HELP my HAIR is FALLING OUT! Let's discuss Hair Loss in Women

Hair loss can be a distressing experience for women, often impacting self-esteem and emotional well-being. At Nashville Dermatology Physicians, both Dr. Jeffrey Berti and Dr. Toula Berti, see numerous patients concerned about hair thinning or loss. We have outlined a brief overview of this condition, including causes, diagnostic steps, and some treatment options.

Common Causes of Hair Loss in Women

1. Androgenetic Alopecia (Female Pattern Hair Loss): This is the most common form of hair loss in women, often genetically determined. It typically results in a widening part or a general decrease in hair volume. Hormonal imbalances, particularly high levels of androgens (male hormones like testosterone), can exacerbate this condition. However, there is some evidence that is showing a low dose of exogenous testosterone may help. This can be a source of confusion and frustration for many women, hence there is a need to follow up with a physician who is well versed on hair loss, who also has excellent physician referrals that are leaders in the field of hormonal replacement.

2. Telogen Effluvium: This type of hair loss is often triggered by a physical or emotional stressor, causing a higher number of hair follicles to enter the resting phase (telogen phase) simultaneously. Common triggers include childbirth, major surgery, severe infection, or psychological stress. Remember, stress can even be a happy event, such as a new job or marriage.  This hair loss generally is all over the scalp and can occur up to 6 months after such a stressor occurs.

3. Alopecia Areata: An autoimmune condition where the body's immune system attacks hair follicles, leading to patchy hair loss. This can occur suddenly and can affect all body hair.  Generally, there is a patch or multiple patches of missing hair that looks like a circular bald spot(s). There is much research surrounding alopecia areata, including diet, lifestyle and one's general metabolic health.

4. Nutritional Deficiencies: Lack of essential nutrients like iron, zinc, and vitamin D can lead to hair thinning. 

5. Hormonal Changes: Conditions like thyroid disease, menopause, or the cessation of birth control pills or other medications can cause generalized hair loss.

6. Tinea Capitis: A yeast infection on one's scalp is a very reversible cause of hair loss, so it is important to visit your doctor to further evaluate if this is happening and medications are needed. This condition typically is associated with itching of the scalp and flaking or soreness.

Here at Nashville Dermatology Physicians we offer a Diagnostic Approach

Medical History and Physical Examination: Understanding your medical and psychiatric background, family history and the pattern of your hair loss is important.

Laboratory Tests: We may order the following:

- Thyroid function tests

- Iron levels

- Vitamin D levels

- Hormonal profile (especially androgens)

-General Chemistry panel

Scalp Biopsy:In complex cases, a biopsy might be necessary. This involves removing a small piece of scalp tissue for microscopic examination, which can help in diagnosing conditions like scarring alopecia or to differentiate types of alopecia,  or if there is an infection causing hair loss.

Some Treatment Options

Medications:

Depending on the cause and type of hair loss one has, the treatment may differ.

- Minoxidil: Applied topically, it can promote hair growth and slow hair loss. Some physicians may prescribe oral minoxidil as well.

- Finasteride: Sometimes used off-label for women; it blocks the conversion of testosterone to DHT, a hormone linked to hair loss. (Note: As with oral minoxidil, this should only be used under medical supervision due to potential side effects.)

- Spironolactone: An oral medication that can help by reducing androgen levels.

- Thyroid medication if level was low

- Antifungal medications if tinea capitis

- Steroid intralesional injections if alopecia areata

Supplements: If deficiencies are detected, addressing these with supplements can help. However, indiscriminate use of supplements isn't recommended without testing.

Hormone Therapy: For those where hormonal imbalance is the cause, hormone replacement therapy might be beneficial, especially post-menopause.

Lifestyle Modifications: Stress management, a balanced diet, and ensuring good hair care practices can also play a role in managing hair loss.

Hair Transplantation: For those with significant permanent hair loss, surgical options might be considered, although this is less common for women than for men.

At Nashville Dermatology Physicians, we tailor each treatment plan to the individual's specific type of hair loss, its cause, and personal circumstances. Hair loss can be complex, involving multiple factors, and what works for one might not work for another. Our goal is to provide comprehensive care, helping you not just to treat but to understand your hair loss journey. 

If you're experiencing hair thinning or loss, consider consulting with either Dr Toula Berti or Dr. Jeffrey Berti for a personalized approach to reclaiming your confidence and hair health.

We are located 1001 Health Park Dr, Suite 470, Brentwood, TN

Call 615.212.2517 to schedule an appointment.