Sudden Hair Loss in Women: The Good, The Bad, & The Unpleasant
Women, more than men, are susceptible to sudden bouts of hair loss often characterized as ‘hair shedding’ or ‘losing clumps of hair.’ With men, not so much. For them, 95-percent of all hair loss is genetic hair loss–male pattern baldness caused by, well, a male hormone. In women, hair loss is roughly divided in half between genetic causes, and non-genetic causes. Those two causes can also be categorized as permanent, and temporary.
The good news with sudden hair loss is that the cause, most likely, is non-genetic and therefore, temporary. You can treat temporary hair loss to foster quicker passage through the hair growth cycle; or, you can wait, do nothing, and you will still see significant improvement in in three to six months.
To understand sudden hair loss better, we can see it more clearly with an understanding of its counterpart—permanent hair loss. Genetic hair loss is not sudden, it is gradual, and takes a much longer time before it is even noticeable. When genetic hair loss does occur, it is most often in women who are in their late 40s and early 50s, and is preceded by that major life event, menopause.
The Hair Growth Cycle
Our hair, all of our hair, regardless of any predisposition for hair loss, has a three-stage cycle:
Growth Phase—Approximately 85 percent of the hair on your head is in the growing phase at any given time. This phase, in which it ‘thrives,’ can last two to six years. Our hair grows at the rate of five to six inches per year, and any individual hair is unlikely to grow more than one yard long; and growth means it is thriving. Time period = 2 to 6 years. Scientific name=Anagen Phase.
Transitional Phase—When the growth phase comes to an end, a hair shaft will first progress to a transitional phase, which only lasts one or two weeks. During that time, the hair follicle shrinks to about 1/6th of the normal diameter. The “root” is diminished and the dermal papilla breaks away and rests below the scalp. Time period = 1 to 2 weeks. Scientific name=Catagen Phase.
Resting Phase—After the transition phase, hair goes into the resting, or dormant phase. This period can last five to six weeks. Although the hair does not grow during this stage, the dermal papilla stays in the resting phase below the scalp. Approximately ten to 15 percent of all hairs on your head are in this resting phase at any given moment. At the end of this stage, the hair follicle reenters the growth phase. The dermal papilla, and the base of the follicle, join together again and a new hair shaft begins to form. In some cases, the new hair will push the old hair out of the way and the hair growth cycle starts all over again. Time period in 3 units: days = approximately 100 days; weeks = 12 to 16 weeks; year = 1/3 of a single year. Scientific name=Telogen Phase.
Hair does not go through the hair growth cycle in patches, sections, or zones. Each hair can be in a different stage of this cycle in relation to adjacent hairs.
As with male pattern hair loss, and genetic hair loss—read permanent hair loss—understanding the natural hair growth cycle is the shortest route to understanding why ‘sudden hair loss’ is often ‘temporary hair loss’—making it less to worry about than first feared.
Non-Genetic Cause of Hair Loss
Non-Genetic causes of female hair loss are sub-categorized under seven factors:
- Nutritional (diet, low iron, low zinc, too little vitamin A, too much vitamin A);
- Hormonal (read – recently having a baby is the most common cause);
- Medication (side effects of certain drugs);
- Emotional Stress (death of parent – spouse – or child, loss of job, divorce, custody battle);
- Illness & Physical Stress (thyroid disease, lupus, cancer, hospitalization, high fever, surgery, physical injury, injury with decrease in mobility or function, et cetera);
- Hair Diseases: alopecia areata, alopecia totalis, alopecia universalis, and tinea capitis;
- Traction Alopecia (tight hairstyles, binding hair into tight rows, faulty hair weaves, and chemical processing, as in too much dye or caustic hair straightener. This sub-category also includes trichotillomania.)
Nutritional: Nutritional problems stemming from a poor diet, weight loss surgery, pregnancy, and/or recently giving birth are the most common cause of sudden hair loss in women. According to a study conducted on 153 women from 1995 to 1998, iron deficiency was the number one cause of sudden hair loss in women. Low iron levels were often caused by a pregnancy in which there was a sudden drop in iron and ferritin levels, which initiated sudden loss.
“Blood loss during and after birth may cause a woman to become iron-deficient, which may result in anemia or hair loss,” reports HealthWise.com. (2)
Please see our article: iron deficiency induced hair loss to learn more.
Hormonal: As with a drop in iron, pregnancy, and a sudden shift in hormone levels, is a another common cause of sudden hair loss. During those entire nine-months of pregnancy, female hormones are going up-up-up. From the highest point imaginable, there is a steep drop. That sudden shift can be problematic when it comes to hair. The International Society of Hair Restoration Surgeons, a leading hair loss and hair restoration organization, explains why that is:
“The hormonal changes following pregnancy can cause an abnormal number of hair follicles to shift into [transition] phase…once the placenta is delivered, with subsequent drop of high estrogen level, more hair shifts into the [dormant] phase in the months following the pregnancy.
“Unfortunately, women get it from both barrels following delivery: hormonal shift is one, the emotional stress and physical toll it takes on them is the other. We’ll examine that right after Medication induced hair loss.
Medication: There are two types of hair loss that occur due to medications: Anagen Effluvium and Telogen Effluvium.
Anagen Effluvium: Sudden and heavy hair loss that usually results from chemotherapy drugs in the antineoplastic agent class.
Telogen Effluvium: Telogen Effluvium, in general, describes any hair loss where more hairs than normal (normal is 50 to 100 a day) go into the dormant phase of the growth cycle. Nearly all forms of non-genetic, temporary, or transient hair loss are classified as (telogen effluvium). As it applies to medication, telogen effluvium describes a type of hair loss that was slower, and is a direct cause of non-cancer related medication such as birth control pills, blood thinners, some anti-depressants and anti-psychotics, gout medicine, and drugs for high blood pressure or heart disease.
Emotional Stress: A highly emotional and stressful event such as the loss of a parent, spouse, or child, job loss, financial stress, a new baby, and divorce can actually cause excessive hair loss. The strange thing about stress and hair loss is that the stressful event usually precedes the hair loss by three months. That means, by the time you notice your hair falling out, the emotionally taxing event could already be over (hopefully). According to the American Hair Loss Council, a second, three-month deferral is tacked on to the end of that one. “There may be another three month delay prior to the return of noticeable hair regrowth.”
Why the three month time lag to lost hair, and three months for regrowth? It goes back to thriving, then transitional, and then dormant cycles of hair growth explained above.
There are two important things to think about with stress and hair loss: 1). why stress plays a role, and 2). to never self-diagnose yourself with stress related hair loss.
1) The Why: Our hair plays no major role in our life anymore. We have it now because at one time, centuries ago, hair was needed to keep our heads warm–because we lose heat through our head–and to keep our scalp from being sunburned. In modern time, however, we can live and function in a healthy way without our hair.
Physical and emotional stress related hair loss occurs because our hair has a lower priority to receive our ‘natural resources.’ All of the restorative benefits our body receives during that stressful period –sleep, nutrition, grief derived growth–go toward the most important problem with which we are coping. Your body’s built-in, ‘self-healing process’ considers your other problem(s) so important, that it concentrates on that issue, and ignores your hair.
It’s as if your body is saying, “I’ve got bigger problems to worry about and soothe, I don’t need to worry about hair growth right now.”
And that is why, according to the British Journal of Dermatology, we have stress and/or medication related telogen effluvium, which is when “…a sudden or stressful event can cause the hair follicles to prematurely stop growing and enter into a resting phase.” (1)
2) The Never: The second most important thing to remember about stress and hair loss is to avoid giving yourself a self-diagnosis and regard your sudden hair loss as “stress related,” because it may not be. Your sudden hair loss could be related to other health related issues, physical and emotional.
“I have diagnosed nine women with systemic lupus, who did not know they had lupus but presented to the office because of thinning hair,” Lynn Drake, MD reported in article for Dermatology Times. (6)
On the mental health side, emotional stress can lead to trichotillomania, a compulsive disorder where stress leads one to twist and/or pull on hair until it is damaged and breaks off, leading to uneven hair growth. Often, this is done without thinking or direct intent. It is a nervous reaction to anxiety, something we do to soothe ourselves during a crisis.
Trichotillomania is seen more often in women and children, but more in children who have not learned efficient anxiety coping strategies. (Read – breathing exercises, relaxation techniques, et cetera.) Learn more about anxiety coping skills from the book: The 10 Best-Ever Anxiety Management Techniques: Understanding How Your Brain Makes You Anxious and What You Can Do to Change, by Margaret Wehrenberg Psy.D.).
Illness and Physical Stress: Much like emotional stress, physical stress to our body, such as a major illness or accident, can cause stress related hair loss. Here again, we are reminded that our hair today serves no vital function. When your body is in trouble, it “…shuts down production of hair during periods of stress since it is not necessary for survival.” (4)
Hair growth, for our survival, has a low priority; that is as short and unpleasant as it gets.
Besides the stress of an accident or illness, some diseases feature hair loss as a symptom. This includes thyroid disease, lupus, and high fever – to name a few. Other diseases such as anemia and anorexia may cause nutritional shortages leading to hair loss.
Alopecia areata is a type of hair loss characterized by round patches of complete baldness. Although it is unknown exactly what causes this condition, some evidence suggests that family history, and possibly an autoimmune disorder, may play a role. Children affected by Alopecia Areata will usually grow their hair back in approximately one year.
Included in the alopecia areata family is: 1). alopecia totalis, and 2). alopecia universalis.
Totalis causes a complete loss of hair on the scalp, and universalis causes a complete loss of hair on the scalp and the entire body. Again, the cause of both is unknown, but an autoimmune disorder and a hereditary predisposition are the suspected culprits.
Although no completely effective treatment method exists, the prognosis for a full recovery is excellent, as the problem of alopecia areata seems to go away on its own. To help reverse the disease, doctors might treat patients with topical or injected steroids to stimulate new hair growth. (7)
A second type of hair disease, tinea capitis, is caused by a fungal infection, and is most commonly seen in teenage girls and boys. For treatment, your doctor will mostly likely prescribe an oral anti-fungal medicine, as well as a medicated shampoo containing selenium sulfide. Pets and other family members, who may have come in contact with the affected child, should also be examined.
Traction Alopecia: Traction alopecia is another cause of hair loss and is caused by damage to the follicle and dermal papilla when hair is repeatedly fashioned into a style that pulls, tears and breaks the hair off, often permanently. Hair that is over processed by chemicals may also damage hair and cause it to be lost permanently.
Read our article on Traction Alopecia to learn more about this type of permanent hair loss.