Postpartum Hair Loss: Causes and Solutions
Everything seems to be going well with life as a new mother, when slowly you begin to notice increased hair loss. It could be extra strands of hair on your pillow or more loose strands during washing, which could progress to hair falling out in clumps. You may change your shampoo or try various hair tonics, but you start to panic about going bald.
As a new mother it’s important not to fall into distress – the above scenario is very common.
There are many possible causes of hair loss, generally known to dermatologists and hair restoration specialists as alopecia. In postpartum hair loss, we are dealing with a very specific type of alopecia known as telogen effluvium, and it is one of the most common conditions treated by dermatologists.
For the majority of individuals, 5 to 15 per cent of the hair on one’s scalp is in the telogen phase, meaning that these hairs are in their resting phase. Telogen effluvium is triggered when a physiologic or hormonal change causes a large number of hairs to enter telogen at one time. Shedding does not occur until the new anagen hairs begin to grow, which usually takes two to three months. The emerging hairs help to force the resting hairs out of the follicle, which is why most people notice a sudden increase in hair fall a few months after delivery, or after an acute illness. The good news is that the prognosis is excellent and in almost all cases, recovery occurs within six months. Often, no specific treatment is required.
Unlike some other animals that shed hair, human hair growth is asynchronous, which means that there are hairs in different stages of the growth cycle at any one time. Normal hair grows in cycles and goes through three stages:
- Anagen: growing phase
- Telogen: resting phase
- Catagen: falling phase
Therefore, the effect of normal or physiological hair fall is usually not too obvious because about 80 to 90 per cent of our scalp hairs are in the growing anagen phase at any given moment. Thus, it is normal for a person to lose as many as 50 to 100 strands of hair daily, and these usually show up on a comb, brush or on the bathroom floor, especially after washing your hair.
As a first response to excessive hair fall in newly made mothers, supplements are occasionally prescribed and, in some cases, medical topical therapy as well, taking into account whether the mother is breastfeeding or not.
At Modena Hair Institute in Orange County, we generally advise patients to use a doctor-developed conditioning shampoo like groMD, as well as minimize activities that might result in excessive hair loss, such as rough combing and brushing of the hair, or tying it into very tight braids or buns. It’s uncommon for hair loss associated with pregnancy to persist unless there are other medical issues involved such as iron deficiency or thyroid disorders. If symptoms of excessive hair fall continue beyond six months, you should seek medical counsel.
In summary, there are a number of modalities which combat the specific form of telogen effluvium that is postpartum hair loss. Patients may try one modality at a time, beginning with the least involved and add or replace modalities as they see results. Each has positives and negatives and not all will be equally effective. Hair transplantation is the final and most definitive solution, however this should be delayed until you have reached a stable hair pattern. This is due to the fact that the transplanted hair is permanent and if you have not reached a stable pattern you can expect further losses and the need for more grafting to avoid the appearance of a double hairline (grafted hairline followed by losses and the receding natural hairline)
The crucial first step before considering various treatments is establishing the underlying cause. In most cases, as discussed previously, hormonal changes associated with pregnancy are a likely suspect. Given enough time, most of the hormonal effects caused by child birth are transient and will balance themselves out in six to eight months. If no response is noted, a medical workup is recommended. Once these issues have been properly addressed, the mother should consider the above listed modalities and decide where to get on board with the help of a hair restoration specialist.
Dr. Amir Yazdan, MD, is an internationally renowned hair transplant surgeon, expert guest on Dr. Phil and The Doctors, creator of the GroMD hair restoration product line, ISHRS member, accredited member of the IAHRS and a visceral advocate for patient care. Learn more about Dr. Yazdan or read rave reviews from his patients.