No one wants to lose their hair. But for women, when it happens, it can feel particularly bleak. And it does happen — eight million British women are afflicted to some degree.
Although it’s a relatively common ailment, female hair loss remains a taboo subject. A recent survey revealed that 46 per cent of sufferers kept their problem a secret. Many hid it from husbands and friends and did not seek medical help.
Thinning hair shatters self-esteem — Nadine Dorries, the Conservative Member of Parliament (MP) for Mid Bedfordshire, said losing her hair was like having a mastectomy. “You’re losing your femininity,” she said. “You’re losing your confidence and you’re losing your ability to go out and actually face the world because you think what identifies a woman is her hair and her breasts.”
Dr Jennifer Jones, a dermatologist specialising in hair loss at London’s Royal Free Hospital, agrees. “Women who have it are upset,” she says. “It has a big impact on their confidence.” Her message, and that of all experts, is unequivocal: there is no need to suffer in silence. Thanks to extensive research and ground-breaking new treatments, there is help available.
Here, with the help of the very best medical minds on the subject, we bring you the essential guide to keeping healthy, young-looking hair:
The first step is admitting you have a problem
If you think your hair is thinning, seek medical advice as soon as possible, as certain types of hair loss respond better to early treatment. “Your first port of call should be a GP,” says Dr Jones. They will take your medical history and examine your scalp and pattern of hair loss. They may also do blood tests to investigate which kind you have and refer you to a dermatologist.
Women can go bald ... just like men
Female-pattern baldness is the most common form of hair loss in women and usually results in thinning hair on the top and front of the head, in much the same way a man would lose his hair (called male-pattern baldness). About a third of women develop this to some degree by the age of 50. Also known as androgenetic alopecia, it happens when your body becomes overly sensitive to male hormones called androgens, which can decrease hair growth. It can be caused by polycystic ovarian syndrome (PCOS), which raises levels of androgens in the body, and may also become more prevalent after the menopause, when oestrogen levels fall.
Singer Maureen Nolan and television presenter Cheryl Baker have both spoken of suffering hair loss during the menopause but, says Dr Jones, it does not affect only middle-aged women. “Many women who have this have normal hormone levels and I’m seeing it in younger women and even teenagers. Treating it early is helpful to prevent hair thinning too much.”
Medication and stress can be a trigger
Another very common kind of hair loss in women is telogen effluvium, a generalised thinning and shedding of the hair from all over the head. This happens when the normal hair growth cycle is interrupted, and the good news is that it’s usually temporary.
Between 80 and 90 per cent of your hair is in an anagen — or “growth” — phase, and about 10 per cent of your hair is in a falling-out phase.
“It is normal to lose 100 strands of hair a day but with telogen effluvium some sort of trigger pushes more of your hair into the falling-out phase,” explains Dr Jones.
This trigger can be caused by a wide array of factors, including medication such as statins, blood-pressure tablets and some contraceptive pills. Stress can have a similar effect, as stress glands secrete male hormones into the body that block hair growth.
Thyroid problems are often to blame — both an underactive and overactive thyroid gland can push hair into the falling-out phase. Iron deficiency can also be a trigger; iron binds to a protein called ferritin which protects against hair loss.
Telogen effluvium also affects up to 45 per cent of new mothers, with Hollywood actresses Kate Hudson and Selma Blair having suffered.
Dr Jones says: “This is caused by hormonal changes and usually happens three months after giving birth. It can continue for months, but in most cases the hair recovers.”
Rare types can be hard to tackle
High-profile sufferers of more unusual, dramatic and harder- to-tackle types of hair loss called alopecia areata and alopecia totalis include television presenter Gail Porter and cyclist Joanna Rowsell. It happens when the body’s immune cells attack the hair follicles, and leads to either round patches of hair loss (areata) or total baldness (totalis) all over the body.
It affects one person in every hundred and is most common in women and children. “The follicle normally has a ‘wall’ around it but if you’re genetically predisposed to alopecia, a trigger — often stress — makes this ‘wall’ collapse,” says Dr Jones.
“Your body then recognises the hair follicle as foreign and attacks it. Your hair may spontaneously grow back but can be lost again.”
Another autoimmune type of hair loss is scarring alopecia, when the body’s immune system attacks the hair follicle, causing inflammation and the formation of scar tissue.
The most common form of it is frontal fibrosing alopecia (FFA). It generally starts at the ears and moves upwards until as much as the first 5 inches of the hairline are lost. It is most common in post-menopausal women. “We see a lot of this in our clinic,” says Dr Jones. “It can cause redness and scaling, and can burn and itch. It is slowly progressive and often women don’t notice until their hair has receded far back. We still don’t know whether it’s genetic or environmental — or a combination — and it is irreversible.”
Another form of scarring alopecia happens among the Afro Caribbean population with braided hair and is called traction alopecia. “It happens when patients have been braiding their hair since they were children and causes tension on the roots,” says Dr Jones.
The visible symbol of cancer
Many women who have had cancer say that hair loss often caused by chemotherapy is almost as devastating as the disease itself. It happens because the cytotoxic drugs that chemotherapy uses to destroy cancer cells also affect follicle cells.
But not all chemotherapy drugs will make hair fall out, and not all those whose hair does fall out will end up completely bald.
Hair loss normally happens within three weeks of starting chemotherapy, and hair can either fall out very quickly or over the course of a few weeks. The follicle cells recover rapidly when chemotherapy has finished and hair almost always grows back.
The psychological cause
Unlike other causes of hair loss, trichotillomania is a psychological condition in which a person feels compelled to pull their hair out. Experts claim up to one million Britons, most of them women, suffer.
They will often feel an unbearable tension, relieved only by pulling at the hair. The condition leads to bald patches on the head, along with feelings of embarrassment and guilt. Some experts describe trichotillomania as an addiction, while others say it is a reaction to stress and anxiety. It can also be a form of self-harm.
“This is sometimes misdiagnosed as alopecia areata,” says Dr Jones. “Most sufferers start pulling their hair in adolescence, and more adult women appear to be affected than men.”
Whatever the condition and cause might be, there are steps to take to tackle hair problems. Read on to find out more...
... And if you can’t, “cheat” like Nigella
Domestic goddess Nigella Lawson was recently pictured with noticeably thinning hair — but then shortly afterwards at a professional photo-call she looked transformed, leading some to speculate she had had “a little help” from a hairpiece.
Whatever the truth, the 55-year-old TV cook would not be the first celebrity to have enhanced her crowning glory.
Although wigs are still an option — something Nigella herself admits to having “fun” with for parties — the modern choice is a system in which hair extensions are weaved into an ultra-fine lace cap alongside existing hair to disguise thinning and cover up bald patches. The method was pioneered in 1984 by hair loss specialist Lucinda Ellery (lucindaellery-hairloss.co.uk), who suffered from alopecia and wore wigs for 23 years before she developed what she has called the Intralace.
Singer Cheryl Fernandez-Versini and actress Barbara Windsor have relied on Lucinda’s expertise to add volume to their long manes.
Barbara, who used to rely on wigs, said: “I’ve seen women walk into her salon almost suicidal and leave it on cloud nine. She saved my hair.”
Lucinda said: “You can’t underestimate the devastating power a woman’s hair loss has over her life.”
An Intralace can be treated like normal hair — you can wash, brush and swim in it and it won’t stop natural hair growth. It costs between £1,895 (Dh10,496) and £2,500. Every two years it needs to be replaced.
Helen Todd, 52, from Dagenham, Essex, has had an Intralace for ten years. “I wore scalp make-up to try to disguise my thinning hair but was terrified of being caught in the rain, or sweating, as it would run,” she says. “I hated meeting new people and lost confidence but now I go swimming and no longer shy away from people. It has changed my life.”