I have encountered many patients who experience hair loss after pregnancy and wonder what is going on. What happens during pregnancy is that the body is sustained at a high level of estrogen. Estrogen causes the hairs to stay in a prolonged state of anagen, or growth phase. When the estrogen is reduced at the time of delivery, the hairs cycle back toward a more normal distribution in each of the three hair phases: anagen, catagen, and telogen. This condition of related hair loss is known as telogen effluvium. At the time of childbirth, the hairs appear to shed because the percentage of hairs that were intended to be in a different hair phase rapidly cycle into that phase and hairs are then shed all at once rather than in smaller waves as they do in non-pregnant individuals.

Typically, this hair loss does not make anyone bald, but noticeable thinning can occur. It is also a self-limiting problem that tends to rectify itself in the first few months after childbirth. It is oftentimes worse after the first child is delivered than in subsequent pregnancies. Minoxidil, or Rogaine, can be used to help stabilize the hair loss and shorten the period of shedding. However, two words of caution should be extended. Sometimes additional shedding can be noted at 3 to 4 weeks after starting minoxidil because the hairs can cycle back into the growth phase again causing hairs that move into this phase to be shed. In addition, after stopping Minoxidil, hair shedding can be noted again as hairs cycle out of the growth phase. Sometimes not intervening and just waiting it out may be a preferred course of action if there is not significant and socially embarrassing hair loss related to post-pregnancy shedding. Remember whenever you experience hair shedding it is oftentimes worth seeing a dermatologist on internist just to make sure that it is in fact a benign condition like telogen effluvium and not indicating something more serious.

Samuel M. Lam, MD, FACS is a board certified hair transplant surgeon in Dallas, Texas. To learn more about female hair loss, and Dr Lam’s female hair transplant procedures please visit our website hairtx.com or call 972-312-8105 to schedule a consultation.