Why is my hair falling out?
Hair thinning is the most likely hair loss type if you’re a woman. For most people, this happens as part of the ageing process as the rate of hair growth slows down.
However, there are several other reasons why your hair might be falling out or thinning, including medical conditions that may need treatment.
In many of these cases, female hair loss is temporary.
Losing your hair can be upsetting and can affect your confidence.
We’re bombarded with images of glossy, vibrant heads of hair as a key marker of being healthy, attractive, youthful and glamorous. Even when you know half those images are created by hair extensions, elaborate hairstyling and filters, it can be really hard to come to terms with your own hair getting thinner.
So read on to learn more about hair loss in women, including what causes it, when to see a doctor, and what hair loss treatments and self-care tips you could try.
Hair thinning is a normal part of getting older
It’s normal to lose about 50 to 100 hairs every day, and you usually won't even notice. For most people, hair getting thinner happens naturally as part of the ageing process.
Reasons for this include:
- the rate of hair growth slowing – when you shed your hairs after their average 2-7 life span, the time it takes for new ones to replace them also gets longer
- individual hairs are finer over time – hair quality changes which can make it look and feel less full, shiny and bouncy. For example, grey hair is more sensitive to damage from the environment such as UV light and weather
Help your hair look its best
- eat a nutritious balanced diet
- use products and styling methods that keep your scalp and hair healthy
- avoid shampooing every day as this can dry out the hair and more likely to break
- apply shampoo to keep your scalp healthy rather than thinking about it as a way to clean your hair. Scalp debris and build-up can negatively impact hair growth. Your hair gets enough cleaning when you rinse the shampoo off the scalp and out of your hair
- untangle your hair before you wash it; apply shampoo to your scalp with your fingertips and rub gently
- although shampoos and wash-out conditioners are unlikely to have any effect on the hair growth cycle or thickness, they can help your hair look and feel more shiny and manageable
- check your shampoo doesn’t contain sodium lauryl sulphate, but the more moisturising sodium laureth sulfate, or choose one without either. Ingredient jargon calls them cationic, non-ionic and amphoteric – which are milder, less irritating and leave hair even more manageable
- there is some evidence to suggest a leave-in preparation with ingredients of caffeine, niacinamide, panthenol, dimethicone and an acrylate polymer (CNPDA) can increase the thickness of the hair fibres and reduce the risk of breakage
- use protective styling techniques. Avoid regular heat styling such as hairdryers, use wide-toothed combs, and brushes with rounded tips, and avoid regular bleaching, perming and permanent dyes
Hair loss causes in women
If you start losing more hair than usual, or you suddenly lose hair, it may be due to a health condition or genetics.
Some of the common causes of hair loss or thinning in women include:
High stress levels
Stress can cause you to start shedding more hair than usual. One cause is a condition called telogen effluvium. This is the most common cause of losing hair across your scalp. It can be triggered by a period of high stress or a one-off stressful event, such as surgery or childbirth, or an illness such as COVID-19.
Telogen effluvium tends to go away in a few months after the stress has passed, and your hair will usually grow back.
Hormonal changes can affect your hair, particularly a drop in the hormone oestrogen.
This is why it’s common to lose more hair than usual for a few months after giving birth but your hair should go back to normal by the time your child is a year old.
Hair loss is also common in the menopause – when you stop having periods – when lower levels of oestrogen and progesterone mean your hair grows more slowly and becomes thinner.
Read more about menopause and hair loss.
Hair loss is a possible side effect of several medications, including certain blood thinners, chemotherapy drugs and beta-blockers.
Medication-induced hair loss is usually temporary, and your hair will grow back once you stop taking the medication.
Weight loss or diet changes
Losing a lot of weight in a short amount of time (for example after gastric band surgery) or going on an extreme diet can cause your hair to fall out. This could be because your body isn’t getting enough nutrients, particularly zinc, biotin, and high-quality protein.
Supplements containing certain nutrients – such as vitamin A, E and selenium – can actually cause hair loss. Always check the recommended daily amount (RDA) if you’re taking a supplement.
Iron deficiency anaemia
Your hair loss could be because you’re not getting enough of the nutrient iron, which can lead to iron deficiency anaemia. Other symptoms of this condition include tiredness, pale skin and shortness of breath. A blood test can check your iron levels.
Good sources of iron include dark-green leafy vegetables, meat, beans and fortified breakfast cereals.
Using a lot of hair products or heated styling tools, such as hairdryers and straighteners, is a common cause of hair loss. If you use a hairdryer, try to use it on a low heat setting.
It’s also a good idea to avoid too many chemical or colour treatments, and not to rub your hair with a towel after washing it or style it when it’s wet – these can all cause damage, and lead to breakage and hair loss.
Certain hairstyles can also lead to hair loss, as they pull on your hair. These include:
- tight braids
- tight ponytails and buns
- hair extensions
Conditions that affect the scalp
Frontal fibrosing alopecia is another inflammatory condition that can cause hair loss at the front of the scalp, above the forehead, which is sometimes permanent.
Hair loss in women can also be due to the genes you get from your parents (known as hereditary hair loss).
The most common genetic type of hair loss is female-pattern hair loss, also known as androgenic alopecia – which can also be linked to hormones.
Like male-pattern hair loss, it often begins when you're in your 40s or 50s, and is gradual. Unlike male pattern baldness, female-pattern hair loss is thinning across the whole scalp.
Autoimmune disorders such as alopecia areata start with the sudden loss of round or oval patches of hair on the scalp, but any part of the body may be affected.
Cancer treatments and hair loss
Some cancer treatments can also cause hair loss.
When to see a doctor about hair loss
Hair loss and thinning hair can sometimes be a sign of a condition that needs treatment. You should see a doctor if:
- your hair loss is sudden
- hair is coming out in clumps
- you get bald patches
- your head burns and itches
- your hair loss is worrying you, making you feel low, knocking your self-esteem, affecting your social life or confidence
- you’re worried your hair loss might suggest an underlying condition
Research into the adverse psychological effect of losing your hair has linked it to low self-esteem, depression, introversion, and feelings of unattractiveness. Hardly surprising in our image-obsessed culture.
It’s important to let your doctor know if your hair loss is affecting your mood, as they may be able to offer support or suggest treatment.
Hair loss treatment for women
In many cases, female hair loss is temporary, and your hair will grow back without treatment. If it’s caused by a medical condition, it usually stops after you’ve recovered.
However, hair loss can be very upsetting, and you may want to find techniques and treatments to help. Some measures you can try yourself, while others involve a prescription or treatment by a medical professional.
Nutrients and supplements
If blood tests show you have an iron, have an iron, B12 or folate deficiency – all of which can affect hair growth – a supplement may be recommended.
Some supplements that are marketed for hair loss aren’t necessarily helpful, as they contain a lot of just one nutrient and can lead to you taking too much which can be harmful (unless recommended by your doctor).
You should be able to get all of these nutrients as part of a healthy balanced diet. If you don't think you are getting all the nutrients you need, you could consider a supplement like a multivitamin.
Wigs and concealers
If you want to cover up your hair loss, a wide range of synthetic and real-hair wigs are available, at various price points.
There are also sprays and powders that can conceal hair loss – they’re available in many pharmacies and beauty stores. They’re often known as concealers or keratin fibre sprays, or thickening sprays. You could ask a pharmacist or dermatologist for advice on the best ones to try.
Many people also use hair extensions, make-up or scarves to disguise hair loss. You might need to try out a few things to find what works for you.
Minoxidil is a lotion you apply to your scalp to encourage regrowth, which works best if it’s used in the early stages of hair loss. You can buy it from a pharmacy. Results can take 3 to 6 months, and once you stop using it your hair loss is likely to return.
Laser caps and combs can also be used to treat hair loss at home, as can micro-needling. However, there have been few studies on their effectiveness, so they’re unproven and can be expensive.
Essential oils and scalp massage
Some small studies have indicated that massaging the scalp with essential oils such as rosemary or peppermint oil in a carrier oil can help, but more research is needed. It’s also worth doing a skin test before you apply too liberally to check for an allergic reaction.
Medication from a doctor
Depending on what’s causing your hair loss, you may be prescribed antibiotics or antifungal medication, or a medicated scalp lotion such as one containing a steroid. Some of the medications used to treat hair loss are off-license.
You also may be given spironolactone or more rarely, finasteride, which is only available on private prescription. These treatments help by blocking the side effects of hormones like testosterone. Sometimes you might use the minoxidil lotion together with tablets.
Spironolactone is a prescribed treatment for female-pattern hair loss. It can help stop hair loss and increase the thickness of the hair you still have.
Depending on the cause of your hair loss, a medical procedure may be an option. These can be effective but are often expensive. Options include:
- corticosteroid injections
- laser therapy
- hair transplant
- platelet-rich plasma
A hair transplant is usually a one-off session (unless you’re having a lot of hair transplanted), while the other treatments will need multiple sessions.
Losing your hair can have a big effect on your wellbeing and how you feel about yourself. You might find it helpful to talk to someone about how you’re feeling, such as a close friend or family member, or a support group.
Read more coping tips for women with hair loss.
Your health questions answered
Does the Mirena coil cause hair loss?
“The Mirena coil is a type of contraception called an intrauterine system (IUS) – a small device that fits in your womb and releases a progesterone-like hormone. It’s also sometimes used to as part of HRT for menopause (read about the Mirena coil and the menopause).
Like any medicine, it can cause side effects, and in rare cases, this may include hair loss. Mirena product packaging lists hair loss as a side effect reported in less than 5% of people. If you’re using Mirena and you notice hair loss, see a doctor so they can check the cause and advise you about your options." – Answered by: Healthily’s medical team