Hair Loss

Women can be psychologically devastated by hair loss says Dr. Charlene Linzon, director of the University of Toronto Hair Clinic at the Women’s College Ambulatory Care Centre. That's why, as one of only a few dermatologists who have specialized in diseases of the hair, Dr. Linzon is alarmed at the number of misconceptions there are about hair loss in women.

Join us as Dr. Linzon clears the air on six common ideas and misconceptions women have about hair loss.

1. As women age their hair thins.
   
   Some women have a genetic tendency to hair loss, called androgenetic alopecia, which causes their hair to thin beginning in their 20s or 30s. Some women do experience hair thinning with advancing age, however there is no reason for most women to expect that their tresses will thin as they get older.
   
   Many women worry that the hormonal changes that occur at menopause will lead to thinning hair. Hair loss in not typically related to menopause, says Dr. Linzon. Those who experience hair loss during the perimenopausal years may grow some of their hair back with treatments such as oral anti-androgens and by using the topical therapy minoxidil (Rogaine).
   
   
2. There are products at the hair salon and pharmacy that, although expensive, will prevent hair loss.
   
   ‘Be wary of products that are sold over-the-counter for hair loss,’ cautions Dr. Linzon. Some sales people believe that these products can help you maintain your hair or even grow new hair, but there is no scientific proof for these claims.
   
   ‘Two percent topical minoxidil or Rogaine is available over-the-counter at the pharmacy and is the only topical therapy available that’s scientifically proven to grow hair,' says Dr. Linzon. ‘It can be extremely successful in both men and women.’
   
   The potent clear liquid, which was approved for women in 1991 in the United States (but only for men in Canada), is rubbed into the scalp twice a day. When it is stopped, any hair that the drug helped grow or preserve will eventually fall out.
   
   
3. Once I lose my hair it is gone for good.
   
   If your hair loss is caused by a medical problem, once the disorder is corrected the lost hair can return. However, for women with androgenetic alopecia, hair may not completely regrow even with treatment. However the look of fuller hair may be achieved through hair transplants. ‘Hair transplants can be a great option for some women’ says Dr. Linzon. While most men are candidates for hair transplants, many women are not. Female pattern balding is more diffuse. Unlike male-pattern balding there may not be a thick enough fringe of dense hair around the sides and back of the head from which hair plugs can be taken.
   
   
4. How my hair is cut will affect its growth and texture.
   
   Your haircut will not affect hair growth, nor will the use of dyes, tints or soft permanents. Hair grows from follicles that which are beneath the skins surface. ‘If bleaching is overdone, it can change hair texture and increase breakage but not cause hair loss,’ says Dr. Linzon. ‘Everything in moderation is OK.'
   
   Popular with some Afro-Canadians are tight weaves and braids, or straightening of the hair with permanents. ‘Frequent mechanical and chemical stress on the hair can lead to hair breakage and eventually hair loss,’ says Dr Linzon.
   
   Also causing hair breakage, leading to a less full head of hair, is the use of a hair dryer on a hot setting. The water inside the hair shaft actually boils at high temperatures causing hairs to break.
   
   To protect the hair shaft, Dr. Linzon recommends using a conditioner – protein or otherwise – and avoiding excessive styling.
   
   
5. Certain foods will help your hair grow.
   
   Some people claim that gelatin and calcium encourage hair growth, but in fact no single food or supplement will cause new hair to grow. Adequate nutrition, though, is essential for healthy hair. Crash dieting or too little iron or protein or fat can lead to hair loss. Hair will return over several months once the diet is corrected and a woman's weight has stabilized.
   
   
6. If you are losing hair, go to a hair salon.
   
   ‘Any woman who has hair loss should be encouraged to go to her family doctor,’ counters Dr. Linzon. Hair loss can be an early sign of a disease such as hyper or hypothyroidism or of anemia. Prompt diagnosis and treatment of these conditions are crucial. A thorough medical history, complete physical, scalp biopsy, and blood tests may be needed to diagnose the cause of hair loss. The key to treating hair loss is making the correct diagnosis.
   
   Hairstylists, though, can play a role in helping women with hair loss find a style that makes their hair look fuller. Women losing hair may have an advantage over balding men in that it’s more accepted for women to wear wigs, hair extensions and scarves. ‘A hairstylist should be an expert in camouflage,’ says Dr. Linzon.
   
   Some family doctors feel comfortable treating hair loss, others refer patients to dermatologists. The hair clinic at the Women’s College Ambulatory Care Centre treats women, men and children. Before attending the clinic you must first be evaluated by a dermatologist. Demand for this specialty is high. The clinic currently has an extremely long waiting list.

Written by Susan Pedwell in consultation with Dr Charlene Linzon, Director of the University of Toronto Hair Clinic at Sunnybrook & Women’s. Updated Sept 2002.

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