Is female baldness the final taboo?

Is female baldness the final taboo? In the November issue of IMAGE, on sale now, Rosaleen McMeel examines the condition women are still refusing to discuss.

Irish women have come a long way in a few short years. From abortion to menstruation, vaginal reconstruction to miscarriage, there’s very little that’s off the table in 2019. While some of the above definitely still need work, progress is being made in lifting stigmas and normalising conversations around all things female health.

While reassuringly moving in the right direction, this openness is less comforting if you’re a bald woman. Why? Female pattern hair loss (FPHL), although a relatively common ailment, remains a taboo subject affecting self-esteem, confidence, quality of life and relationships. But with hair loss affecting women of all ages, now is the time to open up and start talking about it.

“Hair loss is devastating for patients,” says Dr Caitriona Ryan, consultant dermatologist and founder of the Institute of Dermatologists (instituteofdermatologists.ie). “It is singularly the most impactful condition I see in my practice. I don’t think anyone understands the psychological and social impact of hair loss until they go through it themselves.

“Hair loss can dramatically affect the way people see themselves and can result in anxiety, withdrawal, loss of confidence and depression. A person’s hair is part of their identity, beauty and perceived youthfulness, so losing it can cause a detrimental impact on their quality of life.”

Stress

The reasons for hair loss can vary hugely – ranging from nutritional deficiencies to stress – or a combination of several issues. One of the most common types of FPHL is androgenetic alopecia. It is male hormone-related but isn’t caused by too much testosterone.

The hair thins gradually, often over decades, around the top frontal area and extending back to the crown. It can start at any age, is progressive and inherited.

Instead, the hair follicles become sensitive, due to a genetic predisposition, to normal levels of male hormones in a woman’s body. According to recent figures, FPHL affects approximately 12% of females up to the age of 30, but up to 50% of women over 70. The hair thins gradually, often over decades, around the top frontal area and extending back to the crown. It can start at any age, is progressive and inherited. While FPHL may not get the press it deserves, rest assured solutions are available.

“Topical Minoxidil (Regaine) is one of the cornerstones of treatment,” explains Dr Ryan. “Oral hormone therapies such as spironolactone and finasteride can be helpful. Over recent years, platelet-rich plasma (PRP) therapy has become an increasingly popular treatment for female pattern hair loss, with some studies showing it to be superior to traditional medical treatments such as Minoxidil. It is often used in combination with medical therapy and has been shown to increase hair density and volume, with high patient satisfaction and minimal side effects or downtime. Many of my patients who wish to avoid medications and use more natural methods are choosing this treatment.”

PRP therapy

PRP therapy looks menacing (think Vampire facial), but is proving highly effective in treating FPHL. Plasma is extracted from the patient’s own blood, so there is no risk of an allergic or adverse reaction. A small vial of blood is drawn and a centrifuge is used to separate the red blood cells from the platelets and growth factors, which is then injected into the scalp using a tiny needle.

“This accelerates the growth of the hair follicles by stimulating the stem cells and other cells in the environment of the hair follicle and increasing blood supply, leading to denser and stronger hair. There is no downtime, and patients can return to work on the same day.” Treatments start at €550 at the Cosmetic Suite at the Institute of Dermatologists, and most patients require two treatments four to six weeks apart, with a follow-up treatment required six months later.

“When I look at patients with hair loss, the question is always, what is driving it, is it in isolation or are there other symptoms”

Nutrition shouldn’t be overlooked either. “When I look at patients with hair loss, the question is always, what is driving it, is it in isolation or are there other symptoms,” says Maev Creaven, a nutritional therapist and director of the Functional Medical Conference, Ireland (nutritioncentre.ie).

“I look to digestive health and absorption, and of course, hormonal health.” Having swapped a career in software programming to study nutrition, Creaven strongly believes that you are what you eat, digest and absorb. “If the diet is poor, then this is the first place to start. Most women that come to me have gone down the conventional route, but haven’t been tested for hormones or gut/microbiome health. If the conventional approach isn’t working, look at diet, nutrient deficiencies, hormonal imbalances, lifestyle, stressors.”

If you think you have FPHL, it’s important to see a GP and get advanced blood tests. Creaven recommends getting a thyroid panel too.

“Undiagnosed thyroid is very common in Ireland. I like to look at the thyroid antibodies also. Check iron levels, get a CBC, red and white blood cells, add in iron storage, ferritin, all of which your regular GP can offer.”

Meanwhile, a dermatologist can tell you whether it’s FPHL or something else that is causing your hair loss. Other causes of hair loss can look like FPHL, so it’s important to rule out these causes. Whatever route you choose, know that you don’t need to suffer in silence.

This article originally appeared in the November issue of IMAGE Magazine, on sale now. 

Read more: Amber Rowan: “I didn’t really understand what my hair meant to me until it was gone”

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