November 9th 2018
“I saw light shining through to my scalp, like a forest half-felled"
May 9th 2019 / 0 comment
Journalist Lauren Clark first noticed her hair clogging the plughole at the age of just 24. Here’s her story of experiencing hair loss as a young woman, why Instagram made her feel ‘less than’ and the solutions that worked for her
I’ve taken my thick hair for granted for as long as I can remember. From the unruly mane of my childhood that my mum would frequently break a Mason Pearson brush in an effort to tame to the fluffy teenage locks that I desperately ironed into an Alexa Chung-esque bob, hair was never a department in which I was lacking.
Then, in my mid-20s, I started noticing not just the odd strand - but clumps - of hair swirling their way down the plug hole. My Tangle Teezer heaved and my ponytail shrunk, but I mentally dismissed it as a consequence of the “change of the seasons”.
The real shock came when, mid-application of my favourite Charlotte Tilbury Pillow Talk lipstick one sunny day in 2017, I glanced up at my reflection in the mirror to see the light shining through to my scalp, like a forest half-felled, in a way that it never had before. From that moment forward my thinning hair became an unhealthy obsession. How could I, as a woman in my relative prime, be balding?
Yet, I was definitely not alone. It is estimated that female hair loss and thinning, known as alopecia, is on the rise, with up to 40 per cent of British women experiencing it in some form by the age of 40. That’s the same rate as male hair loss but while we’re so all accustomed to seeing balding men in public, from Jason Statham to British princes, it’s a topic swept under the rug by society when it comes to women.
Swishy-haired magazine cover stars, red carpet celebrities and Instagram influencers rarely betray a protruding scalp. While journalist Bryony Gordon, former England rugby player Heather Fisher and actress Jada Pinkett Smith are women in the public eye who have bravely opened up about the matter in recent years, they remain in the minority.
There’s a uniformity around hair online - a lot of people have unbelievable hair because it's not real
With my social media feeds awash with seemingly luscious locks, I felt that it was just me suffering from hair loss. My self-esteem dwindled every time I ran my fingers over my scalp or came face to face with a widening parting in the mirror. I’d convince myself that people were talking to my forehead and became paranoid that I was growing old prematurely. Plans would be cancelled and hours wasted studying my scalp, just like that man in the hair loss clinic ad on the tube (if you know, you know).
At one point, I hoped it might all be in my mind. Then a hairdresser pointed it out to me and, no questions asked, chastised me for abusing straighteners and hair tongs, warning me that I was on a fast-track to a mullet. I sobbed into my pillow that night.
The powerlessness I felt towards my disappearing head of hair was having a direct impact on my mental health and corresponded with a huge dip in confidence and crippling bouts of anxiety - a side effect of hair loss backed by science so at least I knew I wasn’t going mad.
Research has linked hair loss to reduced wellbeing, depression and social avoidance, but why exactly does what’s on your head affect what’s going on inside it? “With voluminous hair comes a perceived element of vitality and health,” says Deborah Maloney, a psychotherapist who has worked extensively with hair loss sufferers. Indeed, there are historic associations of thick hair with female success and desirability. “From a young age women are called pretty, not clever - there's so much about our external appearance that is valued as part of our femininity and sexuality,” she explains. “So when it comes to it changing, there's a fear and it's really upsetting.”
The lack of discussion or acknowledgement of the issue only adds to the sense of fear and shame. Deborah notes that “there isn’t that openness of dialogue - in the same way as there is with say, wrinkles, which makes us assume that hair loss isn’t normal, which in turn leads to feelings of isolation that become internalised. Very often when our appearance is affected, we socially withdraw.” Instagram doesn’t help here either. “There’s a uniformity around hair online,” she adds of the type of thick hair we are repeatedly exposed in #ads, but as with images of lip filler and washboard abs, “a lot of people have unbelievable hair because it's not real.”
Hairdresser Edward James, founder of Edward James London salons, has seen an increase in female clients expressing concerns about hair loss. He explains that many people don’t realise that those in the public eye use very natural-looking methods to conceal thinning:
“Hair extensions, mesh systems, scalp tattooing and lace wigs can provide a seamless and realistic effect for creating body and adding to the hairline. Those who wear their hair up for big events will also use makeup to colour in the scalp - just as you would for filling in your brows.”
As such, we simply aren’t exposed to female balding in the same way as we are with men and that lack of conversation, unlike in the case of acne or bloating, left me pretty stumped when it came to finding a literal root cause. Internet research brought up a multitude of possible triggers, both viable and far-fetched.
As it turns out, female hair loss is complex. For starters, there are two types - thinning and shedding. “The former is like men’s balding,” says Jane Mayhead, trichologist at The Private Clinic. This more common form - called female pattern hair loss in women or androgenic alopecia - is where the hair follicle, and what’s inside it (the dermal papilla), shrinks. The number of hairs in clusters on the head declines, so across the scalp there will be a slow, progressive reduction in the overall number of hairs. Jane explains that the process “often begins in your early 20s, so by the time you reach your early 40s hair loss can be quite significant”. As in men, this form of hair loss is genetic, meaning that you have inherited a follicular sensitivity to circulating ‘male’ hormones in your body - a predisposition that can be exacerbated by stress, the menopause and polycystic ovary syndrome (PCOS).
The other form - known as shedding or telogen effluvium - occurs when hair falls out for a limited period of time - it’s more likely to be immediately obvious during shampooing or styling. “It occurs when an internal imbalance triggers more hairs than usual to move from the anagen - or growth - phase of the hair growth cycle, to the telogen - the resting or shedding - phase,” states Anabel Kingsley, director and trichologist at Philip Kingsley.
This ‘reactive’ type of hair loss can be triggered by pretty much anything and everything, from hormonal imbalances caused by having a baby (postpartum hair loss affects half of new mums), thyroid issues, menopause or coming off the contraceptive pill. Certain drugs including those used in chemotherapy and stress triggered by major trauma can also be behind it, as can wearing tight ponytails and braids. Restrictive diets and fast weight loss can also cause shedding on account of nutritional deficiencies - when your body is undergoing upheaval, our hair comes last on the priority list.
“Shedding in women is nearly always related to a deficiency in vitamins and minerals,” explains Jane. Low levels of stored iron (known as ferritin) can affect 20 per cent of women, and vitamin B12, folic acid, zinc and vitamin D - many of which are found in animal products - also need to be checked out. My vegan diet dabbling can’t have helped, and stress - which can negatively impact nutrient absorption - is also another likely factor in my hair shedding. Tight work deadlines, a busy social life that doesn’t leave much room for sleep, family illness and the lifestyle anxieties of any millennial have peppered my last couple of years.
Whatever the trigger, it usually takes six to twelve weeks for hair to shed after the event that caused it - and often this hair will grow back on its own. Complications arise when both types of hair loss happen side by side and exacerbate one another - an all too common happening.
“Asking your doctor for a blood test should be your first starting point,” says hair transplant surgeon Christopher D’Souza. “Other types of hair loss may require a biopsy to diagnose.” While I had initially feared that my GP would file my concerns under ‘anxious snowflake’, I was pleasantly surprised by her sympathy, however, checks on my vitamin and mineral levels, as well as thyroid, came back normal. We’ve concluded that stress and a change in my contraception method were probably to blame and the beginnings of regrowth around my temples is a positive sign.
I’m lucky that, while my thinning hair causes me distress, it’s largely unnoticeable to others and the baby hairs that are coming through give me hope that whatever was upsetting my scalp has passed. Others experiencing more advanced hair loss may have to resort to a range of treatments to stimulate regrowth. Low-level laser therapy, platelet-rich plasma (like a ‘vampire facial’ but for your head) and medications such as Minoxidil can all help. There’s also more temporary solutions on the high street these days, including concealers and thickening conditioners (Jane urges you not to bother with shampoos), with permanent hair transplants more widely available at the other end of the scale.
Some believe there’s a correlation between patients complaining of hair loss and over-use of dry shampoo
Personally I’ll be following Anabel’s recommendations of yoga and meditation to manage stress levels alongside eating a balanced diet rich in protein, complex carbs and iron. She also adds that you should never skip breakfast. “It’s when energy levels to your hair follicles are at their lowest,” she underlines, suggesting poached eggs with wholewheat toast or quinoa porridge with berries as a perfect ways to start the day.
James recommends exfoliating the scalp once a week to ensure that hair follicles don’t get clogged up and massaging in a hair oil to stimulate healthy blood flow. He adds that colouring shouldn’t be a problem if it’s kept away from the scalp, although it’s advisable to avoid extra-firm hold hairspray, hair mousse and hard gels, all of which can put a strain on follicles.
I’ll also be moving my beloved Batiste to the back of the bathroom cabinet for the foreseeable. Some - including my GP - believe there’s a correlation between patients complaining of hair loss and over-use of dry shampoo which, while invaluable, is thought to soak up excess oil to the point of irritation, causing hair to fall out.
Lastly, I’ll be changing my mindset. I’ve come to appreciate that you can be perfectly healthy with fine hair. “We need to celebrate that not everyone has naturally thick, flowing hair,” says Deborah. “Being open about it is so important for our mental health.” With this in mind, it didn’t take me too long to discover that many of my outwardly-confident twenty-something friends were going through something similar. Because while a thinning mane is no trivial matter, you’re certainly not going through it alone.