Hair loss can be particularly confronting for women, but is surprisingly common, with many experiencing some degree of hair loss by the time they reach their 70s – and often decades earlier.
For many women, the first indication that your hair is thinning is the gradual awareness that the centre part of your hair is becoming wider or that the amount of fallen hair accumulating in your hairbrush or comb is increasing.
Hair loss that occurs suddenly and quickly may be telogen effluvium (which causes sudden generalised, diffuse hair loss, and is particularly common 2-3 months after childbirth or a physical or emotional stressor) or alopecia areata (in which hair rapidly falls out in small circular patches).
In both cases, the hair follicles retain their ability to grow hair; in telogen effluvium regrowth typically commences after around three months, while in alopecia areata it may take much longer.
However, the majority of women who experience hair loss have pattern hair loss, in which the volume of hair reduces progressively over several years in a distinct pattern.
Typically, female pattern hair loss (FPHL) is characterised by thinning in the crown area, with the hairline at the front, sides and rear of your head remaining unaffected. From there, hair loss may progress to a diffuse loss around the centre of the head, encircled by hair of normal density around the edges.
Other patterns of hair loss that may affect women include a Christmas tree pattern in which there is a wide area of thinning towards the front of the scalp and narrowing towards the top of the head, and a pattern of hair loss more typically seen in men, in which the hairline above the forehead and at the sides of the temples recedes.
For women, the psychological and social effects of hair loss tend to be more significant than they are for men, and may include reduced self-esteem and low moods.
The various forms of hair loss involve different causative factors, not all of which are completely understood.
For example, alopecia areata is an inflammatory autoimmune condition that is at least partially linked to genetic factors, while about 70% of cases of telogen effluvium can be traced back to some form of physical or emotional stress that occurred 2-3 months prior to the onset of the hair loss. When it occurs after childbirth, telogen effluvium is a natural re-synchronisation of the normal hair growth cycle, which is temporarily paused during pregnancy.
Pattern hair loss is the result of a complex interplay of hormonal and genetic factors that affect the normal hair growth cycle and consequently the volume and properties of the hair.
The hair growth cycle is an ongoing process in which each individual hair on the scalp moves through stages of growth (anagen phase), transition (catagen phase) and resting before falling out (telogen phase).
Amongst other factors, testosterone and other male hormones (collectively called androgens) that are present in the bodies of both men and women play a vital role in the cycle of hair growth and hair loss.
In people affected by pattern baldness, genetic factors lead the androgen receptors in the hair follicles to become particularly sensitive to a powerful form of testosterone called dihydrotestosterone (DHT) and may also increase the concentration of an enzyme called 5-alpha-reductase, which acts on regular testosterone to convert it to DHT.
The magnified effects of DHT promote the telogen (shedding) phase of the hair growth cycle at the expense of the anagen (growth) phase, which becomes shorter.
Since they have less time in which to grow, the affected hairs become finer and shorter, often losing pigment at the same time. Over time they become more easily shed and less easily replaced, until the affected follicles no longer produce new hairs.
Despite the importance of androgens on FPHL, the majority of affected women do not have high levels of male hormones. Instead, their genetic make-up predisposes their hair follicles to be particularly sensitive to normal levels of DHT.
However, some women do experience pattern hair loss as a result of an underlying hormonal imbalance in which androgen levels are too high, and in such instances, hair loss may be symptomatic of a condition such as polycystic ovarian syndrome.
Treatment of hair loss should always be based on addressing any known causative factors.
In addition, traditional Chinese medicine (TCM) recommends optimising and supporting the functioning of the Kidney and Liver organ-meridians, which are regarded as being responsible for the health of the hair follicles and scalp.
According to this philosophy, the most common causes of hair loss and declining hair condition are deficient and/or stagnant Liver Blood and Kidney energy. In particular, pattern hair loss is often considered due to deficiency of Kidney essence or Jing, which is required for normal hair growth and Kidney Yin, which is required to nourish and moisten the hair.
In TCM, the herb Fallopia has traditionally been used to address many forms of hair loss in women, including female pattern baldness, general thinning of the hair, telogen effluvium and alopecia areata.
It is believed to work by stimulating hair follicles that are in the telogen (shedding or resting) phase of the hair cycle, and prompting them to return to the anagen (growth) phase.
It may also reduce the effects of DHT on the hair cycle in pattern baldness via an inhibition of activity of the enzyme 5-alpha-reductase.
From the perspective of TCM, these effects occur because Fallopia tones and strengthens the Liver and Kidney organ-meridian systems, promoting healthy functioning of the scalp and hair follicles, which in turn has benefits for volume and condition of the hair.
At Fusion® Health we use an exclusive Fallopia extract called Phytofol®, which has been specially formulated to deliver the optimal benefits of the herb.
Other traditional Chinese herbs that may aid the management of hair loss by supporting the Kidney and Liver organ-meridians include Rehmannia (which tones the Liver and Kidney Yin and replenishes Jing), Cuscuta, which balances Kidney Yin and Yang and nourishes the Liver, and Psoralea, which has a stabilising effect on Jing.
These herbs are often taken in combination with Fallopia (Phytofol®) and others such as Dong Quai and White Peony, which have additional benefits for women’s hormonal balance.
Zinc is important for both the growth and development of the hair and normal hormonal balance.
It may have particular benefits for female pattern hair loss due to its inhibitory actions on the enzyme 5-alpha-reductase, which may in turn help to reduce the impact of DHT on the hair follicle.
Biotin and silica support the growth and condition of the hair. Amongst other actions in the body, they also help strengthen soft and brittle nails, helping to reduce their tendency to break, split and chip.