It usually starts with your shower drain looking a little scarier than usual.
At first, you tell yourself it’s nothing. Maybe you skipped a wash day or used a new conditioner. But then, you notice more strands on your pillow, your brush and your favorite black sweater.
Cue the spiral.
Hair loss in women can be distressing and the root cause doesn’t always come with an obvious explanation.
“When experiencing and treating hair loss, it is important to remember that hair growth is slow
and can take several months to show changes,” Michelle Green, MD, board-certified dermatologist and hair loss expert, shared. “Hair loss is often multifactorial, requiring a combination of oral and topical medications and in-office treatments to reduce shedding and thinning and promote growth and retention.”
Many different factors can cause hair loss in women. The most common factors include
genetics and hormone fluctuations.
“Female pattern baldness, also known as androgenic or androgenetic alopecia, is thought to result from imbalances in androgen hormones,” Dr. Green explained. “Patients may be genetically predisposed to produce higher levels of androgen hormones or may have hypersensitivity to androgen hormones.”
Androgen hormones such as testosterone and dihydrotestosterone (DHT) can weaken hair shafts and thin hair follicles, leading to hair loss. “Hormone fluctuations in estrogen and progesterone also play a large role in women’s hair loss,” Green continued. “Estrogen extends the growth phase of hair, reducing shedding and promoting follicle health.”
Declining levels of estrogen, particularly in those with polycystic ovarian syndrome (PCOS),
post-pregnancy or undergoing menopause, can all lead to hair thinning and
loss as well.
According to Green, the best medications to combat hair loss include Minoxidil, Spironolactone and Finasteride.
“Topical minoxidil is an FDA-approved product for hair loss and has been shown to keep hair in
the growth phase and increase hair thickness and density,” she explained. “Low-dose oral minoxidil is also commonly prescribed off-label to reduce hair loss and thicken hair.”
Spironolactone is an oral medication that helps slow the production of androgen hormones, such as dihydrotestosterone (DHT), which can inhibit hair growth and lead to hair follicle miniaturization. “Spironolactone is particularly beneficial for patients with PCOS-related hair loss,” Green added.
Finasteride, commonly known as Propecia, works by inhibiting the conversion of testosterone to dihydrotestosterone (DHT), thereby lowering DHT levels. “While Finasteride is currently only FDA-approved for men, it is commonly prescribed to women off-label to combat hair loss. However, women who are pregnant or planning to become pregnant should avoid Finasteride, as the medication may cause congenital disabilities.”
Non-medication ingredients that can help with hair loss include biotin and saw palmetto. “Biotin
is a B vitamin that helps produce keratin, a protein essential for growing healthy hair,” Green highlighted. “It also increases red blood cell production, which carries vital oxygen and nutrients to the scalp and
hair follicles.”
Moreover, saw palmetto is an herbal supplement that can reduce levels of DHT to prevent
hair follicle miniaturization and hair loss.
Straight to the point: the best products to combat hair loss will contain minoxidil, per Green.
“Topical minoxidil is an FDA-approved product that restores inactive hair follicles to reduce hair loss and increase hair density, thickness and count,” she explained. “Topical minoxidil is available over the counter as a foam or solution.”
Platelet-rich plasma (PRP) is a serum derived from a patient’s own blood and contains
a high concentration of growth factors necessary for tissue regeneration and growth. “When
injected into the scalp, PRP can increase blood flow and stimulate hair follicle regeneration,
promoting hair retention and growth.” Green explained.
Most patients need a series of four initial treatments, spaced one month apart, followed by regular maintenance sessions for optimal hair restoration results.
It is unclear whether creatine causes hair loss. Creatine is a dietary supplement used to
promote muscle mass and growth.
“Currently, no large-scale studies have assessed the link between creatine and hair loss,” Green shared. “Some research suggests that creatine may increase DHT levels, which can cause hair thinning and lead to hair loss. However, other studies have found no differences in DHT levels or hair parameters between creatine and placebo groups.”
That said, more research is needed to understand the relationship between creatine and hair loss.
Postpartum hair loss occurs due to hormonal fluctuations. “During pregnancy, estrogen levels
are high, resulting in thicker hair and increased hair retention,” Green explained. “After childbirth, hormones begin to return to pre-pregnancy levels, resulting in a drop in estrogen levels and excessive shedding.”
Unfortunately, there is no way to prevent postpartum hair loss. However, patients can take
vitamins or use hair-growth supplements to strengthen hair and reduce hair loss.
“Products safe to use during pregnancy include prenatal vitamins that contain biotin, iron and zinc, and
serums that contain biotin and peptides,” Green listed. “When using an oral or topical hair product during
pregnancy, it is always best to consult with your obstetrician to determine its safety.”
“Ozempic has been shown to regulate blood sugar levels, reduce appetite, support weight loss and decrease the risk of major cardiovascular events,” Green shared. “While hair loss is not listed as an Ozempic side effect, many patients have reported increased hair shedding and thinning while on the medication.”
Researchers believe that the hair loss may be due to the stress of the rapid weight loss and
reduced calorie intake rather than the effects of the medication itself. “This type of stress-related hair loss, known as telogen effluvium, pushes hairs into the resting phase, resulting in
significant shedding,” Green added. “Typically, telogen effluvium is a temporary condition, and hair growth resumes normal cycles once the stress is resolved.”
No, wearing a hat does not cause hair loss. In fact, hats may actually protect hair strands from UV
damage and oxidative stress, according to Green.
“However, it is important to wash hats regularly, as trapped dirt and sweat can lead to scalp irritation, dandruff and temporary shedding,” she instructed. “Additionally, hats should not be worn tightly on the scalp, as constant tugging on the hair can lead to hair loss.”
No, dandruff does not directly cause hair loss.
“Dandruff can occur for several reasons, including excess scalp oil, a dry scalp, yeast overgrowth and poor hygiene,” Green explained. “While dandruff itself does not cause hair loss, persistent itching and inflammation can damage hair follicles, leading to temporary hair thinning or shedding.”
When experiencing dandruff, it is best to consult a board-certified dermatologist to determine the most effective treatment.
Yes, stress is a very common cause of hair loss, and stress-induced hair loss is known as telogen
effluvium.
“Telogen effluvium is characterized by intense shedding that occurs two to four
months after a stressor,” Green said. “Telogen effluvium can be caused by factors such as emotional or
psychological stress, death of a loved one, pregnancy, illness, surgery, hormone changes, diet
and some medications.”
Telogen effluvium is temporary and typically resolves several months after the stressor is gone, per Green. “However, it is best to undergo treatment as soon as hair loss occurs to reduce hair loss and promote hair retention,” she recommended.
Researchers state that it is normal to lose anywhere between 50 and 100 hair strands a day. “This type of hair loss is a normal part of the hair growth cycle, as hair strands constantly grow and shed,” Green added. “If you notice excessive thinning or shedding, or a drastic change in hair density, it is
best to consult a dermatologist to determine the cause and prevent worsening hair loss.”
“Hair growth relies on vitamins and minerals, and a deficiency in these nutrients can significantly
impede hair growth,” Green explained. “Vitamin deficiencies that can cause hair loss include iron, vitamin B12, biotin, zinc and vitamin D. These vitamins play key roles in red blood cell production, keratin production, tissue repair and hair follicle stimulation.”
Many of the vitamins and nutrients we need come from our diet, and a well-balanced diet is essential for maintaining a healthy lifestyle and supporting hair health. “A nutritious diet that includes fatty fish, eggs, leafy greens, fruits and nuts provides the necessary nutrients to promote healthy hair growth and help
prevent further hair loss,” Green listed.
Supplements can also be taken to reduce deficiencies and promote hair health.
Yes, testosterone can cause hair loss in women. “Testosterone is an androgen hormone that can
be converted to dihydrotestosterone (DHT),” Green explained. “DHT is an androgen hormone that causes hair follicle miniaturization and weakening, leading to thinner hair and slower growth.”
Ultimately, the best approach to women’s hair loss is rarely a single product, but a consistent routine tailored to one’s specific needs. Results take time, so patience and regular use of evidence-based treatments are key.
This article was written by Victoria McDonnell, New York Post Commerce Journalist & Content Strategist, who has spent countless hours researching, testing hundreds of products and comparing the latest makeup, skincare, hair and beauty items and trends to determine what’s truly worth your hard-earned cash. She evaluates formulas, textures, ingredients and more, in addition to consulting medical and industry experts. Some of Victoria’s latest conquests include testing the best sheet masks on the market, and a rinse-and-repeat review of the best shampoos for all hair types and budgets. Victoria, who received a beauty industry essentials certification from the Fashion Institute of Technology, has been creating shopping guides for the New York Post since 2021 and previously held positions at Insider Reviews and CNN Underscored.
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