Hair loss in women

What it is

Hair loss in women can be gradual thinning or sudden shedding.

How it works

Female-pattern hair loss involves follicle miniaturisation; shedding often follows illness, childbirth or stress.

Why it matters on darker skin

Traction and CCCA are important causes in Black women.

Causes and triggers

Genetics, hormones, iron deficiency, thyroid, traction.

What helps — and why it works

See a doctor for blood tests: identifies treatable causes. Minoxidil after pharmacist/doctor advice: proven for pattern loss. Expected timeline: 4–6 months.

More detail

Female-pattern hair loss usually shows as widening of the central parting and thinning over the top of the head, with the front hairline often preserved. Follicles gradually become smaller and produce finer, shorter hairs; this is influenced by genes and hormones, and can start any time after puberty, often becoming noticeable around menopause. Shedding conditions (telogen effluvium), traction alopecia from styles and scarring conditions such as CCCA can look similar or occur together, which is why a doctor's assessment matters. A doctor may examine the scalp, ask about periods, pregnancy, stress and diet, and check blood tests for iron, thyroid and sometimes hormones. Topical minoxidil is the best-studied treatment for pattern hair loss and needs months of continued use; other medicines may be considered by a doctor. Camouflage options such as well-fitted wigs, fibres and loose styles are perfectly reasonable while treatment takes effect.

What to avoid and why

Avoid unproven supplements.

Common mistakes

• Waiting too long.

Handling textured hair gently

Coily and curly hair is naturally the most fragile hair type because each bend in the strand is a weak point and natural oils travel down it slowly. That makes handling — how often and how firmly hair is combed, styled and pulled — as important as which products you buy. Detangle only when hair is wet and coated in conditioner, working in sections from the ends towards the roots with fingers or a wide-tooth comb. Keep heat to the lowest effective setting and always use a heat protectant. Sleep on satin or silk, or wear a satin bonnet, to reduce friction. Between wash days, a water-based leave-in followed by a light oil or cream helps hold moisture. Give the scalp attention too: it is skin, and needs regular cleansing, especially under wigs, weaves and braids, to prevent build-up, itch and infection. Any style that hurts, causes bumps or leaves the scalp tender is too tight and should be loosened. Hair grows about one centimetre a month, so changes in care take two to three months to show in length and thickness.

Scalp health and product choice

Choose a shampoo that suits the scalp and a conditioner that suits the lengths: the scalp may need cleansing or a medicated shampoo while the ends need moisture. Fragrance, essential oils and heavy waxes can irritate a sensitive scalp or cause build-up, and heavy oils on the scalp may worsen dandruff. Look for a clear ingredient list and a NAFDAC number, and patch-test new dyes and relaxers 48 hours before every use. Products that promise dramatic growth are usually untested; the treatments with the best evidence for pattern hair loss are medicines such as minoxidil, which should be started only after speaking to a pharmacist or doctor. Signs that you need medical advice rather than a new product include patches of hair loss, scarring or shiny skin, pain, pus, or shedding that continues for more than six months.

Questions to ask your doctor or pharmacist

Useful questions include: What do you think is causing this? Is it likely to come back, and how can I prevent it? Which products should I stop? How long before I should expect improvement, and when should I come back if it isn't better? Are there side effects to watch for? Is this treatment safe if I am pregnant, breastfeeding or for my child? Writing your questions down, bringing your products (or photos of their labels) and taking dated photos of the problem make an appointment much more useful.