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For women, pregnancy is a type of physical stress that can also cause hair loss (that, and hormones). — AFP

A thinning crown

Men are usually more likely to lose their hair than women, mostly due to male pattern baldness. But thinning hair and hair loss are also common in women, and it’s no less demoralising.Reasons can range from the simple and temporary, such as a vitamin deficiency, to the more complex, like an underlying health condition.

There are ways to treat hair loss – it all depends on the cause. Here are some common and not-so-common reasons why you might be seeing less hair on your head.

Physical stress

Any kind of physical trauma – surgery, a car accident or a severe illness, even the flu – can cause temporary hair loss. This is a type of hair loss called telogen effluvium. Hair has a programmed life cycle: a growth phase, rest phase and shedding phase.

“When you experience a really stressful event, it can shock the hair cycle, pushing more hair into the shedding phase,” explains Dr Marc Glashofer, a dermatologist in New York City, United States. Hair loss often becomes noticeable three to six months after the trauma.

What to do: The good news is that your hair will start growing back as your body recovers.


For women, pregnancy is a type of physical stress that can also cause hair loss (that, and hormones). Pregnancy-related hair loss usually occurs after the baby has been delivered, rather than during the actual pregnancy.

What to do: If you do experience hair loss, rest assured that your hair will grow back in a couple of months, especially if combined with healthy nutrition.

Dramatic weight loss

Sudden weight loss is a form of physical trauma that can result in thinning hair. This can happen even if the weight loss is ultimately good for you. It’s possible that the decreasing weight is stressing your body out, or if you’re not eating right, it can be a result of vitamin or mineral deficiencies. However, loss of hair, along with noticeable decreasing weight, may also be a sign of an eating disorder such as anorexia or bulimia.

What to do: Sudden weight loss can shock your system, and there will be a six-month period when you’ll experience hair loss, but it’ll eventually correct itself.

Emotional stress

Emotional stress is less likely to cause hair loss than physical stress, but it can happen. For instance, in situations like going through a divorce, after the death of a loved one, or while caring for an ageing parent. The stress won’t actually trigger hair loss, but it usually exacerbates a problem that’s already there.

What to do: As with hair loss due to physical stress, this type of shedding will eventually abate. While it’s not known whether reducing stress can help, it can’t hurt either. Take steps to combat stress and anxiety, like getting more exercise, trying talk therapy, or getting more support if you need it.

Too much vitamin A

Overconsumption of vitamin A-containing supplements or medication can trigger hair loss, according to the American Academy of Dermatology. The recommended daily intake for vitamin A is 5,000 International Units (IU) per day for adults and kids over the age of four; supplements can contain 2,500 to 10,000 IU.

What to do: This is a reversible cause and once you stop consu- ming the excess vitamin A, hair should grow normally.

Vitamin B deficiency

Low levels of vitamin B are another correctible cause of hair loss.

What to do: Like anaemia, simple supplementation should help the problem. So can dietary changes. Find natural vitamin B in fish, meat, starchy vegetables and non-citrus fruits. As always, eating a balanced diet plentiful in fruits and vegetables, as well as lean protein and “good” fats such as avocado and nuts, will be good for your hair and your overall health.

Lack of protein

According to the American Academy of Dermatology, if you don’t get enough protein in your diet, your body may ration it by shutting down hair growth. This usually happens about two to three months after a drop in protein levels.

What to do: There are many great sources of protein, including fish, meat and eggs. If you don’t eat meat or animal products, consult a nutritionist on non-meat sources.


Female-pattern hair loss, called androgenic or androgenetic alopecia, is basically the female version of male pattern baldness. Unlike men, women don’t tend to have a receding hairline, instead their partings may widen and the hair may thin noticeably.

What to do: Like men, women may benefit from minoxidil to help grow hair, or at least maintain the hair you have. It is available over-the-counter and is approved for women with this type of hair loss.

Female hormones

Just as pregnancy hormone changes can cause hair loss, so can switching or going off birth control pills. This can also cause telogen effluvium and has a higher chance of happening if you have a family history of hair loss. The change in the hormonal balance that occurs at menopause may also have the same result.

“The androgen (male hormone) receptors on the scalp become activated,” explains Dr Mark Ham-monds, a dermatologist. “The hair follicles will miniaturise and then you start to lose more hair.”

What to do: Talk to your doctor about other birth control options. Stopping oral contraceptives can also sometimes cause temporary hair loss. For women with hormonal imbalance or menopausal women, ask about bioidentical hormone therapy. Don’t make your problem worse with hair-damaging beauty regimens.


Almost one in 10 women aged 20 through 49 suffer from anaemia due to an iron deficiency (the most common type of anaemia), which is an easily-fixable cause of hair loss. Your doctor will have to do a blood test to determine if you have this type of anaemia.

What to do: A simple iron supplement should correct the problem. In addition to hair loss, other symptoms of anaemia include fatigue, headache, dizziness, pale skin, and cold hands and feet.


Hypothyroidism is the medical term for having an underactive thyroid gland. This little gland located in your neck produces hormones that are critical to metabolism, as well as growth and development, and when it’s not pumping out enough hormones, it can contribute to hair loss.

What to do: Synthetic thyroid medications, or better still, supplementing with dessicated thyroid, will take care of the problem. Once your thyroid levels return to normal, so should your hair.

Autoimmune-related hair loss

This is also called alopecia areata and is basically a result of an overactive immune system. The immune system sees the hair as foreign and targets it by mistake. The course of the condition can be unpredictable, with hair growing back, then falling out again.

What to do: Steroid injections are the first line of treatment for alopecia areata, which appears as hair loss in round patches on the head. Other drugs may also be used.


One specific type of autoimmune disease that can cause hair loss is lupus. Again, it’s a case of mistaken identity with overzealous immune cells attacking the hair. However, this type of hair loss is called “scarring”; the hair won’t grow back.

What to do: If the hair loss is mild, try a new hairstyle to camouflage the damage. Short hair, for instance, is stronger than long hair and may hide bald patches better.


Some of the drugs used to beat cancer can unfortunately also cause hair to fall out. Chemotherapy destroys rapidly dividing cells like cancer cells, but also rapidly-dividing cells like hair.

What to do: Once chemotherapy is stopped, hair will grow back, although often it’ll come back a different texture (perhaps curly when before it was straight) or a different colour. Researchers are working on more targeted drugs to treat cancer, ones that would bypass this and other side effects.

Polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is another imbalance in male and female sex hormones. An excess of androgens can lead to ovarian cysts, weight gain, a higher risk of diabetes, changes in your menstrual period, infertility, as well as hair thinning. Because male hormones are overrepresented in PCOS, women may also experience more hair on the face and body.

What to do: Treating PCOS can correct the hormone imbalance and help reverse some of these changes. Treatments include diet, exercise, maybe birth control pills, as well as specific treatment to address risks of infertility or diabetes, especially correcting insulin resistance and oestrogen dominance.

Anabolic steroids

According to the American Academy of Dermatology, anabolic steroids – the type abused by some athletes to bulk up muscle – also contributes to hair loss. The steroids can have the same impact on the body as PCOS, as the mechanism is the same.

What to do: The condition should improve after going off the drug.

Antidepressants, blood thinners and more

Certain classes of medication can also cause hair loss, like specific blood thinners and the blood pressure drug known as beta-blockers. Other drugs that might cause hair loss include methotrexate (used to treat rheumatic conditions and some skin conditions), lithium (for bipolar disorder), nonsteroidal anti-inflammatory drugs (NSAIDs) including ibuprofen, and possibly, antidepressants.

What to do: If your doctor determines that one or more of your medications is causing hair loss, talk to her about either lowering the dose or switching to another medicine.


Vigorous styling and hair treatments over the years can cause your hair to fall out. Examples of extreme styling include tight braids, hair weaves or corn rows, as well as using chemical relaxers to straighten your hair, hot oil treatments, or any kind of harsh chemical or high heat. Because these practices can affect the roots, your hair might not grow back.

What to do: In addition to avoiding these styles and treatments, the American Academy of Dermatolo-gy recommends using conditioner after every shampoo, letting your hair air dry, limiting the amount of time the curling iron comes in contact with your hair, and using heat-driven products no more than once a week.


Trichotillomania, classified as an “impulse control disorder”, causes people to compulsively pull their hair out. It is sort of like a tic where the person is constantly playing with and pulling their hair. Unfortunately, this constant playing and pulling can actually strip your head of its natural protection: hair. Trichotillomania often begins before the age of 17 and is four times more common in women than in men.

What to do: Some antidepressants may be effective, but behavioural modification therapy is another option.


It’s not uncommon to see hair thinning or loss as women enter their 50s and 60s. Experts aren’t sure why this happens.

What to do: One of the latest treatments to manage hair loss, aside from hair transplant, is photo-activation platelet rich plasma treatment (PAPRP) to the scalp. PAPRP has a “soup of goodies” such as growth factors and anti- inflammatory cytokines, and promotes new blood vessel formation in the scalp.

With an increase in the number of new blood vessels, more nutrients are carried to the scalp, thus promoting better hair growth. Some experts don’t recommend that hair loss be treated. That leaves women with cosmetic approaches such as scarves, wigs and hairstyles to cover up thin spots.

That said, there are also plenty of tricks to prevent hair breakage and ways to keep your hair looking shiny and healthy in your 50s and above.

By Datuk Dr Nor Ashikin Mokhtar
Published in Star Newspaper,February 12, 2017