hair loss is called alopecia and can occur gradually or suddenly [1,2]. The causes are varied, which often complicates diagnosis and increases the emotional distress for those affected.
The most common causes of hair loss
Hair loss in women can be caused by numerous factors. Hormonal changes, nutritional deficiencies, or certain diseases are often the triggers. Over 95% of cases involve hormonally related hair loss, which is often genetically determined [3].
Hormonally induced hair loss
Androgenetic alopecia is the most common form of hair loss. It is caused by an oversensitivity of the hair follicles to male hormones. This leads to thinning hair, especially at the crown. However, complete baldness, as occurs in men, usually does not develop [3-6].
Hormonal changes, such as those occurring during pregnancy, after childbirth, during menopause, or after discontinuing hormonal contraceptives, can also trigger temporary hair loss. In most cases, the hormonal balance stabilizes on its own, but the psychological distress often persists [4].
Circular hair loss
Alopecia areata, also known as patchy hair loss, occurs suddenly and in localized areas. Small bald patches often appear unexpectedly. The exact cause is not fully understood, but autoimmune reactions and inflammation are suspected triggers. While hair regrows on its own in some cases, it remains permanently absent in others. Cortisone or minoxidil can be a treatment option, but they do not guarantee a successful outcome [7,8].
Diffuse hair loss
In diffuse hair loss, the entire scalp loses hair volume. This type of hair loss is often noticeable as thinning hair, which becomes apparent when the hair is styled or on the scalp. Causes range from nutritional deficiencies and thyroid disorders to stress and medication side effects. Diffuse hair loss is also common after serious illnesses or chemotherapy. The good news is that in most cases, hair grows back after the underlying cause is treated [1,3].
Did you know?
We lose more hair in summer than in winter. This phenomenon has also been observed in animals and is probably related to changes in sunlight.
Other causes
In addition to health and hormonal causes , external influences can also play a role.
Hairstyles and styling
- Hairstyles such as tightly tied braids or tight buns can put stress on the hair roots due to constant tension and lead to hair loss. Looser hairstyles or avoiding tight ties can help in this regard [12].
Seasonal hair loss
- Interestingly, hair loss varies throughout the year. Studies show that more hair falls out in summer than in winter. This phenomenon has also been observed in wild animals and is likely related to temperature fluctuations and sun exposure [13].
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How can nutrition help?
A balanced diet can have a major impact on hair health – especially when hair loss is caused by nutrient deficiency .
Important nutrients for healthy hair growth
The most important vitamins and minerals include:
- Vitamin D
- iron
- Folic acid
- B vitamins
Adequate intake of these nutrients can support hair growth. However, caution is advised: dietary supplements should only be taken after a medical diagnosis, as an overdose can have negative consequences [9,10].
Natural active ingredients
Certain natural substances such as miliacin from golden millet , cystine , or biotin are often associated with healthy hair growth. Many women report positive experiences with these supplements, although scientific studies on this topic are scarce [11]. It remains important to note that dietary supplements should always be used in consultation with a healthcare professional.
Diagnosis & Therapy
The first step in dealing with excessive hair loss should be a medical examination. A detailed medical history and blood tests can reveal whether nutritional deficiencies , hormonal imbalances , or other causes are present.
Therapeutic approaches
Depending on the diagnosis, there are different treatment options:
- Hormonal therapies: Hormone preparations can help with hormonally related hair loss.
- Topical treatments: Products such as minoxidil promote blood circulation in the scalp and hair growth.
- Dietary supplements: A targeted intake of vitamins and minerals can compensate for nutrient deficiencies.
- Hair transplantation or hair replacement: In severe cases, these options can offer a long-term solution [9,14].
Conclusion
Feminine hair loss is a common but often unspoken problem that can significantly impact quality of life. It's crucial to identify the causes early and treat them effectively. Whether hormonal fluctuations, nutritional deficiencies, or genetic predisposition are the culprits, there are effective treatment approaches for many forms of hair loss.
With a combination of modern medicine, targeted nutrition, and gentle hair care, many women can manage hair loss and regain their self-confidence. Patience and professional advice are essential in this process.
Our expert
Dr. Anne Bansleben
Nutritionist
Key areas:
Product development in analytical chemistry | botany | microbiology
What are the most common causes of female pattern hair loss?
The most common causes of hair loss in women are hormonal fluctuations (e.g. pregnancy, menopause), genetic predisposition (androgenetic alopecia), nutrient deficiencies, stress, and health problems such as thyroid diseases or autoimmune diseases.
How can I tell if my hair loss needs treatment?
Hair loss requires treatment if significantly more hair than usual falls out over a prolonged period, bald patches become visible, or the hair becomes thinner overall. A medical diagnosis is crucial to determine the cause.
Can diet influence hair loss?
Yes, a balanced diet plays an important role in healthy hair growth. Nutrients such as vitamin D, iron, zinc, biotin, and folic acid are particularly important. A deficiency can promote hair loss, which is why dietary supplements can be helpful after consulting a doctor.
What is the difference between hormonal and diffuse hair loss?
Hormonal hair loss (androgenetic alopecia) often affects the crown area and is genetically determined or triggered by hormonal changes. Diffuse hair loss, on the other hand, is characterized by a uniform thinning of the entire scalp and can be caused by factors such as stress, nutritional deficiencies, or medications.
What role does stress play in hair loss?
Stress can disrupt the hair growth cycle and lead to diffuse hair loss. Long-term stress damages the hair follicles and promotes premature hair loss. Relaxation techniques and stress management can help reduce hair loss.
Can female pattern hair loss be reversed?
In many cases, hair loss can be treated, especially if the cause is known. Hormonal fluctuations or nutrient deficiencies can be corrected, and in cases of circular or diffuse hair loss, the hair often grows back after the underlying cause is treated.
What treatment options are available for female pattern hair loss?
Treatment options include hormonal preparations, topical solutions such as minoxidil, dietary supplements, and hair transplants. The choice of therapy depends on the cause of the hair loss.
Which hairstyles can promote hair loss?
Tight hairstyles like braids, buns, or cornrows can promote hair loss by pulling on the hair roots. Looser hairstyles or avoiding such styles altogether are recommended to protect the hair.
How quickly does hair grow back once hair loss has stopped?
After successful treatment of the underlying cause, hair usually grows back within 3 to 6 months. However, the complete hair growth cycle can take up to a year. Patience and consistent care are essential.
References for further reading:
- Hadshiew I. Diseases of the hair. In: Sterry W, Czaika V, Drecoll U, Hadshiew I, Kiecker F, Papakostas D, Philipp S, Stefaniak R, Stieler K et al., eds. Concise Textbook of Dermatology. 3rd, unchanged edition. Stuttgart: Thieme; 2022. doi:10.1055/b-0042-191468.
- Middeke M. Hair loss. In: Füeßl H, Middeke M, eds. Dual Series Anamnesis and Clinical Examination. 7th, revised edition. Stuttgart: Thieme; 2022.
- German Endocrinological Care Center: Hereditary hair loss https://www.endokrinologen.de/androgenetische-alopezie.php (accessed on January 28, 2024)
- Gynaekologikum Vienna: Hair loss https://gynaekologikum.at/yvonne-helmy-bader/hormonelle-beschwerden/haarausfall/ (accessed on 28.01.2024)
- Suchonwanit P, Thammarucha S, Leerunyakul K. Minoxidil and its use in hair disorders: a review. Drug Des Devel Ther. 2019 Aug 9;13:2777-2786. doi: 10.2147/DDDT.S214907. Erratum in: Drug Des Devel Ther. 2020 Feb 10;14:575. PMID: 31496654; PMCID: PMC6691938.
- Choe SJ, Lee S, Choi J, Lee WS. Therapeutic Efficacy of a Combination Therapy of Topical 17α-Estradiol and Topical Minoxidil on Female Pattern Hair Loss: A Noncomparative, Retrospective Evaluation. Ann Dermatol. 2017 Jun;29(3):276-282. doi: 10.5021/ad.2017.29.3.276. Epub 2017 May 11. PMID: 28566902; PMCID: PMC5438932.
- Miller X. Alopecia areata. In: Moll I, ed. Dual Series Dermatology. 8th completely revised edition. Stuttgart: Thieme; 2016.
- American Academy of Dermatology: Alopecia areata https://www.aad.org/public/diseases/hair-loss/types/alopecia/treatment (accessed January 28, 2024)
- Austrian Medical Journal: Hair loss in women https://aerztezeitung.at/2016/oaz-artikel/medizin/haarausfall-frauen-menopause-univ-prof-klemens-rappersberger-univ-prof-jolanta-schmidt/ (accessed on January 28, 2024)
- Almohanna HM, Ahmed AA, Tsatalis JP, Tosti A. The Role of Vitamins and Minerals in Hair Loss: A Review. Dermatol Ther (Heidelb). 2019 Mar;9(1):51-70. doi: 10.1007/s13555-018-0278-6. Epub 2018 Dec 13. PMID: 30547302; PMCID: PMC6380979.
- Patel DP, Swink SM, Castelo-Soccio L. A Review of the Use of Biotin for Hair Loss. Skin Appendage Disorder. 2017 Aug;3(3):166-169. doi: 10.1159/000462981. Epub 2017 Apr 27. PMID: 28879195; PMCID: PMC5582478.
- American Academy of Dermatology: Hairstyles that pull can lead to hair loss https://www.aad.org/public/diseases/hair-loss/causes/hairstyles (accessed January 28, 2024)
- Kunz M, Seifert B, Trüeb RM. Seasonality of hair shedding in healthy women complaining of hair loss. Dermatology. 2009;219(2):105-10. doi: 10.1159/000216832. Epub 2009 Apr 29. PMID: 19407435.
- Dr. med. Trüeb, R. 2011. Hair loss in women. The General Practitioner, 1, 36-41 https://www.rosenfluh.ch/media/gynaekologie/2011/03/haarausfall.pdf
- Keophiphath, M., Courbière, C., Manzato, L., Lamour, I., & Gaillard, E. (2019). “Miliacin encapsulated by polar lipids stimulates cell proliferation in hair bulb and improves telogen effluvium in women.” Journal of Cosmetic Dermatology. https://doi.org/10.1111/jocd.12998
- Hengl, T., Herfert, J., Soliman, A., Schlinzig, K., Trüeb, RM, & Abts, HF (2018). Cystine-thiamine-containing hair-growth formulation modulates the response to UV radiation in an in vitro model for growth-limiting conditions of human keratinocytes. Journal of Photochemistry and Photobiology B: Biology, 189, 318–325. https://doi.org/10.1016/j.jphotobiol.2018.09.005
- Hoeller Obrigkeit, D., Oepen, T., Jugert, FK, Merk, HF, & Kubicki, J. (2006). Xenobiotics in vitro: The influence of L-cystine, pantothenate, and miliacin on metabolic and proliferative capacity of keratinocytes. Cutaneous and Ocular Toxicology, 25(1), 13-22. https://doi.org/10.1080/15569520500536584