Why women get thinning hair, especially when they age, and what they can do about it
“We get more tears.”
That’s the emotional state of women and girls when they go in for a consult about their thinning hair or sudden bald patches on their head.
Unlike men who are expected to have these or to go completely bald eventually, the effect on women is more emotional, more devastating—and not only because it’s less commonplace. Their hair being their “crowning glory,” a woman’s appearance can change dramatically with their hair.
“It’s a traumatic experience for women especially for younger ones, like those in their teens or in their 20s,” says Shai Aya-ay, a trichologist at Svenson Hair Loss Clinic. Trichologists deal with all aspects of hair and scalp; they are not dermatologists or doctors. They diagnose scalp diseases and give advice on hair maintenance.
I know exactly what she means about “traumatic.” As someone who had alopecia areata in her 20s, I sat, crying, across doctors who explained that I had an autoimmune disease that attacked my hair follicles and resulted in significant hair loss and bald spots.
I had a bald patch at the back of my head that measured 11 cm or 4.3 inches, and had to undergo steroid injections on my scalp.
Back then, steroid injection was painful even with a topical anesthesia. The doctor used a “gun” with a needle that had to go under my scalp (not very deep—but not just on the surface either) for the medicine to be absorbed.
I endured these monthly treatments for about a year. I wouldn’t say my bald patch gave me low self-esteem because, after all, our hair is just one part of our sum, but it did make me feel very self-conscious knowing that, literally behind my back, people were staring.
Today, there are more options for treatments, and delivery methods for medicines have improved (the process is no longer painful).
But first, why do people lose their hair?
It’s more complex for women
People typically lose 50 to 100 hairs a day. It’s normal to see strands in your shower or on the floor where you brush your hair.
Losing this much isn’t noticeable because new hair is growing in at the same time. Thinning hair happens when new hair doesn’t replace what has fallen out. It usually happens on one’s temple or the top of your head.
Starting when a woman turns 40, having a lower hair count is normal. Men, on the other hand, can get this starting in their mid-20s. We have a longer timeline to enjoy our hair, so to speak.
For men, the leading cause of hair loss is genetics or hereditary. Male pattern baldness happens as hormone levels change over their lifetime especially as they grow older.
The causes are more complex for women, according to Shai. “If this was a guessing game and a male client came in, majority of the time it’s male pattern hair loss or genetic type of hair loss. If it’s women, you have to have a thorough consultation covering their health history—surgeries, dieting, high-grade fever, pregnancy, scalp disorders, etc.”
Yes, restrictive dieting can cause significant hair loss.
Then there’s age-related thinning. “Starting when a woman turns 40, having a lower hair count is normal. Men, on the other hand, can get this starting in their mid-20s. We have a longer timeline to enjoy our hair, so to speak.
“When women age, lower levels of progesterone and estrogen occur especially during menopause. Women notice thinning throughout their scalp not necessarily in one place though it’s common to lose more hair on the crown.”
On the other hand, women who experience hair shedding early, like in their 20s, is usually secondary to an underlying medical condition like hypothyroidism or polycystic ovarian syndrome—it could be anything.”
And, yes, she says, stress and anxiety can really trigger hair shedding. “Loss of job or death in the family, or transitioning from one job to another and working long hours. If it’s not mental stress, physical stress can be a cause like getting shorter hours of sleep.
“Anyone can experience stress at any age. We get clients as young as seven years old with alopecia areata.”
Treatments for hair shedding
As crash diets can cause excessive shedding, improving your nutrient profile can give your body what it needs for hair growth. Choose foods high in biotin, vitamins C, D and E, zinc, iron, omega-3 and omega-6.
For topical treatments, Minoxidil is probably the most famous (I used it after steroid injections many years ago).
Curiously, Minoxidil wasn’t originally created for hair loss but for hypertension. In the ‘60s, the maker of the drug, Upjohn, noticed that patients in clinical trials started “getting a bit hairy,” which was then considered a “harmless side effect.” Of course, they and everyone else capitalized on this accidental discovery to make a topical solution.
There’s also Platelet-Rich Plasma (PRP) therapy, which uses the regenerative and healing benefits of growth factors in one’s own blood platelets. These growth factors are known to boost hair growth, density, and vitality, according to Shai.
The platelet-rich plasma is topically applied on the scalp. Then an electroporation machine is used to spread the plasma, accelerating its absorption and increasing its distribution all over the scalp.
In the Philippines, this therapy is offered at Svenson clinics. “Several studies have shown that a high concentration of growth factors can help achieve new hair growth and thicken the hair shaft of pre-existing hairs. Growth factors can also help in the faster transition from the hair’s resting phase (telogen phase) to its active growing phase (anagen phase).”
The procedure begins with a nurse applying topical anesthesia on the scalp to numb the area. The nurse then collects a sample of your blood and processes it through a centrifuge. The blood is spun down for eight minutes to separate the platelet-rich plasma from other components of your blood.
The blood is spun down for eight minutes so it's going to separate the plasma from other components of your blood. “Instead of putting a synthetic treatment, this will be your treatment for hair stimulation. The expectation is not full restoration for everyone but an improvement in terms of coverage on the parts where your scalp still has active follicles.” Shai says.
When the anesthesia has taken effect, the micro-needling begins, which uses a “pixel pen” to create micro- punctures that are 2 mm deep into the scalp.
“This alone already triggers the tissue repair process and helps boost hair stimulation,” according to Svenson. “Next, the platelet-rich plasma is topically applied on the scalp. Then an electroporation machine is used to spread the plasma, accelerating its absorption and increasing its distribution all over the scalp.”
The plasma is left on the scalp overnight and you can shampoo your hair the next morning.
Is it painful? According to Svenson, the PRP therapy itself is painless because of the topical anesthesia, which is applied on the scalp 30 minutes before the session. “There may be a tingling sensation on the scalp due to the pixel pen.”
Each session takes around two hours. For best results, the procedure is done every three to four weeks for the first four months; then every six months.
Can you take other treatments like Minoxidil with PRP? Yes, Shai says. The PRP actually better prepares your hair follicles to receive it.
What about salon treatments like hot oil, does it help stimulate growth? They can leave you with shiny hair, sure. But the trichologist says, no, they will not simulate hair growth.
Visit Svenson Hair Loss Clinic’s website here.