Although it is more acceptable to see hair loss in men as normal, it is not considered so in women. 30% of women over the age of 30 lose hair to some extent but sometimes it is not a genetic condition but related to hormonal changes that should be investigated. I rarely perform surgery on a woman without at least this initial laboratory and/or scalp evaluation to rule out other conditions. This article will not explore all the reasons for hair loss in women but will cover some of the most frequently encountered conditions.

In young women of childbearing age, perhaps the most common condition leading to women’s hair loss is a low iron level because of menstruation. If the physician can elicit from the woman, a history of significant menstrual blood flow, then this can trigger a laboratory evaluation to determine whether this is the culprit. Iron replacement is an ideal way to help a woman restore hormonal balance but thereby aid with her hair loss condition.

The second most common condition that can lead to hair loss is a low thyroid level. If a woman looks significantly overweight, then this can be either due to a hypothyroid state or to a condition known as polycystic ovary disease if it is not related to the just overeating. Generally, the degree of hair shedding and hair loss is not as profound as in those women who have severe iron deficiency but it still can be in certain cases. Appropriate thyroid replacement would obviously be the method of choice to correct the hair loss. Of note, there can be thinning of hair in the outer portion of the eyebrows as further indication of a low thyroid condition.

Besides these two conditions, hormonal imbalances are another major reason that hair loss can occur in women. A high testosterone and lower estrogen ratio can affect women, especially in the peri-menopausal and post-menopausal period of time. Evaluating all women for hormonal imbalances and correcting that condition can be very important as part of a protocol for evaluating women with hair loss. The type of hair loss that is evident in these types of women can resemble male pattern baldness with recession in the fronto-temporal region.

Besides these three reasons for hair loss in women, inflammatory hair loss conditions like lupus occupy the remaining types of non-genetic hair loss in women. A workup evaluation in the suspected patient who may have scaly red patches or other skin issues should be considered. With good clinical judgment, the physician can also rule out reasons for hair loss other than the above like post-pregnancy hair loss; hair loss related to stress or stressors like general anesthesia, major weight loss, etc.; and chemical or infectious damage to the scalp; among other types of problems that can lead to female hair loss.

Samuel M. Lam, MD, FACS, a board certified female hair transplant specialist in Dallas, Texas. If you would like to to schedule a consultation please call 1-888-866-3388, or visit the following links to learn more about Dr Lam’s female hair restoration procedures and female hair loss conditions, or Ask Dr. Lam a question in our Hair Loss Forum.