December 3, 2020

Why do many women lose their hair?


When you talk about alopecia, it is generally thought of men. In them, baldness is socially accepted and, although it is clear that it is not a desirable condition, there are even studies that point out that bald men – due to cultural stereotypes – are seen as “stronger” and “more dominant”.

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However, alopecia is far from a problem that affects nothing more than men. The number of women who suffer from hair loss is less than that of men, but it is also very high. Estimates indicate that the 25-30% of women suffer from some type of alopecia at some point in their lives.

And the consequences they suffer are more serious because, as there is very little talk about this issue, feelings of shame, decreased self-esteem, insecurity, withdrawal arise. It is an aesthetic matter, yes, but its implications go much further: the psychological impact it can lead to heartbreak, anxiety, and depression.

Earlier this year, US Congresswoman Ayanna Pressley revealed his baldness in a video. “I want to free myself from the secret and the shame that that secret carries“He explained. Actions like that, and the work of support groups like Bareback Y Alopecia Madrid, contribute to the visibility of this problem, something that is key to improving the quality of life of these women.


Alopecia in women, why does it occur?

The most common cause of hair loss in women is the so-called female androgenic alopecia. It is usually seen between thirty and forty years of age. Unlike male alopecia, the line where the hair begins in general does not recede, instead there is a loss of capillary density on the top of the head. That is, the hair becomes thin and the scalp begins to “thin” until it becomes visible.

At the origin of androgenic alopecia (also known as female pattern baldness) there are genetic factors. There is often a increased amount of male sex hormones: androgens. What happens as a result is that the follicles – the tiny holes in the skin where each hair grows – shrink in size. Because of this, the hair that is born is getting thinner and shorter. Ultimately, the follicle stops producing new hair.

These hormonal changes of origin may be related to the menopause, the start or stop taking birth control pills or certain medications, a postpartum situation or pathologies such as polycystic ovarian syndrome or congenital adrenal hyperplasia, among others. And certain nutritional deficiencies may also intervene –especially in vitamins and iron–, which may be due to low-calorie diets or Eating Disorders, such as anorexia nervosa.

Other types of female alopecia

Although androgenic is the most common alopecia in women, it is not the only one. In fact, there are more than a hundred different types. Another possibility is alopecia areata, a disease that initially causes hair loss “in patches” in one or more areas of the scalp, but which can end in universal alopecia, causing the loss of all hair, both the head as well as the rest of the body. In one in ten cases, alopecia areata also affects the nails.

It is also frequent diffuse alopecia or telogen effluvium, the technical names for what in colloquial terms is known as “stress hair loss”. This is a loss of large amounts of hair in a short time: strands of hair that seem to be effortlessly detached from the head.

It is such a striking loss that it often causes great concern for those who suffer it. Fortunately, telogen effluvium is reversible in a relatively short time: hair grows back after stress is over that caused the problem.

How does a Article by Sergio Vañó Galván, alopecia specialist at the Ramón y Cajal University Hospital in Madrid, the stress caused by the COVID-19 pandemic or confinement have caused, in recent months, many cases. Another possibility is the so-called anagenic alopecia, which includes those caused by chronic diseases, by thyroid problems, by chemotherapy or the administration of other drugs, etc.

My hair is falling out, what can I do?

Many of these hair loss are reversible: when the cause that causes them disappears (such as stress, illness or an external agent), the hair grows back. Others, on the other hand, such as alopecia areata, have a unpredictable development and in general you can only wait to see how far they go.

In the case of androgenic alopecia, which gives rise to most cases, the fact that it depends on genetic factors and hormonal alterations makes it difficult to prevent it. What can be done is keep a balanced diet, which includes the calories and nutrients necessary for it to be healthy.

And, as far as possible, avoid or limit stressful situations, which are not only responsible for telogen effluvia, but – according to studies– They also promote androgenic alopecia.

exist treatments against androgenic alopecia. They do not cure it, but they stop its advance and contribute to hair repopulation. These therapies consist of the use of drugs that try to strengthen the follicles or the nascent hair, such as minoxidil, or that reduce the production of androgens, such as finasteride – their use is contraindicated in women of childbearing age, since in case of pregnancy it can originate malformations in the external genitalia of the male fetus– and dutasteride.

The negative of these treatments is that they work while they are applied, but as soon as they are interrupted setbacks are observed: restocking stops and hair falls out again. What is recommended is intensive treatment for an initial period of about two years (the effects are seen between 6 and 18 months after starting) and then periodic “maintenance” sessions.

One possibility that does allow hair to be recovered in a stable way is that of hair transplantation. This technique consists of follicular micrografts: “hair by hair”, follicles are repositioned from areas that do not suffer from baldness (almost always on the nape) in the areas of the scalp that have suffered it. The results begin to be seen about six months after this surgery.

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