Style Shedding Light on Shedding: How I Navigated Female Hair Loss

00:30  23 september  2021
00:30  23 september  2021 Source:   vogue.com

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  Shedding Light on Shedding: How I Navigated Female Hair Loss © Photo: Getty Images

I wake up, brush the loose hairs off of my pillow and take a cool shower, delicately washing and conditioning my hair with personally customized products from Prose before letting it air dry. I unclog the dark clump from the drain and clean up all the hair from the sink after brushing through a Curlsmith weightless air dry cream. Then I head into the kitchen to eat a few handfuls of nuts and take Nutrafol hair supplements. Thus has become my daily routine as I try to improve the health of my hair and rebuild my confidence since this overactive hair shedding began several months ago.

I am not alone: female hair loss is on the rise in the high-stress mid-pandemic world we live in. This is not the first time I have experienced thinning strands, but it is the first time I feel brave enough to share my story in hopes of shedding light on the well-kept secret of female hair loss that in fact touches many of us.

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Primarily thought to be a men’s issue, hair loss affects approximately 40% of women by age 50, according to a 2015 study in the Journal of the American Academy of Dermatology. Even though a high number of women are affected, many are so embarrassed that they never go to a doctor. Why is male hair loss so openly discussed and treated while women suffer in silence?

Societal pressure for women to have long, full hair dates all the way back to biblical times: The phrase “crowning glory” is believed to originate from 1 Corinthians 11:15: “if a woman have long hair, it is a glory unto her.” Throughout history, a healthy head of hair has been associated with femininity, fertility, youth, and beauty. In Victorian times, long beautiful hair was so highly prized in art, literature and popular culture that it was believed to hold a woman’s magical powers and contain her vitality. So it’s no surprise that when a woman starts shedding more hair than usual, she may feel like they are losing part of their identity. As board certified dermatologist Dendy Engelman tells me, “I have had more women break down in tears in my office when talking about hair loss than when discussing a cancer diagnosis.”

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I spoke with Dr. Gillian O’Shea Brown LCSW, Psychotherapist and Adjunct Professor of Trauma at New York University to dive deeper into the symbolism of female hair and the traumatic effect that losing it can have on the psyche. “I have seen firsthand the link between stress and hair loss,” she explains. “Anything that negatively affects our mind, emotions, or body can affect our hair. I have treated clients who in the past have undergone a really stressful time in their life and then months later start to notice thinning of the hair or the development of hair loss. Trauma not only impacts mental health, but also deeply impacts physiological well-being and overall health.” When hair thinning is brought on by a stressful event, a person must deal with the initial trauma of the event but also the trauma that occurs when losing their hair.

Although I can’t pinpoint the exact moment my increased shedding started, I do remember when I noticed it. I was dealing with the grief of losing loved ones, feeling scared and unsure about the state of the world, and experiencing complete culture shock after moving away from my beloved New York City. I had to make new friends in the middle of a pandemic, and I felt so insecure about the way I looked because of my hair. I didn’t know who this person was; my self-confidence plummeted. Staying home was not a problem because I didn’t want to be seen in the world. I wanted to hide away.

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For patients experiencing this type of distress, O’Shea Brown gravitates towards “grounding techniques to empower [a patient] to manage their stress symptoms outside of the therapy room,” she says. “Though we as therapists cannot take the pain away, we can take that walk with you.”

But before seeking treatments, it is important to find out what type of hair loss you are dealing with.

What are the different types of female hair loss?

Engelman explains how the hair cycle is a four phase process: Anagen (growth), Catagen (end of growth cycle), Telogen (dormancy), and Exogen (shedding). Each hair follicle goes through this process at different times, otherwise we would lose all of our hair at the same time before it started to grow again. There is no exact “normal” number of hairs shed per day—it depends on the individual. But if your normal seems to have changed, and you’re finding extra hairs on your pillows, clothing, and even falling into your food, it could mean your hair growth cycle has been disrupted.

According to Joshua Zeichner MD, Associate Professor of Dermatology at Mount Sinai Hospital, female pattern hair loss, or FPHL, is polygenic, meaning that it’s likely caused by a combination of genetic factors from both your mom and your dad, though other factors can contribute to hair loss. “It is important to understand whether hair loss is caused by genetics alone or whether there are contributing medical factors involved,” Zeichner adds. Medical factors might include hormonal changes that occur during perimenopause, menopause and post-partum, as well as stress, illness, weight loss, and even gut health.

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Zeichner explains that alopecia—the partial or complete loss of hair—is typically divided into scarring and non-scarring cases. Scarring alopecia is caused by an inflammatory process that leads to scars around the follicles with permanent damage. “If you notice red patches, significant itching or scabs associated with hair loss it is important to visit a board certified dermatologist right away,” Zeichner says. “Early treatment can prevent worsening.”

Androgenic alopecia, or nonscarring alopecia, is determined by genetics. The hair thins out in the front and top of the scalp and the part appears to get wider. This type of thinning may also be seen in conditions where there are elevated hormone levels like in polycystic ovary syndrome (PCOS). Anagen effluvium is a nonscarring alopecia that affects the follicle in the growth stage when hair suffers a toxic shock (such as chemotherapy), fracturing the shaft in its active growth stage.

Stress can play a big role in female hair thinning and loss. The Mayo clinic describes

Alopecia areata as hair loss where the immune system attacks the hair follicles, causing additional shedding. Then there’s Telogen effluvium, or TE, a condition where a physical or emotional stress leads to a rapid shedding of the hair, especially along the temples and sides of the scalp. The stress shocks hairs into a resting phase, and they fall out. “While we treat telogen effluvium like other forms of hair loss, the good news is that in this case, the hair generally corrects itself on its own over the course of a few months,” says Zeichner.

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How can you treat female hair loss?

Regardless of the cause, the goal of treating thinning hair is to encourage the hair follicles to function to the best of their ability. It’s important to have realistic goals: Of course I want my hair to go from puny shedding strands to 1970’s-style Cher goddess hair, but alas, I know that is not going to happen. Before starting any treatment, it is important to consult with your dermatologist to make sure the treatment path you decide is the one that is right for you.


In the past, and during this particular bout of shedding, I took Nutrafol, a supplement that contains a combination of botanical ingredients and vitamins to support healthy hair follicles. It is formulated to treat hair loss in multiple ways, containing highly-concentrated botanicals to support hair at every stage of the growth cycle, Engelman explains. She also recommends Prose, particularly their Root Source product for those with thinning hair. “The supplements are custom-made for each person, and they’re packed with vitamins, minerals, antioxidants and plant extracts designed to boost our stores of nutrients and target the causes of thinning hair. They have been proven effective in clinical trials, and are a fantastic—and healthy—way to address hair thinning/loss,” she says.

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In-Office Treatments

Engelman also recommends PRP, or Platelet-rich plasma treatment, which is done in-office by a board certified dermatologist. It involves drawing the patient’s own blood, processing the enriched cells, and injecting them back into the scalp. The plasma contains proteins that stimulate hair growth naturally. “This is a great method of hair growth because it is effective, doesn’t require downtime, and has minimal to no side effects in most patients. The procedure can be repeated once a month, and once the desired hair growth is reached, it is recommended that the patient return for treatments every 6 to 12 months to maintain results,” Engelman notes.

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Over the Counter

Minoxidil, a treatment applied directly to the scalp, is thought to work by dilating blood vessels to improve circulation to the scalp. There are specific formulations for women, and a foam that can be easily applied. Zeichner notes that Minoxidil may also extend the active growth phase of the hair follicle.

Prescription Pill

Zeichner adds that the prescription pill Finasteride can be used to treat both male and female pattern baldness. “It blocks conversion of testosterone to its more active form called DHT,” he explains. “We don't understand why, but high DHT is thought to be associated with hair thinning in both men and women. It should not be taken in women who are looking to get pregnant.”

At-Home Laser Therapy

The Capillus hair regrowth laser cap is FDA cleared for the treatment of androgenetic alopecia at home. The cap uses 100% medical grade laser diodes to stimulate and renew cells within the hair follicle for thicker, healthier hair. Wearing it for six minutes a day can help reboot the blood supply to the scalp. According to Engelman, “There are real data to support the efficacy of [this treatment] aiding hair growth. I prefer hair caps to light emitting hair combs because patients tend to be more compliant with the caps. Both use the same technology to deliver the red light energy to the scalp to help support hair growth. The trick however is to continue with daily use and not to slack once you start to see desired results.”

Specially Formulated Styling Products

Choosing your styling products wisely is another important step that is often overlooked, and something I neglected to take into account the first few months that I noticed my recent hair shedding. But lately I’ve turned to Curlsmith, which has a line of hair-care products formulated with nutrients like keratin, collagen, biotin and natural actives to make hair grow longer, fuller, and healthier. Philip Kingsley Trichnotherapy also has a line of four products engineered to address hair thinning, including a volumizing protein spray with antioxidants to help improve the appearance of your hair.

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  Shedding Light on Shedding: How I Navigated Female Hair Loss © Provided by Vogue

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After six months of noticeably thinner and thinner strands, I am finally starting to see some good hair days on the horizon. I can blow dry and style my hair without leaving the sink covered in shed strands, and some days I actually like my hair. Engelman reminds me that patience is important: it can be anywhere from three to six months before you start to notice a difference in shedding and growing. But the journey can only start once you speak up and seek help—you’re not alone in this.

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