We're sure Jada Pinkett Smith didn't want her alopecia-related hair loss to dominate the Oscars. The silver lining, though, is that it has made her condition, and hair loss in women in general, a hot topic that will hopefully result in less stigma and shame.
The 50-year-old actress (and wife of Will Smith) first spoke of her alopecia on a 2018 episode of her Facebook Watch series Red Table Talk, in which she admitted the experience of losing handfuls of her hair in the shower was 'terrifying'. She shaved her head fully in July 2021, when she realised she was losing the battle against her receding hairline.
But hair loss in women can range from pregnancy to stress, losing too much weight and even how tightly you do your ponytail. Here, with the help of Dr Bessam Farjo, Hair Restoration Surgeon at Farjo Hair Institute and Dr Sophie Shotter, medical director and founder of the Illuminate Clinic in Kent (check out her tips on hair loss in the video above), we explore the potential reasons behind your hair fall, and what hair loss treatments may work for you.
Alopecia and hair loss
The word alopecia is actually a generic term for hair loss. And one of the most common forms is androgenetic alopecia which is hereditary and happens when you're older. (It's also known in men as male pattern hair loss and women as female pattern hair loss).
But alopecia areata, which Pinkett Smith has, is also very common. Dr Farjo explains that it's an autoimmune condition in which the immune system attacks the hair follicles, and as a result, the follicles become smaller and stop producing hair. It that can show up as small bald patches which can sometimes merge together and look larger.
"Unfortunately, in extreme cases, it can result in alopecia totalis - total hair loss on the scalp. Or even alopecia universalis which means the hair loss also spreads to the face, including eyebrows and eyelashes, and the rest of the body including pubic hair," he adds.
Dr Farjo advises that hair loss treatments for alopecia areata can include the use of topical agents, such as Minoxidil, steroid injections – a common option for mild, patchy alopecia to help hair grow back on bald spots – and oral treatments including cortisone tablets, which are sometimes used for extensive alopecia.
Stress and hair loss
“Mental, emotional or physical stress can cause your hair to fall out," says Dr Sophie, "as can a major life event such as a divorce or if you've been unwell. The stress on your body means your hair follicles have been undernourished and you start to shed hair.”
Of course, one of the biggest causes of global stress in the last two years has been Covid and we now know one of the (many) side effects of the virus is hair fall.
Google searches for Covid-19 hair loss have soared and in a study carried out by a doctor at the Indiana University School of Medicine, hair loss was identified as a long-term symptom of Coronavirus.
“In people who have had Covid, once they’ve recovered around six weeks later their hair starts to thin,” Sophie says. “This is because while you’re so, sick your body drives all of your resources, all of your nutrients and all of your energy to healing [your body] rather than growing hair.”
Anaemia vs your hair
The World Health Organisation estimates that one-third of all women of reproductive age are anaemic - this means their red blood count is lower than it should be.
"Iron deficiency anaemia can cause fatigue, shortness of breath, heart palpitations – and hair loss," says Dr Farjo. "If your body is lacking iron, your body can’t produce the haemoglobin that is needed for the growth and repair of cells – including the cells that stimulate hair growth."
Suspect this could be your issue? Make an appointment with your GP who'll be able to measure your iron levels. If you're lacking then you'll be advised to take iron supplements. "Keep in mind though that hair is more sensitive to low iron than other parts of the body, and therefore we like the iron levels to be a little higher than the minimum recommended for general health," adds Dr Farjo.
Hair loss after weight loss
If you've been on a diet recently and have now returned to normal eating you may notice more strands on your hairbrush than usual; don't fret. The lack of calories when dieting meant your follicles may have gone to sleep. And then when you eat normally again and they get nourished, your hair starts to grow and the dead follicles are pushed out along with the hair that was in there, Dr Sophie explains.
Dr Farjo adds: "This is known as telogen effluvium. Often when losing weight, people aren’t taking in enough protein. As your hair isn’t your body’s priority, it will use the nutrients it’s taking in to fuel your organs."
But, phew, telogen effluvium usually goes away by itself once your weight has stabilised. However, Dr Farjo says it's a good idea to stay on top of your nutrient intake. Noted.
The post-pregnancy hair fall
Luscious flowing locks are common when you’re expecting thanks to an increase of oestrogen in the body.
After you give birth oestrogen dips and your hair will fall out. It will recover but it can be emotionally difficult when you’re adjusting to a new you at the same time, says Dr Sophie.
Dr Farjo reassures that in most cases your hair will be back to its glorious best within six to 12 months.
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The hormone effect on your hair
As well as pregnancy, other periods of hormone change can cause hair growth issues. "If you go through a sudden hormonal change such as coming off the contraceptive pill after having been on it for a long time, or you develop a hormonal disease such as an under or overactive thyroid, or polycystic ovaries, this can impact our internal balance and show in our hair," explains Dr Sophie.
"You need to address the hormonal imbalance to recover your hair growth. In some cases, this might be as simple as giving your body time to rebalance after stopping the pill but if it’s a thyroid condition you will almost certainly need medical treatment," she adds.
It could be your hairstyle
It may come as a shock but wearing your hair in a too-tight style (think scraping it back into a sleek bun or ponytail) can cause traction alopecia. Over to Dr Farjo: "When the hair is regularly pulled in the same area, it can damage the root and cause the hair to come out."
Hair extensions can also be an issue because they pull at your hair and scalp - and this tension on the roots can cause hair loss.
In the early stages, it’s usually reversible, but, sorry, you'll need to leave your hair down as much as you can, or step away from the hair extensions. "However, in severe cases, the follicles may be too damaged for the hair to regrow in which case a hair transplant may be needed," warns Dr Farjo. Gulp.
Clinic treatments for hair growth
There's a variety of in-clinic treatments that could work such as PRP, aka platelet-rich-plasma therapy, where blood is taken from your arm and injected back into the scalp to drive hair growth. There's also growth factor mesotherapy which injects lab-developed growth factors into the scalp to nourish and enhance it. Dr Sophie adds that scalp microneedling has also had good results as have LED caps.
At home hair loss treatments:
To stop product build-up affecting your hair growth, Dr Sophie recommends a scalp scrub. Check out our edit of the best exfoliating scalp scrubs for every budget.
She also suggests supplementing with vitamin D because it stimulates new and old hair follicles. When there isn't enough in your system, new hair growth can be stunted. She recommends a hair supplement that includes hair growth supporting ingredients including biotin and marine extract, such as Viviscal Professional , available in hairdressers and clinics.
Scalp serums with caffeine to support hair growth are also a favourite of Dr Sophie's (we tried caffeine shampoo Plantur 39 , £9.75 and were impressed with the results). Try also The Inkey List's Caffeine Stimulating Scalp Treatment , £12.99.
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