Hair loss in women

June 25, 1999|By KATE COLEMAN

Hair. It was the source of Sampson's strength. It was a Broadway musical.

And hair is a big part of a woman's appearance. We base a lot of our opinions of a woman's attractiveness in her hair, says Dr. Paul Waldman, a Hagerstown dermatologist.

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Hair loss can be debilitating for women, says Dr. Tara Rumbarger, a Hagerstown dermatologist. "It brings tears to many," she says.

Hair loss is much more socially acceptable for men than women. Men have role models without hair, Waldman says. There's Michael Jordan and Jesse Ventura.


But it happens to women, too. The most common type of hair loss, female pattern alopecia - baldness - is hereditary. Hair thins mostly on top and at the sides of the head, not at the forehead hairline like in balding men, Waldman says. A diagnosis of this type of hair loss is made after other possible causes - many of them fixable - are excluded, according to Rumbarger.

American Academy of Dermatology lists several causes of hair loss in women, some the same as those that cause hair loss in men:

* High fever, severe infection or flu

* Surgery, chronic illness

* Thyroid disease, both overactive and underactive

* Medications, including those for high blood pressure, depression, arthritis and gout

* Too much vitamin A

* Cancer treatments

* Diet - not enough protein, iron or zinc.

Rumbarger adds lupus and other rheumatological or autoimmune diseases to the list.

Hormonal changes - taking birth control pills or being perimenopausal - can cause women to lose hair. During pregnancy, less hair than normal is lost, but after childbirth, a lot of hair goes into the resting stage and, a couple of months later, will fall out.

If you are losing what seems like an excessive amount of hair, a visit to a dermatologist can help determine why. A medical history is important, according to Waldman. Rumbarger says she sometimes does a biopsy of the scalp to look at reasons for lack of hair, to see where hair is rooted, to see if there is any inflammation or a scarring pattern where hair will not grow.

Hair usually will grow back after chemotherapy. Prescriptions can be changed. But there are possible remedies for some forms of hair loss.

A 2-percent lotion of Minoxidil (Rogaine) is available over the counter for women, Rumbarger says. It is applied twice a day for four to six months. Because there is a risk of birth defects, another drug, Propecia, has not been approved for women, but it can be used if the woman is not pregnant. Anti-androgens, which decrease the action of androgen hormones that can trigger hair loss, can help. And although she is not prescribing them, some prostate cancer medications are being used, Rumbarger says.

Surgical solutions include:

* Transplants - moving grafts of scalp with hair to a bald spot.

* Transferring a larger area or flap of skin with hair to a balding area.

* Removing bald sections of the scalp and extending the remaining hair-covered scalp.

Hair salons provide nonmedical alternatives.

Carol Craig, owner of Hair After Style Quarters in Hagerstown, got into hair replacement 30 years ago when her sister had cancer treatment and lost her hair. The shop has private rooms for clients and can help them with wigs, toupees, turbans and a halo - a ring of face-framing hair worn with a scarf or turban. The shop also provides weaves, attaching a hairpiece to the person's own hair.

Another solution is an "integration," says Mae Wetzel, a hairstylist at the shop for four years. It's like a hair net. Strands of a nylon-fiber hair - the trade name is Cyberhair - are attached to the grids of the web. It's worn like a hair net, and the natural hair is pulled through the spaces. The look is really natural.

Most of the shop's work is custom, Wetzel says. The stylists at the shop teach their clients how to wear the integrations. It takes 10 to 30 minutes to style, Wetzel says. The integration is sold by the square inch. Cost ranges from about $300 to $1,600.

A local woman who didn't want to be identified wears one of these hairpieces, but you wouldn't know it. She works in a public place, and Craig noticed her thinning hair. Not wanting to humiliate or insult the woman, Craig summoned her courage, handed her a business card and said, "I can help you."

She did. The woman, who was very self-conscious about her thinning hair, is happy and says people tell her she looks 10 years younger.

How much hair do you have?

If you haven't lost your hair, how much do you have?

Redheads usually have heads of about 90,000 hairs, brunettes 105,000 and natural blondes - that's NATURAL blondes - 140,000 hairs, according to American Academy of Dermatology.

Normally, about 90 percent of your hair is growing. That phase lasts between two and six years.

The other 10 percent is in a two- to three-month resting stage. After the nap, it is shed. It is normal to shed 50 to 100 hairs per day. After a hair is shed, a new one replaces it.

Scalp hair grows about a half inch a month. That rate slows with age, according to American Academy of Dermatology.

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