Wednesday, September 2, 2015

My hair is falling out. I am female and young. How much hair loss is normal and what can I do about it if it's not?

There is one time in your life as a young woman when losing your hair is a normal thing.

My hair is falling out. I am female and young. How much hair loss is normal and what can I do about it if it's not?

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How much hair loss is normal? Not everyone has tresses like this. A hair festival in Bulgaria in 2007. (AP Photo/Petar Petrov)
How much hair loss is normal? Not everyone has tresses like this. A hair festival in Bulgaria in 2007. (AP Photo/Petar Petrov)

Laurel Schwartz, dermatologist and dermatopathologist, assistant professor in the Department of Dermatology and Cutaneous Biology, Thomas Jefferson University Hospital

It is normal to lose 100 hairs a day, on average. But there is one time in your life as a young woman when losing your hair is normal. Extreme shedding can take place three months after you give birth, and is a condition known as post-partum telogen effluvium.

In other cases, extreme hair loss should be investigated. There are many different reasons why people lose hair. It can be drugs, it can be hormonal, it can be related to the thyroid gland. Your doctor should evaluate you, and the first thing to figure out is if it’s a scarring or non-scarring loss. Scarring hair loss is the result of an inflammatory skin disease that causes a scar to grow in place of a hair follicle. Once the scar is formed, the hair follicle can't grow back. The earlier you get treatment, the better you will be able to control the inflammatory disease from spreading. Non-scarring hair loss is often the result of female pattern balding. That is something that is unusual in young women, but it can sometimes happen early in life.

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With other kinds of telogen effluvium, it can feel as if you’re losing a lot of hair, but it’s not actually decreasing the density of your hair, and this is known as chronic telegenic effluvium.

Alopecia areata is another kind of non scarring autoimmune hair loss where the body is attacking its own hair follicles. The hair often falls out and leaves a little bald circle on the scalp, but other patterns are seen.

Traction alopecia is another type of hair loss that is very common in African Americans, and results from contant pulling of the hair. If you pull long enough with tight braids and weaves, you can lose the hair altogether.

Treatments will vary according to the type of hair loss. You may have to have a biopsy of your scalp to see what’s going on. If it has to do with your thyroid, you need to be given hormone treatment to correct the thyroid. With telogin, you need to see if you’ve been taking new drugs that are increasing the shedding. For cases of androgenetic alopecia, a type of female pattern hair loss in which the hair shrinks back to look like the fine hair on your arm, your hair still has the potential to reactivate back to a terminal or long thick hair. Rogaine is the only FDA approved hair-loss medication for androgenetic alopecia in women, but there are also other ways your doctor can treat it. Ultimately, you need to discuss your treatment according to your diagnosis with your doctor, all things considered.


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Check Up is a blog for savvy health consumers, covering the latest developments, discoveries, and debates from the Philadelphia area and beyond.

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