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January 25, 2008

Female Hair Loss: Thinning Hair

30 million American women are seeing scalp, and it's often a symptom of a serious illness.

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blond woman with her hands in her hair

Photo Credit: pidjoe/iStock

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Stylists always gushed, "Wow, you've got a lot of hair." I took my lush mane for granted, perming, straightening, and bleaching my way through my teens. But during my sophomore year of college, as I found myself pulling more and more tangles out of my brush and strands from the shower drain, the compliments stopped and the worry began. I jealously examined the girl next to me on the subway — why couldn't I see through to the roots on her scalp, too? Once a sheet of shiny darkness, my hair had taken on an alarmingly transparent quality. I spent hours every week staring at my scalp in the mirror, parting and reparting my hair to see which side looked fuller. I drenched my head with volumizing sprays, detoxifying tonics, and shampoos for "weakened hair." Remedies were thick on the ground — but my hair kept getting thinner. I was molting. And I was scared.

Like a peacock's brilliant feathers, hair is a secondary sexual characteristic, explains London trichologist Dr. Philip Kingsley. "You don't need it to keep you either warm or cool, so its primary function is to increase attractiveness." We live in a culture of hair, coveting Victoria's Secret supermodels' voluptuous waves as much as their curves. So closely linked are sex appeal and self-esteem that a 2004 Rogaine survey of more than 500 women across the U.S. revealed that 24 percent equated losing their hair to losing a limb. Since 30 million women in America — roughly one in four — have thinning hair, there's a serious portion of the population at risk for an emotional crisis.

When I brought up my hair issue at an annual physical, my doctor tested me for lupus. Fortunately, the tests came back negative. Then I was told that since I wasn't completely bald, I really didn't have a problem. So I began to wonder if it was all in my head. When my boyfriend ran his fingers through my hair, all I could think of was whether I was losing strands. Did this gross him out? Or more importantly, was a lot coming out? Needless to say, that relationship didn't last long, lacking trust and the basic belief that he could find me attractive in this condition. I didn't dare ask my friends for a second opinion, because I didn't want them to scrutinize my scalp. After another frustrating physical (with no answers), I consulted my dermatologist, Dr. Fredric Brandt. Instead of dismissing my concerns as mere vanity, he immediately wrote up requests for endocrine blood tests, which prompted my general practitioner to finally cave and grant me a specialist referral.

There are many causes of shedding, from stress to chemotherapy, but 90 percent of hair loss is genetic and needs to be treated with medication. It can also be a sign of a thyroid disorder, says my endocrinologist, Dr. Emilia Liao, who diagnosed me with mild hypothyroidism. "It's a good thing you came in when you did," she told me on my first visit. "It gets more complicated — and possibly dangerous — the older you get, especially if you want to have a baby." Apparently, hair loss during pregnancy is a big red flag. "One out of 50 women is diagnosed with hypothyroidism while pregnant — it's still the most common cause of mental retardation in children," says Liao.

The average age for women dealing with thinning hair is 25 to 35 — that it's just another "gift" of menopause is a myth. Also, we can't simply blame our mothers, as previously believed — if there's baldness anywhere in your family tree, you're at risk. Unlike male-pattern baldness, where patches of hair fall out over time, female hair loss means a reduction in hair volume, making transplantation extremely difficult. "The total number of hairs doesn't always decrease, but the diameter of each strand shrinks," says Kingsley. And too-thin hairs won't grow past a certain length — which explains the baby fuzz around my hairline.


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