Juhl: Postpartum hair loss is a taboo topic. But it's temporary and reversible
Q&A with dermatologist Christina Han: "It’s hard not to panic when it seems like clumps of hair are falling out every time you take a shower or brush your hair."
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Show me the mother who hasn’t had days she thinks she’s going to pull her hair out. The early days are like that (so are the later days). What’s worse is when she puts her hands to her head and her hair falls out, through no action of her own.
There will be days like that. It’s normal in the postpartum period, which doesn’t make it any less distressing.
“It’s hard not to panic when it seems like clumps of hair are falling out every time you take a shower or brush your hair,” says Christina Han, a dermatologist and medical director of Vancouver-based XYON Health. “I’m a mother, too, and I went through this three times with my kids.”
Society doesn’t respond the same way to women’s hair loss as it does with men.
“It’s more taboo for women to lose hair,” Han says. “A lot of men will experience male pattern hair loss and it’s somewhat socially acceptable, which isn’t to say it isn’t as emotionally distressing for them, but it’s not uncommon for my female patients to get tearful.”
Postpartum hair loss happens in all ethnicities and demographics. It is a physiological response that happens after birth. It is temporary. It is reversible.
We asked Han to talk us through it.
Some women say their hair is more luxurious when they are pregnant.
When you think about growing a baby, there are a lot of growth factors that go into that process and it can certainly affect your hair, skin and nails. There’s often a period of less shedding of hair during pregnancy and potential increased growth of hair during that time. Some women report faster-growing or fuller hair.
But we’re here to talk about hair loss. How common is it?
The most common hair loss occurs in two age demographics: young women, especially in the postpartum period, and post-menopausal. They are two different entities. Women really are very scared to lose their hair and once they start to notice thinning or hair falling out, they do seek medical advice.
Is this related to hormones?
In postpartum women, it’s usually related to a significant drop in hormone levels that were needed to sustain the pregnancy. Once they give birth, those hormones, especially progesterone and estrogen, drop significantly and as a result there can be a significant shedding of hairs on the scalp. It is usually delayed by a few months after the baby is born, so women don’t always realize it’s related to delivery.
Will it grow back?
That’s the most important message: it’s temporary.
Almost all women will have a restoration of their baseline regrowth once that period ends. Usually that is by the time the baby is one year old. Shedding of hair can last several months and it can be very anxiety-provoking at that time.
What can they do?
They can try a new hairstyle. Sometimes having it shorter or styling it differently can minimize the appearance of thinner hair. They should also minimize certain hairstyles, like tight buns or ponytails, to reduce traction on hair follicles.
Volumizing shampoos can help. So can dry shampoos, because you’re minimizing washing in between. Volumizing shampoos can add volume to the scalp because there is less weighing down from product. For that reason, I also advise using light conditioners or skipping the conditioner because it can weigh down the hair — most people don’t need it during the postpartum period.
What if hair loss continues?
That’s when I tell people to seek advice from their doctor and potentially a dermatologist. If one year after delivery things are not starting to slow down and they’re not seeing regrowth, there could be other factors playing into the ongoing shedding. Medical and nutrition checks should be done. It’s worthwhile to seek medical attention if things don’t resolve by a year.
Family doctors are usually well-versed in postpartum hair loss because it’s so common. If things feel like they haven’t been answered after screening for issues, then a referral to a dermatologist is warranted.
There are other forms of hair loss that are beyond what we’ve discussed. There could be autoimmune-related hair loss issues, scarring hair loss, patchy forms of hair loss that are treatable, such as alopecia areata, which is common but treated completely differently than postpartum hair loss.
If it’s truly postpartum female hair loss, it can also be related to genetic factors. Just like with men who have male pattern baldness, women can have genetic forms of hair loss where the hair follicles tend to get smaller over time. There could be more than just hormones playing into it.
What about body hair?
It’s usually only on the head, related to the different receptors that stimulate hair growth in different parts of the body. A good example is male pattern hair loss: When men lose hair, it’s usually in a specific pattern that’s predictable. Men don’t tend to lose beard hair or eyebrow hair. Anatomically, there are differences at that molecular level.
Are there medical treatments?
This is such an unmet need in the world of dermatology, to have good treatment options for women, particularly in post-menopausal women.
The problem is the approval process when it comes to organizations like Health Canada or the FDA. They require rigorous data in the form of a clinical trial to have a good knowledge of efficacy and safety in that demographic. The treatments for men were tested exclusively in men. That approval is not automatically stamped for women. At this stage, there are no clinical trials for the female cohort when it comes to already established treatments for men.
Fortunately, being in North America, there is a rigorous process to get drugs on the market and it does require sufficient evidence as to efficacy and adverse effects.
It’s why it’s exciting for me to be part of a team that’s innovative in regards to over-the-counter shampoos and conditioners, as well as prescription treatments. It’s an unmet need.
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