Girls, is your head bald? Is there a lot of hair loss?

When you comb your hair in the morning, is your hair all over the comb? When you finish showering, is your own hair all over the bathroom floor? When you put your ponytail back on, is it not even half the size it used to be? Samanmali doesn't even feel like going to the mirror in the morning because of this hair problem. If you're suffering from this situation, you're not alone. In fact, many women have this problem. But instead of thinking, "Oh, it's not just me," and feeling sad, isn't it important to know why this is happening and what we can do about it?

Many people think that hair loss is only for men and that it doesn't concern us. But look, that's not the truth. It is said that more than half of women will face the problem of hair loss at some point in their lives, that is, significant hair loss! So, this is not a problem that only affects you. But, if you know exactly what causes it and what you can do about it, it's better than just being scared, right?

What exactly is "female pattern hair loss"?

Simply put, if the number of hairs that fall out of your head per day is much higher than normal, that's what we call " hair loss . " According to doctors, losing about 50 to 100 hairs per day is normal. It's natural. Just like old leaves fall off a tree, our old hairs fall out and new hairs grow in their place. This is a great system in the body. But the problem starts when this balance, that is, the balance between the amount of hair that falls out and the amount that comes in, is lost. If you lose more than 125 hairs per day, or if your hair looks like it's empty in places, or if your hair feels much thinner and thinner than it used to be, that's a condition that needs some attention. In medicine, there is a beautiful name for this, "Alopecia."

We have hair almost everywhere on our bodies, right? Everywhere except our palms, soles of our feet, lips, and eyelids! Some hairs are very fine, cottony, and short. They are called "vellus hair." The other type is called "terminal hair." These are the long, thick, black hairs on our heads that we love to grow.

How our hair grows: A little science lesson!

Our hair doesn't just fall from the sky and just fall out, right? It happens in a very orderly, regular cycle. There are three main stages to this cycle. Let's see what they are.

The growth phase, called "anagen," is very short for short hairs like our eyelashes and the hair on our arms and legs. But the hair on our heads can grow for six years, and in some people even longer! Isn't that amazing?

Every woman's hair is different!

Yes, this is also something you need to know. Not everyone's hair falls out the same way, for the same reason. There are three main types that we can see:

1. Androgenetic Alopecia / Female Pattern Hair Loss (FPHL): This is the most common type. Hair usually starts to thin on the top and sides of the head. Some people may notice a gradual thinning of the frontal hairline (also known as the "crown"). This is also influenced by genetics.
2. Anagen Effluvium: This occurs when the hair follicle is suddenly damaged during the "anagen" phase of hair growth. For example, strong medications such as chemotherapy for cancer can cause this type of hair loss. In this case, hair falls out very quickly, often from the entire head.
3. Telogen Effluvium: This is when a large number of hairs on the scalp suddenly enter the "resting" phase called "telogen" and fall out after a few months (usually after 2-3 months). Instead of the usual 100 hairs falling out per day, in this case, 300 or even 500 hairs can fall out per day. Imagine the fear! The following are possible causes:
   • Severe stress – Something that is difficult to bear, such as an upcoming exam, a major problem at work, or the loss of a family member.
   • After childbirth.
   • After a major operation.
   • When you suddenly lose weight (like crash diets).
   • Certain illnesses (e.g., sudden increase or decrease in thyroid function, severe fever).
   • When using certain medications.

Really? Do many women have this problem?

Oh yes! Even though we don't know it, this is a very common thing. While many people think that hair loss is limited to men, studies have found that more than 50% of women will experience significant hair loss at some point in their lives. Especially the aforementioned condition called FPHL (Female Pattern Hair Loss) is the most common among women. So, it's a bit of a relief to know that you're not alone, right?

How to recognize hair loss? - Let's identify the symptoms!

Sometimes we find ourselves thinking, "Oh, my hair is falling out too much, what's going on?" But what exactly are the symptoms of this? Let's take a look.

• More hair than usual, hair everywhere: look on your pillow in the morning, look on the bathroom floor when you shower, if hair clumps on the comb when you comb your hair, that's the first signal.
• Hair becomes thinner, scalp becomes visible: The hair becomes wider in places, especially at the parting line in the middle of the head, and the scalp becomes visible through it. The thickness that was there before is no longer there.
• The ponytail has become small and thin: If your ponytail, which used to be big and tight, now feels so thin and small that you can't even hold it in your hand when you tie it.
• Hair breakage: The hair strands do not fall out first, but instead break more at the middle and ends. The hair feels lifeless when touched.

Oh, why is my hair going like this? - Not one reason, many!

Rather than complaining, "Why is this happening to me?", wouldn't it be wiser to find out what's causing this? Actually, there's not just one reason for this, there can be many reasons. Let's take a look at the main ones.

1. Self-inflicted damage to the hair follicle:
   • Tying your hair too tightly: Some people wear their hair very tightly, such as in ponytails, braids, or buns. When you pull your hair too tightly, it can damage the roots of the hair shaft and cause a condition called "traction alopecia." Over time, hair may stop growing from those areas.
   • Harsh Chemical Treatments: Frequent hair relaxing, perming, and coloring with harsh bleach can weaken the hair roots, causing hair to break and fall out.
2. Food and drink and the chaos of our lifestyle:
   • Rapid weight loss : Some people go on a crash diet to lose weight quickly. Even though they lose weight suddenly, their body may not get the nutrients it needs and they may start losing hair.
   • Stress : This is a problem that affects many people these days. Excessive stress can cause the condition called "telogen effluvium" mentioned earlier. If Nimal feels like his hair is falling out too much as exams approach, stress could be the main reason for it.
   • Vitamin and mineral deficiencies: Hair loss can occur when the body does not get enough iron, zinc, vitamin D , and vitamin B12 . This problem is especially common in people with anemia.
3. Medical treatment and other internal illnesses:
   • Chemotherapy or Radiation Therapy: We all know that these treatments for cancer cause hair loss (anagen effluvium).
   • Thyroid problems: Both high (hyperthyroidism) and low (hypothyroidism) thyroid hormone levels can cause hair loss. This is common among women.
   • Other medical conditions: Alopecia areata (patchy, circular baldness) and some scalp infections (such as fungal infections) can also cause hair loss.
4. Hormonal Changes:
   • Pregnancy and postpartum: Some people have very beautiful, thick hair during pregnancy. But after a few months of having a baby, their hair can suddenly start to fall out. This happened to Malini after having a baby, and she thought her hair would never grow back. But it went away after a few days. This is usually temporary, don't worry.
   • Menopause: During this time, women's hormone levels also change dramatically. Hormones like estrogen decrease. As a result, hair can become thinner and fall out more.
5. Effects of some medications and supplements:
   • Some medications for high blood pressure, medications for gout, some antidepressants, and taking too much vitamin A can also cause hair loss in some people.
6. Things that come from our genes (Genetic Predisposition):
   • If your mother, grandmother, or aunt had a history of hair loss at a young age, you may be at a slightly higher risk. This is the main cause of a condition called FPHL (female pattern hair thinning).

What happens to hair during menopause?

Menopause is a time of great change in a woman's life, isn't it? During this time, the levels of hormones like estrogen in the body decrease. These hormonal changes directly affect the hair.

• Some people start to grow new hair in areas where there was no hair before, such as on the face and chin.
• Also, the hair on your head starts to thin and become thinner. This is because the hair follicle gradually shrinks, and the hair that comes out of it also becomes thinner and less dense than before.

Who is most at risk of this hair loss?

Although hair loss can affect women of any age, some people are at a higher risk.

• If someone in your family has it: If someone in your family (especially your mother or sisters) has hair loss problems, you may also have a bit of that "inheritance".
• After age 40: The likelihood of this problem increases slightly with age.
• After pregnancy: For a few months after having a baby.
• For those undergoing treatments such as chemotherapy or radiation therapy.
• For women who are going through or have gone through menopause.

How does a doctor diagnose this exactly?

If you are concerned that you are losing too much hair, the best thing you can do is to see a doctor, preferably a dermatologist. He or she will examine you thoroughly, take a detailed history, and try to find out what is causing it. They will also ask about any medications or vitamins you are taking.

What test is done for this?

Sometimes, you may need to do a few tests to find the exact cause. Don't worry, these are not serious issues.

1. Pull Test: The doctor will pull a small section of your hair. The doctor will then look at the number of hairs that come out and give you an idea of ​​the nature of the hair loss.
2. Scalp Examination: The scalp and hair roots are examined using a microscope or a special lens (dermatoscope). This allows you to accurately assess the condition of the hair follicles, whether there are any infections on the scalp, and whether there are any scabs (scabies).
3. Blood Tests: This is a very important test that is done frequently. It checks for:
   • Iron levels (Serum ferritin) – Check for anemia. This can be a major cause of hair loss.
   • Essential nutrient levels such as vitamin D, vitamin B12, and zinc.
   • Thyroid hormone levels (TSH, T3, T4).
   • Sometimes hormone levels such as androgens (if there is a suspicion of a FPHL condition).
4. Scalp Biopsy: This is not done for everyone. Only if other tests fail to find a cause, or if a specific condition such as alopecia areata is suspected, a small piece of skin (usually a small circle of about 4 mm) is taken from the scalp and examined under a microscope. A small numbing medicine is applied to the area before this is done, so it is not very painful.

Some questions the doctor may ask you

A doctor may ask you questions like these. Giving accurate, truthful information can help a lot in finding the cause.

• "What hair products do you use for your hair? (Specify things like shampoo, conditioner, oil, hair spray, gel)"
• "How do you wear your hair? What hair styles do you often wear? (Do you wear it very tightly, do you use heat styling?)"
• "Some people have a habit of pulling their hair out when they are alone, like with their fingers. Do you have that habit (also called trichotillomania)?"
• "Has anyone in the family – mom, dad, siblings, grandma, grandpa – lost their hair?"
• "Have you experienced any major stress, sadness, or trauma in your life in the past 6 months? (e.g. exams, job problems, family problems, loss of someone)"
• "What medications, vitamins, and supplements do you currently take daily? (Tell me even if it's just a little bit)"
• "Have you ever had hair like this before? If so, did you find out what caused it? What were you doing during those days?"
• "What is your eating pattern? How many times a day do you eat? Do you eat a good amount of nutritious foods (vegetables, vegetables, fruits, meat, fish, eggs)?"
• "How long have you noticed your hair has been falling out like this? Did it start all of a sudden, or gradually?"
• "Is the amount of hair falling out more than usual? (How much is on the pillow, on the bathroom floor, on the comb? Does it come off when you touch it?)"
• "Apart from the scalp, do you also lose hair on your eyebrows, arms, and other parts of your body?"
• "Do you feel like your hair loss increases when you do certain things (e.g. certain foods, certain hair products, certain oils)? Or does it seem like it decreases?"
• "Does your hair continue to grow, or is there a pattern where it stops after a while?"
• "Do you notice a change in the texture of your hair? (Is it thinner than before, does it break easily, is it dry, or does it have split ends?)"

See, the answers to these questions can help the doctor get a good idea of ​​the cause of your condition, just like a detective!

So what do you do about this? - Let's learn about the treatments without fear!

The best thing to do is to find the exact cause of your hair loss and treat it accordingly. There is no one-size-fits-all treatment. It depends on the cause of your hair loss, your age, your health, and other factors.

1. Lifestyle changes and small things you can do at home:
   • Managing stress: You can reduce stress by doing things like yoga , meditation, engaging in a hobby you enjoy, and getting enough sleep. If necessary, talking to a mental health professional can also be very helpful.
   • Avoiding things that are harmful to your hair: Avoid wearing your hair too tightly, and avoid harsh chemical treatments (relaxing, perming, excessive bleaching) as much as possible. If you use heat styling (hair dryers, straighteners, curling irons), use a heat protectant spray and keep it on the lowest heat setting.
   • A nutritious, balanced diet: It is very important to eat a diet rich in iron, zinc, protein, and vitamins (especially Biotin and Vitamin D). Include greens, vegetables, fruits, nuts (like almonds and walnuts), eggs, and fish in your diet.
   • Soft hair care: Be gentle and gentle when washing and combing your hair. Use sulfate-free, mild shampoos and conditioners. Do not pull or comb wet hair too hard, as hair is very sensitive at that time.
2. Vitamins and Supplements:
   • Only if a blood test confirms that you have a vitamin deficiency (e.g. Iron, Vitamin D, Biotin), will your doctor prescribe the right vitamin or supplement. It's best not to just go to the pharmacy and buy vitamins at your convenience, because taking too much of some vitamins can be harmful to your hair (e.g. Vitamin A).
3. Medical Treatments:
   • Minoxidil (also known as Rogaine®): This is the most commonly used FDA-approved medication for female pattern hair loss (FPHL) in women. It is available over-the-counter (OTC) as a 2% or 5% solution or foam. It should be applied to the thinning areas of the scalp once or twice a day.
     • Things to know: Once you start using Minoxidil, it can take 3-6 months to see results. You need to keep using it. If you stop, the new hair that has grown back may grow back. So talk to your doctor before you start.
     • Are there any side effects?: Some people may experience itching, flaking (like scabs), redness, and dryness of the scalp. If this happens, tell your doctor. Rarely, hair may grow on areas other than the scalp, such as the face and forehead. So be careful when shaving, wash your hands thoroughly, and wash the areas that come into contact with it.
     • Minoxidil is not suitable for pregnant women, those trying to become pregnant, or nursing mothers.
   • Anti-androgens (for example, Spironolactone): These medications reduce the activity of male hormones called androgens in our bodies. Doctors sometimes prescribe these for FPHL, especially if hair loss is associated with conditions like PCOS (Polycystic Ovary Syndrome). These should only be taken under the guidance of a doctor.
   • Finasteride: This is actually a medication for male pattern baldness. However, in some special cases, such as postmenopausal women, when other treatments have failed, doctors may prescribe it with great caution. It is not recommended for women of childbearing age, as it can cause serious birth defects if a male child is conceived.
   • Corticosteroids: If hair loss is caused by autoimmune conditions (where the body's immune system attacks its own cells), such as alopecia areata, doctors may prescribe steroid injections into the scalp or a topical cream.
   • Treating an underlying medical condition: If it is determined that your hair loss is due to something like a thyroid problem or anemia, treating that condition properly can help control your hair loss.
4. Other Advanced Treatments:
   • Low-Level Laser Therapy (LLLT): This involves directing low-level laser beams at the scalp, stimulating the hair follicles, much like waking someone up from sleep. There are devices that can be used at home, such as the HairMax Lasercomb® and Theradome LH80 PRO®. Some dermatology clinics also offer this treatment. These are also FDA-approved for FPHL.
   • Microneedling: This involves creating tiny holes in the scalp with a roller or pen that has many tiny needles. This is said to stimulate the hair roots, improve blood circulation, and help hair growth. It is sometimes combined with Minoxidil liquid, so that the medicine is better absorbed.
   • Platelet-Rich Plasma (PRP) Therapy: This is a relatively new treatment. In this, a small amount of your own blood is taken and the plasma, which is rich in platelets and growth factors, is separated using a special machine. The precious PRP is then injected into the thinning areas of the scalp with a very fine needle. This is also believed to stimulate hair growth. Usually, several treatment sessions are required, about once a month.
   • Hair Transplant Surgery: This can be a good solution for those with permanent hair loss, such as FPHL, who have not responded to other treatments. In this, hair follicles (follicular units) are taken from a thick area of ​​the scalp, such as the back of the head, and are very delicately transplanted into areas where there is no hair, i.e. bald spots. This is a somewhat expensive and time-consuming process, but the results are usually permanent.

Very important: A doctor should decide what treatment is right for you. It's best not to just listen to what others say and do what you feel. Especially if you are pregnant, trying to get pregnant, or going through menopause, some treatments may not be right for you. So before starting anything, talk to your doctor carefully and choose what is best for your situation.

If hair loss is caused by temporary causes, such as stress or hormonal changes during pregnancy, then most of the time no special treatment is needed. Once the cause is gone, the hair loss will stop on its own after a while, and your hair will grow back as beautiful as before.

If I need treatment for this, who should I go to?

Women's hair loss problems are usually treated by a dermatologist, who has the best knowledge about this.

Oh, can't this hair be stopped from growing?

To be honest, it's difficult to prevent all types of hair loss. For example, it's difficult to completely stop a condition like FPHL that runs in families. However, there are some things we can do to control or delay hair loss as much as possible.

• Avoid Harsh Chemical Treatments for Hair: Avoid damaging your hair by frequently applying harsh chemicals to your hair (relaxing, perming, excessive bleaching), and stay away from them as much as possible. Give priority to natural products.
• Healthy, nutritious diet: As mentioned earlier, make sure you eat a diet that provides your body with the nutrients it needs (vitamins, minerals, and protein). Sunethra eats vegetables, fruits, and nuts every day, which is why her hair is still very healthy and beautiful.
• Mild Hair Care: Use sulfate-free shampoo and conditioner that are gentle on your hair.
• Stress Management: Follow methods to reduce stress. Keep your mind relaxed.

What will the future be like? Will this really be good?

This depends entirely on what type of hair loss you have, how severe it is, and how quickly and properly you start treatment.

• Some hair loss conditions (e.g. telogen effluvium) are temporary. Once the cause is removed, hair will grow back within a few months.
• Conditions like FPHL are usually progressive, permanent conditions. But if treatment is started early, it can slow down the rate of hair loss and even regrow some hair. It may not be completely back to normal.
• If the hair follicle is permanently damaged (e.g., some types of scarring alopecia, where hair falls out in a scar-like manner on the scalp), hair will not grow back in those areas.
• When an underlying medical condition (e.g. thyroid) is properly treated, it can lead to better hair growth.

Therefore, it's best not to panic, but to see a doctor and ask what the future holds for your condition.

A few tips to help you cope with hair loss

Losing your hair is not easy, and it can have a huge impact on your mental health. It can lead to low confidence and social anxiety. However, there are small things you can do to help you cope.

• Hair coloring: When you dye your hair, especially when you add highlights, it adds volume to your hair and makes it look fuller than it actually is.
• Head massage: While washing your hair, or just when you're just relaxing, gently massage your scalp with your fingertips. This will improve blood circulation to the scalp and stimulate hair follicles. It's even better if you massage it with a little coconut oil.
• Changing your hair style: There are hair styles that can make your hair look thinner. For example, cutting your hair short, adding layers, and combing it to the side can add fullness to your hair. After Nimali cut her hair short and added layers, she received a lot of positive feedback, and her confidence increased. Seek advice from a good hair stylist.
• Volumizing Shampoos and Products: Use products like shampoo, conditioner, and mousse that add volume and fullness to your hair. Choose mild products that are sulfate-free.
• Scalp Concealers: To reduce the appearance of scalp, you can use powder, spray, or fiber-based scalp concealers that match your hair color. While these are temporary solutions, they are very useful when you need to go out in an emergency.
• Wigs, Hairpieces, or Extensions: If your hair is very thin or if you are balding, you may want to consider using wigs, hairpieces, or extensions. These days, you can find wigs that look very natural and are of good quality.
• Support Groups: Talking to others who are going through the same thing as you and sharing experiences can be a great source of strength. You can also find these groups online.

When should I see a doctor?

If you notice any of these things, see a dermatologist as soon as possible:

• If suddenly, for no apparent reason, a lot of hair starts to fall out.
• If the hair is thinning in patches (patchy hair loss), or if the hair appears to be balding in circles.
• If there are other symptoms of dandruff, such as itching, pain, redness, peeling, and blistering of the scalp, along with the hair.
• If you are very worried and scared about this, don't worry and grieve alone.

Remember, the sooner you start treating hair loss, the better your chances of seeing results! If it's too late, there may be less to do.

What are the most important questions to ask the doctor?

When you go to see the doctor, it's a good idea to write down some questions on paper. That way, you won't forget anything. For example, you can ask questions like these:

• "Doctor, what could be the main reason why my hair is falling out like this?"
• "Can you guess how many hairs I usually lose per day? Is this normal?"
• "What type of hair loss do I have? (FPHL, Telogen Effluvium, etc.)"
• "Is this a permanent condition? Or will my hair grow back? To what extent?"
• "What treatment method(s) are best for me? What kind of results can I expect from them?"
• "Are there any side effects from these treatments?"
• "How long will it take to see results? How long will I need to take treatment?"
• "What special things can I do at home to protect my hair and control this condition?"
• "Are there any things I should pay special attention to when eating and drinking? Are there any foods I should avoid?"
• "Do the things I use like shampoo, conditioner, and hair oil affect this? Should I change them?"

So, friends, I hope you have gained a clear idea and a little strength about this somewhat sensitive topic of hair loss in women. Remember, hair loss is a problem for everyone. However, there can be many reasons for this, and the treatments that can be done have also improved today. The best thing to do is to talk to someone who knows about this, especially a dermatologist, rather than suffering alone. Treat your hair with love, and take care of yourself!