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Expert Q and A: Fighting hair loss in women

An interview with Glenn Lyons
WebMD Feature
Medically Reviewed by Dr Rob Hicks

Many women with hair loss suffer in silence, altering their hairstyle to hide thinning or patches, but the sooner you seek care, the better the chances of successfully treating it, says Glenn Lyons, a fellow of The Institute of Trichologists and clinical director at Philip Kingsley.

Here, Glenn Lyons discusses common forms of hair loss in women and treatment options.

What are the main types of female hair loss?

You can divide female hair loss into three main types: temporary hair loss, semi-permanent hair loss (female pattern hair loss), and cicatricial alopecia.

What is temporary hair loss?

It’s usually hormone or nutrition related, although sometimes it’s caused by medicines (some anticoagulants and antimalarials) and cancer treatments.

In a study I conducted, about 50% of women suffered hair loss about 3 months after giving birth. When a woman conceives there is a big surge of oestrogen, and normally her skin gets better and her hair is better during pregnancy. After delivery, oestrogen comes down to normal levels and the hair responds to the small decrease in oestrogen by falling out. But it’s also due to some of the hair that would be coming out with both men and women, on a daily basis, is kept in during pregnancy. So women feel that their hair is more voluminous, and then it collapses after pregnancy.

The most common cause of temporary hair loss, though, is having inadequate iron storage levels. The storage is a protein called ferritin. Heavy periods can deplete ferritin levels as can a vegetarian diet.

The good news with temporary hair loss is that it is totally reversible. And the reason for that is that the follicles — where the hair grows from — are still healthy.

Is female pattern hair loss (semi-permanent hair loss) very common?

It’s is the most common hair loss, without question. And it’s especially prevalent in young Asian women.

What causes it?

You’ve got to have the genes that put you at risk of female pattern hair loss, but the catalyst is testosterone. It’s due to sensitivity of normal levels of testosterone. I have done hundreds upon hundreds of blood tests and the level of testosterone in the women comes back as normal.

This is the only hair loss where the follicle miniaturises. It gets smaller and smaller until it gives up. It can start as early as adolescence. So if a girl has got a fairly dominant gene, by the time she is 17, her hair will be thinning.

I get some ladies coming to see me with female pattern hair loss and they think it only started happening 4 months ago, but it takes at least 12 to 14 months for a follicle to miniaturise.

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