By Dr. Steven Long, DO, MHA, CPT
Beyond Health | Precision Medicine for High-Performance Living

Why Female Hair Loss Matters

Hair is more than cosmetic—it is tied to identity, confidence, and well-being. Up to 40% of women experience visible hair loss by age 50, yet it’s often underdiagnosed and undertreated. Unlike male hair loss, female hair loss can have multiple overlapping causes—ranging from hormonal shifts to nutrient deficiencies to autoimmune disease.
At Beyond Health, we see hair health as a window into overall health. Understanding the root cause matters more than any one treatment.

Common Causes of Hair Loss in Women

1. Female Pattern Hair Loss (FPHL / androgenetic alopecia)

   • The most common cause, linked to genetic sensitivity of hair follicles to androgens (especially DHT).
   • Presents as thinning at the crown or part line, with preserved frontal hairline.

2. Telogen Effluvium

   • Diffuse shedding, often triggered by stress, illness, postpartum hormonal changes, crash dieting, or medications.
   • Usually temporary if the underlying cause is corrected.

3. Hormonal and Endocrine Causes

   • Thyroid disease, polycystic ovary syndrome (PCOS), and menopause-related estrogen decline can all contribute.

4. Nutritional Deficiencies

   • Iron deficiency, low vitamin D, zinc, and inadequate protein intake are common culprits.

5. Autoimmune or Inflammatory Conditions

   • Alopecia areata (immune attack on follicles).
   • Chronic inflammatory scalp conditions (seborrheic dermatitis, psoriasis).

Evidence-Based Treatments

1. Topical and Oral Medications

   • Minoxidil (topical 2–5%): First-line FDA-approved treatment for FPHL; prolongs hair growth phase.
   • Low-dose oral minoxidil: Emerging evidence for efficacy, especially when topical causes irritation.
   • Anti-androgens: Spironolactone or finasteride may help women with androgen-driven hair loss, particularly in PCOS (prescription only).

2. Nutritional Optimization

   • Correct iron deficiency, ensure adequate protein, zinc, and vitamin D.
   • Mediterranean-style diets are associated with reduced risk of FPHL progression.

3. Platelet-Rich Plasma (PRP)

   • Injections of concentrated platelets stimulate follicle activity. Early trials show benefit in FPHL. This treatment can be extremely expensive and varied based on experience.

4. Low-Level Laser Therapy (LLLT)

   At-home laser caps/combs have modest but growing evidence for stimulating regrowth. Let’s do a deeper dive into this:

   How It Works

   • LLLT uses red or near-infrared light to stimulate cellular activity in hair follicles. The mechanism is thought to involve:
   • Photobiomodulation: Light energy absorbed by mitochondrial cytochrome c oxidase → increased ATP production.
   • Vasodilation: Improved scalp microcirculation.
   • Anti-inflammatory effects: Reduced perifollicular inflammation.
   • Prolonged anagen phase: Encourages follicles to stay in the growth cycle.

Evidence and Results

• Multiple randomized controlled trials have shown that LLLT can increase hair density and thickness in both male and female pattern hair loss compared to sham devices.
• A 2019 systematic review and meta-analysis (Suchonwanit et al., JAMA Dermatol) concluded that LLLT is safe and moderately effective, especially when combined with topical minoxidil.

Key Findings:

• Increases in hair density ranged from 15–25 hairs/cm² over 16–26 weeks in trials.
• Benefits appear greater in mild-to-moderate hair loss compared to advanced cases.
• Works best when used consistently (3–4 sessions per week).

Protocols and Parameters

Wavelengths:

• Most effective devices use red or near-infrared light in the 630–680 nm or 810–850 nm range.
• 655 nm (visible red light) is the most commonly studied.

Power / Dose:

• Typical output: ~5 mW per diode.
• Energy density: 1–6 J/cm² per session delivered to the scalp.

Treatment Schedule:

• 3 times per week, 15–25 minutes per session.
• Consistency is critical—results are seen after 12–24 weeks, with continued use needed to maintain benefit.

Devices Studied:

• Laser combs and caps (HairMax, iGrow, Capillus) are the most studied. FDA has cleared several devices for both male and female pattern hair loss.
• Laser caps with 150–270 diodes (covering the full scalp) are more effective than handheld combs, since they deliver uniform exposure.
• Theradome LH80 Pro Laser Helmet – An FDA-cleared helmet with solid user feedback; aligns with wavelengths and design shown effective in trials. (We have no affiliation with this product—just provided as an example that fits criteria).

Limitations and Considerations

• Not a cure: LLLT can slow progression and thicken existing hairs but does not permanently restore lost follicles.
• Best as combination therapy: Evidence is strongest when LLLT is combined with minoxidil or oral agents like spironolactone in women.
• Commitment required: Must be used consistently long-term; benefits fade if discontinued.
• Cost: Devices can range from $300–$3,000.

5. Lifestyle and Stress Management

   • Stress is a major trigger of telogen effluvium. Mind-body practices, adequate sleep, and exercise support overall follicle health.

6. Hair Transplantation

   • For advanced FPHL when medical therapy has limited benefit. Works best in women with stable donor hair regions.

What Doesn’t Work (or Lacks Evidence)

• “Detox shampoos” or herbal cleanses – no proven mechanism.
• Unregulated supplements – many marketed hair products contain undisclosed ingredients and little evidence.
• Extreme dietary restriction – often worsens shedding.

Beyond Health’s Approach

At Beyond Health, we evaluate female hair loss systematically:

1. Labs – thyroid, ferritin, vitamin D, hormone panels.
2. Scalp health – rule out inflammatory or autoimmune causes.
3. Medication and nutrition review – identify reversible triggers.
4. Targeted interventions – minoxidil, anti-androgens, nutrition optimization, or laser therapy as appropriate.

We emphasize treating root causes, not just symptoms—because hair loss is often a sign of deeper metabolic, hormonal, or inflammatory imbalance.

The Bottom Line

Female hair loss is common, but it’s not inevitable. With the right evaluation and evidence-based therapies, many women can slow progression, stimulate regrowth, and restore confidence.
Hair health is health. Addressing it is not vanity—it’s part of taking full ownership of your longevity, vitality, and well-being.

References

1. Olsen EA. “Female pattern hair loss.” J Am Acad Dermatol. 2001;45(3 Suppl):S70-80.
2. Rossi A, et al. “Female pattern hair loss: a clinical, pathophysiologic, and therapeutic review.” Int J Dermatol. 2012;51(12):1447–1455.
3. Sinclair R. “Female pattern hair loss: pathogenesis and management.” Br J Dermatol. 1999;141(2):275-278.
4. Gupta AK, et al. “Platelet-rich plasma for androgenetic alopecia: systematic review and meta-analysis.” J Am Acad Dermatol. 2019;80(2):478–487.
5. Suchonwanit P, et al. “Low-level laser therapy for the treatment of hair loss: a systematic review and meta-analysis.” JAMA Dermatol. 2019;155(4):397–404.
6. • Jimenez JJ, et al. “Efficacy and safety of a low-level laser device in the treatment of male and female pattern hair loss: a multicenter, randomized, sham device-controlled, double-blind study.” Am J Clin Dermatol. 2014;15(2):115–127.
7. • Avci P, et al. “Low-level laser (light) therapy (LLLT) for treatment of hair loss.” Lasers Surg Med. 2014;46(2):144–151.