Wife losing hair

Dear Alice,

My wife has noted that she is recently losing hair at a much greater rate than normal. She feels her hair is significantly thinner (less density of strands) than in the past. What could be the cause of this?

Dear Reader,

Most people shed a bit of hair here and there. For a frame of reference, a woman can expect to lose between 100 to 200 strands of hair each day — no problem. And, hair loss and thinning might be linked to predictable factors, as described below. On the other hand, hair loss (including thinning) in the absence of these factors might suggest the need to look for underlying medical conditions that require treatment.

The following factors are generally predicable, easy to pinpoint, and modifiable:

  • Natural, monthly hormonal changes
  • Pregnancy
  • Menopause
  • Hormonal contraception
  • Emotional stress
  • Traction alopecia — caused by hairstyles that pull and strain the hair (e.g., cornrows, use of tight rollers, etc.)
  • Taking certain medications (e.g., blood thinners, vitamin A, antidepressants, medicines used to treat gout, chemotherapy, etc.)

Some other underlying medical conditions may include:

  • Over/underactive thyroid glands
  • Lupus
  • Diabetes
  • Fungal infections of the scalp
  • Malnutrition
  • Androgenetic alopecia — a condition occurring when a derivative of testosterone, called dihydrotestosterone (DHT), binds to hair follicles and shrinks them — so they can no longer survive

Given these distinctions, it's probably best to think hard about what possible causes could be at play in your wife's situation. For instance, has she been particularly stressed recently? Also, has she made any recent changes to her medication-taking routines? What about hormones? Has she recently been pregnant, or begun/discontinued taking hormones (via contraception or hormone therapy of some sort)? What about her diet? Would you say she takes in an adequate amount of various and nutritious foods on most days?

If you and your wife can't seem to pinpoint a certain predictable cause, and there's reason to believe there might be an underlying medical problem, she might consider seeing a primary care provider.

If underlying medical causes are ruled out, medical professionals might point your wife toward mental health services or nutrition education. If it's determined that her hair loss stems from intense stress over time or an identifiable traumatic event, she might consider making an appointment to see a mental health professional in your community. Alternatively, or, additionally, she might benefit from nutrition education services.

It's interesting that our hair can serve as a window to our physical and mental well-being. In some way, your wife's hair might be telling her something's not quite right. Throughout all of this, keep in mind the strong feelings both women and men have about their hair. Changes to hair can bring up all sorts of emotions. Add to that some uncertainties about physical health, and a person can get pretty stirred up. While your wife goes through this hard time, she'll likely benefit from your support and genuine concern.

Last updated Jun 15, 2015
Originally published Dec 01, 1993

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