Help me help her have hair.

October 1, 2011 7:21 PM

Could my sister's thinning hair be a result of bad brushing habits? How can I help her address the problem without coming off as a stooge of the patriarchy? Lengthy, confused male-centric description inside...

Let me first state that as a perennially buzzcutted dude I know basically nothing about hair beyond where it grows and who to pay to cut it off. Evidently, my 33yr old sister doesn't know much more than this either, as her hair has been thinning more and more over the years to the point where it's now quite noticeable, and she has absolutely no idea what to do about it.

She has acknowledged that it's a problem, but never having been the most traditionally feminine of sorts, she won't go out of her way to remedy the situation and obviously feels awkward about confronting it in a serious fashion. Any suggestion that she go to a hairdresser and get a weave (as tactless co-workers have put to her) tends to elicit angry feminist harangues about the iniquities of the beauty industry and patriarchal control of women's bodies, which is all good and noble stuff to rant about, except when it's only a mask to hide your anxiety about a problem you wrongly perceive to be intractable.

I think if she could contextualise the problem for the fairly minor thing that it is, and she was given some clear view to a solution, she'd take the necessary steps and not allow herself to get trapped in depression about her appearance, using the crazy-proud feminist shtick to deny that she even gives a shit when she quite obviously does.

Originally she attributed the hair-thinning to a few periods of low carb dieting (cyclical ketogenic diet, totaling ~8 months dispersed over the past two years), but that now seems unrelated given the timeframe (it's only worsened since ending the diet), and that there's not really any alopecia at the scalp.

A much more likely culprit, I suspect, is the fact that over the past year she's increased her hair-washing to 5-6 nights per week due to work. This entails what seems to be, even to my untrained male eyes, a pretty damaging regimen of drying, brushing & styling...

See, she frequently professes to hating the responsibilities of her long hair (it was always mid-back, now shoulder-length after she shoved scissors into my hand and told me "Just chop the frizzy ends off, I don't care where") and hates having to do anything with it. She keeps it tied in a tight bun at home and I think in bed, and when going out only ever wears it in a ponytail (she's aware that binding it results in damage, but she won't ever wear it out, particularly now that it's so thin).

I'm not aware of exactly how she shampoos it. But to dry it she wraps a towel around her dome for 15 minutes, then takes a hairdryer and cylinder brush (sort of like this) and goes at it, brushing in long strokes from the scalp down to the ends while simultaneously blowing it with the dryer. Then she does some weird headbanging Exorcist-kid move to sort it all out, then on goes the elastic hairband. Finito, for the next 24hs at least.

No other woman I have ever known has used this particular method. My sis however has done it forever, so I've never actually applied critical thought to the process until recently, and it does seem somewhat fucked up.

So, are there any good hair-care primers I could "happen across" online that may be of use here? Tips or advice for how to convey anything I find? I want to help her fix the problem without compounding her stress, yet as her younger brother I am singularly ill-equipped to do that, so I ask for guidance.

BTW she's caucasian and her hair is very fair and straight, never dyed. She's average weight, eats healthily, gets regular exercise, and has no regular exposure to drugs, booze or radiation.

posted by Kandarp Von Bontee to Clothing, Beauty, & Fashion (25 answers total)

Has she seen a doctor about this? There are several common causes of thinning hair that can be treated medically. Absent some other problem, brushing and washing her hair, no matter how frequently or vigorously, shouldn't cause noticeable thinning. I would treat this as a medical issue, not a vanity problem.
posted by decathecting at 7:24 PM on October 1, 2011 [10 favorites]

Your hair doesn't fall out because you wash and dry it. It's either her diet or some underlying condition which she should see a doctor for.
posted by joannemullen at 7:27 PM on October 1, 2011 [7 favorites]

A healthy woman in her thirties losing hair to a noticeable extent wants to see a doctor. The styling stuff you describe is nothing at all out of the ordinary; millions of woman do all that, and more. Forget the appearance issues; she should want to see a doctor to rule out its being symptomatic of something more serious.
posted by kmennie at 7:27 PM on October 1, 2011 [15 favorites]

Agreeing with the above - could be hormonal problems, vitamin deficiencies, etc., but brushing isn't going to do this kind of damage.
posted by naoko at 7:32 PM on October 1, 2011

There is absolutely nothing about her routine that would cause her hair to fall out. I don't know what the "exorcist headbang" is, though... I'd say she should she might have a medical issue. And women do lose their hair just like men, though it's not as common. Hell, my PCP is female and balding. She's in her early fourties and is a doctor!

So yeah, your sister's hair routine is probably causing some damage to her hair, but it's not causing it to fall out. Encourage her to see a doctor!
posted by two lights above the sea at 7:33 PM on October 1, 2011 [2 favorites]

This is a health issue.
posted by moira at 7:34 PM on October 1, 2011 [1 favorite]

Hair loss is definitely worth seeing a doctor about; alopecia can be a sign of other medical issues. Having said that, a mechanical cause is perhaps more likely: wearing your hair in a tight bun or ponytail every day—particularly in bed, where the tension of the hair tie is compounted by friction against the pillow—will pull out a tremendous amount of hair.
posted by hot soup girl at 7:34 PM on October 1, 2011

Hair loss is often a sign of thyroid problems. If dyeing, styling, washing and/or drying was a trigger for hair loss, you'd see a lot more bald models.
posted by Ideefixe at 7:41 PM on October 1, 2011 [5 favorites]

(Modifying my answer: traction alopecia is a possibility if her ponytails/buns are really tight. Still, she should see a doc.)
posted by moira at 7:41 PM on October 1, 2011 [1 favorite]

OK, I know that millions of women do that every day but if I did that to my baby-fine but sadly thinnish curly hair, I would be facing a flat-out hairrebellion like your sister is. Does she have curtly hair? If so, she absolutely shouldn't be doing that. And even if it isn't curly, that is still a lot of abuse to hair that is already decidedly not responding in a positive way to such treatment.

Yes, doctor...but check out the curly girl site and look at previous AskMe questions about no-shampoo approaches, etc.
posted by mimi at 7:45 PM on October 1, 2011

I doubt the washing and drying has anything to do with it, as in my experience, shampoo doesn't cause hair to fall out, and washing every day-ish is fairly typical. However, as someone with easily-broken hair (and an underactive thyroid), let me point out that the tight bun and the tight ponytail, and maybe the twisting it up in a towel? Those DO cause my hair to fall out (more accurately, perhaps, be yanked out) much more than it otherwise does. I wouldn't go so far as to say that if her hair is visibly thinning, pulling it back would be the sole cause, but it probably isn't helping. Would she be willing to go for a loose ponytail instead of a tight one, or use a claw clip, which holds hair more loosely, instead of rubber bands and bobby pins? That would be an easy, low-risk step to take to see if it helps, even a little.
posted by badgermushroomSNAKE at 7:46 PM on October 1, 2011

There is such a thing as female pattern baldness. Your sister's hair loss probably has a medical cause that has nothing to do with how she styles it - which sounds pretty typical. That fifteen minutes with a dryer and a round brush? Lots of women do that. Tight ponytails and harsh brushing can pull hair out, but the hair would grow back.

I can't speak for your sister, but I personally would be enraged if someone dismissed my feminist arguments as an attempt to disguise my anxiety, or if they dismissed something I was deeply self-conscious about as "the fairly minor thing that it is." Unless she has explicitly asked for your advice on this matter, don't assume she wants it or will appreciate it. Even if she complains to you, she may be doing because she wants to get it off her chest, not to ask for a solution. Don't "happen across" anything for her, or imply she doesn't know how to take care of her own hair.

Next time she complains to you about her hair, mention that it might have a medical cause, and ask if she's seen a doctor about it. Once you bring it up, don't push it further; it's on her to decide whether to make that appointment. She's already stressed out about her hair; if you keep on her about it, she might start feeling like you're judging her.
posted by Metroid Baby at 8:05 PM on October 1, 2011 [15 favorites]

I don't know what to tell you about the health issues.

In terms of the "pride factor" and conveying of advice, could you get her a certificate for a nice hair salon? They should be able to sort out a flattering cut for her that would dry faster/not need to be tied up and thus reduce the need for blow drying/plastic bands. You could give it to her for a birthday or whatever and just make a lighthearted joke about not wanting to be her hairdresser.

In terms of general advice, I try and let my hair air-dry completely as often as possible and when I do blow-dry, I wait until it's 90 percent dry before doing so. Living in a cold climate, I do blow-dry more in the winter...

If she's sensitive, you could ply her with compliments re: a new hairstyle. Point out a girl with a nice, loose braid and tell your sis how nice she'd look with that style.

Of course, your sis could always buzz her own head :)
posted by cranberrymonger at 8:07 PM on October 1, 2011

I see that you have said it is not alopecia, is that a result of a doctor or dermatologist's diagnosis?

I wash my hair every day, sometimes if it is really hot out, I wash it twice that day. Putting it in a towel and drying it every day doesn't cause hair to fall out so drastically. Stress, anemia, alopecia and other medical conditions do cause hair to fall out. I notice that when I am stressed or not sleeping, my hair falls out a lot more than usual.

If you want to help, maybe give her a gift certificate to a nice spa/salon that will treat her to a great cut and style. Christmas is coming! Get her shampoo that will help. Someone suggested Nioxin shampoo and conditioner. Maybe you can get her a set and put a pretty bow around them and leave them in her bathroom one day.

I think going to a dermatologist and also a GP with this problem is a good idea. You don't want to miss a sign of an auto-immune disease or something like that.
posted by Yellow at 8:19 PM on October 1, 2011

I third Nioxin--I had my hair fall out for six months after having pneumonia (was she ill at any point? Just wondering) and that fixed my hair right up.

Also, DOCTOR. Not that the dermatologist did much for me beyond "yeah, that'll happen with pneumonia, try Nioxin," but she could have a worse problem for all we know.
posted by jenfullmoon at 8:23 PM on October 1, 2011

Definitely nthing that she should see a doctor to determine what could be causing this. However, what sticks out to me is not so much the washing and drying, but the fact that she always has it pulled back in a bun or ponytail. If she's doing it tightly enough (or even is she's not) it could be causing a lot of breakage and damage. And if she's indeed doing it all the time, there wouldn't be the chance for it to grow back.

I also heartily agree with metroid baby that you neither want to dismiss her feminist arguments nor brush it off as a "fairly minor thing." It's great that you are concerned about her, but you definitely want to handle this in a sensitive manner. Be there for her, but don't try be too heavy handed with the advice.
posted by kaybdc at 8:24 PM on October 1, 2011

Around thirty is a typical age for the hormones to shift down, and hair thinning is one common result.
posted by effluvia at 9:31 PM on October 1, 2011

Response by poster: Settled, then. I will gently urge her to visit the GP for safety's sake. Counting it as a possible symptom of a health problem is actually the best strategy believe it or not, as it'll avoid the whole vanity minefield which we'll both feel better about.

And just to clarify, she has explicitly asked me for help, and I would never dismiss her valid points about female body image, but I can recognise she's using them in this instance to conveniently avoid the difficult work of solving her self-acknowledged problem. She's set up a false dilemma in which she has to either continue to go righteously bald, or give in and become a Stepford housewife, which is just stupid. That's how you end up doing the Man's work for the Man.

Many thanks for the advice all.
posted by Kandarp Von Bontee at 9:51 PM on October 1, 2011

On the other hand, the same gene that causes male pattern baldness expresses itself in women too, only to a lesser extent. Does baldness run in your family at all?
posted by rhizome at 11:49 PM on October 1, 2011

Traction alopecia can be caused by hairstyles like tight ponytails/buns, and may result in permanent hair loss.
posted by 6550 at 2:19 AM on October 2, 2011

Coming in late, but how much weight did she lose dieting and how quickly? Periods of weight loss, especially a lot of weight loss or extreme weight loss, can cause hair to fall out months after the actual diet is over and continue for months more. The hair will grow back, it's just weight loss is a temporary shock so your body starts acting weird.
posted by Anonymous at 5:14 AM on October 2, 2011

Late too - some medications can have hair loss or hair changes as an uncommon side effect. This happened to me and I had to switch what I was taking. The hair loss was incredibly distressing, shame-inducing and frightening, and I too am a regular feminist.

It is very unlikely that your sister is doing anything to "cause" this. Some women have subclinical hormone imbalances that trigger hair loss, for example, and there isn't much that can be done about it except to get a better haircut to conceal it.

On the "beauty industry" idea - note that if you go bald, you can shave off the scraggles and no one will look at you funny or refuse to hire you. Women don't have this option. I, frankly, was scared that I'd loose my job if my hair kept falling out.
posted by Frowner at 5:41 AM on October 2, 2011 [1 favorite]

have baby-fine hair and wash it every day, without exception, after which I blow dry it while brushing from roots to ends. And my hair isn't falling out. I see absolutely nothing in the description which is unusual or would cause hair to fall out. It's fairly normal hair care. There are people for whom treating their hair like this would result in the hair being dry or stressed - but not falling out.

If her hair is falling out there's any underlying medical issue, without doubt.
posted by Miko at 6:14 AM on October 2, 2011 [1 favorite]

She needs to see a doctor to rule out nutritional deficiencies like vitamin D, zinc and iron and rule out any underlying physical diseases like hyperglycaemia, PCOS and problems with the thyroid which are the most common reasons, but there are many more that can be causing this.

(it's only worsened since ending the diet)

Mine started out as a symptom of hyperglycaemia and went on to be a symptom of the medications I was taking a year and a half later. After quitting the medication while getting my diet under control my hair never rebounded and continued to thin. For some women, like me, we start off with telogen effluvium, but wind up with female patterned baldness and for others, the temporary hair loss can become a chronic version of the disorder taking years to correct itself.

One thing she can do right now is start using either head and shoulders (a shampoo with 1% zinc pyrithione in it), or nizoral, both have been shown to slow hair loss.

It's not vanity, she's slowly being disfigured which often takes a huge emotional toll on women because they put far more value in their hair than men do. Unlike you, when I shaved my head in my early twenties, it was assumed I either had cancer, was a dyke, or a skinhead and my ability to get a job was severely limited. Society makes a lot of assumptions about a women's crowing glory, what it says about her and you should really be more sympathetic to her plight. She's probably really scared.
posted by squeak at 9:14 AM on October 2, 2011 [1 favorite]

Hair loss from ketogenic dieting doesn't show up right away. It shows up a few months later (I know this from experience.) Hair grows in cycles; you don't see the loss until the hair that should have sprouted a few cycles ago (but didn't) comes "due."

Anyway, the answer is simple - go see a dermatologist. They are the hair loss specialists and will be able to figure out a cause and possibly a solution. If it's something other than the dieting, there are medicines she can take - Rogaine, etc.

(And if it matters, of all cosmetic treatments, treatment for hair loss is the LEAST specifically female, isn't it?)
posted by fingersandtoes at 9:37 AM on October 2, 2011