Help me keep my hair and my sanity
May 31, 2022 9:44 AM   Subscribe

32 year old cis woman and my bloody hair is falling out; likely causes are stress, crash dieting or medication change. Looking for tips on both styling and advocating for myself at the doctor.

I don’t have clumps falling out and was lucky to always have very thick and healthy looking hair in the first place, but something has been getting increasingly Not Right in the past month or two. I’ve had the same cut for years — long and straight with a heavy blunt fringe — and the fringe part is visibly thinner. You can see scalp where it parts from the rest of the hair and under the fringe. The rest of my hair looks fine and still makes a fat ponytail. I don’t know how noticeable it is to other people, but it’s now noticeable to me and I hate it.

1. Styling: what do I do with it? If I didn’t have bangs it wouldn’t be noticeable at all, but I do. The only look I like so far is wearing a silk scarf / bandana as a headband, so it covers the thin area and sticks my bangs flat on my forehead. But I need other fashion options, especially ones appropriate for the office or nicer occasions. I’m a pretty fashionable person and I think wearing, say, an athletic headband out and about is going to scream “something’s wrong here!”.

Also, what to do with the fringe. Do I grow it out and hope that will be less noticeable? I was also thinking of having my hair done in a lighter colour to be less noticeable (I currently dye it black) but worry the bleach will just make the problem worse.

2. Medical: I have problems with doctors brushing off my symptoms as “just stress” and I could imagine someone looking at my hair and thinking it was not a problem. I want to know what tests I should ask for and how to advocate for myself. PCOS and thyroid problems seem very unlikely in my case. My best guess is Telogen effluvium: I have a history of iron deficiency, did some unhealthy crash dieting in the past 6-8 months, went off my antidepressants over the past year and have had significant stress in my relationship which may or may not be ending now. So yeah.

But if it’s a medical explanation I am very eager to get to the bottom of it. I’ve read the Reddit boards on this issue and some women say that stress set off their androgenic alopecia and things just got worse and worse. Terrifying.

3. Psychological: desperate to hear stories of women who lost hair due to stress/illness and had it actually grow back. Please tell me I’m not doomed to be bald for life now.

4. Diet/supplements/treatments: any suggestions? I don’t eat meat but I eat fish. I’ve had this diet for many years without problems. I’m not dieting anymore and hoping to regain like 5 lb while hitting the gym. What does my diet need to support healthy hair, besides an iron supplement if I’m deficient? Are biotin etc. supplements worth it? What about topical treatments? I feel it is too soon to try rogaine but will try anything else.
posted by vanitas to Health & Fitness (27 answers total) 7 users marked this as a favorite
 
You mention an iron deficiency. Have you been tested for celiac? I had a friend here whose main symptom was hair loss (it came back) and bloating after eating gluten (which she figured out in hindsight) and anemia. May want to look into that if other symptoms fit.
posted by jessamyn at 9:50 AM on May 31, 2022 [1 favorite]


- get tested for iron deficiency, yes, although in my experience that would be full head hair loss and not just up front. also once you are iron deficient enough to lose hair there are usually other noticeable symptoms. also testing will be inconclusive if you have been taking iron supplements.

- you may have had asymptomatic covid, which can cause hair loss 6-8 weeks after, but idk how that can be tested for once one has been vaccinated. you might not have any other symptoms at all, ever.

- very unfortunately, hair loss and breakage specifically along the hairline is a symptom of lupus. this is diagnosed via ANA blood testing.

to be taken seriously as a woman with this problem i would (i did) go to a female dermatologist. they will be able to tell you every possible option for regrowth. rogaine is not your only hope.

about 30-40% of my hair fell out from iron deficient anemia in 2014, grew back in full by 2016, reached maximum health during pandemic (waist length, 2h to blow dry). unfortunately due to the other 2 it is about 90% gone right now.
posted by poffin boffin at 10:06 AM on May 31, 2022 [4 favorites]


Start rogaine now. I know it feels early but keeping what you have is important. The generic is fine, use the once a day foam. If it's working (or you've stabilized) don't stop, because it only works as long as you use it. That'll help while you find out the root cause and perhaps address it.

Grow out your bangs. A swept back look will help hide it for most women. Consider easing up on the hair coloring. Some can be harsh on the scalp and you want to be gentle now. Try highlights or lowlights, which can help mask the scalp showing. Gentle shampoos and lighter conditioners without allergens will also help.

Get your hormone levels tested to rule out aldosteronism (which can sometimes be mistaken for pcos just by symptoms). Aldosteronism also leads to feelings of stress and anxiety, which just creates a terrible feedback loop.

For supplements, try Viviscal PRO advanced hair health. It's stupid expensive, but it does help with hair, nails and skin health overall. Also, an iron supplement. There are some that are mixed with probiotics, to help with uptake and prevent side effects in the gut.

Fish is great for hair, make sure you have enough protein and amino acids and all those trace elements. (A supplement will help as you get over the hump from shedding to re-growing.)

It can be demoralizing to lose your hair, but there are a lot better diagnostics and treatments these days than 20 years ago.
posted by typetive at 10:09 AM on May 31, 2022 [1 favorite]


A coworker lost a lot of hair due to a bout with covid, and it has grown back in, gray instead of brown.
posted by happy_cat at 10:14 AM on May 31, 2022 [2 favorites]


I don't know about other causes but I can personally attest that crash dieting will do it all on its own. The metabolic disturbance tops the hair growth cycle; the effect shows up with a few months' delay due to how hair grows (like 1/3 of your hair should be growing at any given time, so you'll notice the problem later, when the hair that should have been growing in at the interrupted time, hasn't.) (By the way, this has nothing to do with how "healthily" you diet. You can do a beautiful Gwyneth-approved fish & fruit diet full of every vitamin, but if it's causing quick weight loss, it'll cause the hair growth interruption.)

Anyway, while ironic and annoying -- doing all that awful diet work in order to look better, and it causes your hair to fall out -- if this is what happened to you, then it will take care of itself as your food intake stabilizes.
posted by fingersandtoes at 10:18 AM on May 31, 2022 [3 favorites]


Minoxodil has worked wonders for me. Rogaine or any of its brethren. It takes about 6 weeks to work in my experience. Good luck!
posted by jeszac at 10:20 AM on May 31, 2022


Response by poster: Just to answer a couple things — I was blood tested for celiac probably 10 years ago when I had problems with my iron and it was negative. I got my ferritin up with supplements but haven’t been monitoring it for a long time since I’d been feeling fine and had been eating better (my early 20s diet wasn’t very balanced, now minus the dieting I eat pretty wholesome).

And I had Covid in January. I was vaccinated (but not yet boosted) and my symptoms were like a mild cold so I didn’t think it was worth a mention, but I will mention to my doctor!
posted by vanitas at 10:22 AM on May 31, 2022 [1 favorite]


I'm not a medical professional and I cannot speak to what is causing your hair loss or if it's something you can recover from.

I can say that I had my hair falling out for like a year after having pneumonia and it more or less recovered (albeit it's thinner than it used to be) after using hair loss shampoos. I can't remember the brand names of any of them, but they exist.
posted by jenfullmoon at 10:23 AM on May 31, 2022


There are so many reasons this may be happening! My hair started to fall out when my vitamin D levels were really low. After 6 months of supplements I'm now in the low average range and my hair is no longer falling out. Just one data point, good luck!
posted by Arctostaphylos at 10:27 AM on May 31, 2022


I'm a late 30s cis female. I likely had Covid in March of 2020, and also a long, drawn-out divorce that was wrapping up around the same time. In June 2020, I started losing my hair - 2 large patches about the size of a silver dollar, and some smaller ones, and a few areas of general thinning. It was pretty bad - my hair is fine and thin to start with, so it was very noticeable very quickly.

I went to my doctor first to do a blood panel (normal), and then to a dermatologist. I was diagnosed with alopecia areata, and given a series of steroid injections in the bald areas. I did two rounds of that, and the hair started to come back. The regrowth really took off once I started a probiotic (Garden of Life, as recommended by the dermatologist). I was surprised by that, even a little mad, because I thought that sounded like some woo bs. It worked, though. The dermatologist also recommended Viviscal, but did not take that due to the cost.

It's all growing back now, and (knock on wood) I've only had 1 time where my hair thinned out in one spot.

It was hard to keep my sanity. Especially as a woman, hair is so important! I honestly felt much better when I was open about it on social media, letting people know that yes I have bald spots, yes you might see them, this is what's going on, and yeah, it sucks. I became the alopecia "expert" within my social circle, and being able to help others is rewarding to me.

The regrowth period also is awful and stressful. The rest of my hair is long, and the regrowth was super awkward when it was about an inch or so, it stuck up in weird ways and didn't blend in no matter what. That too, has passed, and now it's sorta blended into my hair, although shorter than the rest of it.

If you have a hair stylist, getting a haircut and explaining it to them might get you some good ideas on how to manage.
posted by Sparky Buttons at 10:52 AM on May 31, 2022 [6 favorites]


First off, I want to say is that you are not alone and it’s ok to get sad even though it’s just hair. I also want to mention that although you think it’s obvious, most folks don’t even notice your hair loss. Most people I know would never guess that I have alopecia.

Now for suggestions.

#1 priority is to see a dermatologist that specializes in hair loss. You have to know the reason you are losing hair before you can try to correct it. A good doctor will have you get bloodwork done especially for vitamin deficiencies, hormones, and thyroid. Just a warning, if you are taking any supplements with biotin make sure you stop at least a week or two before your thyroid bloodwork. It can mask a thyroid issue.

Secondly, I strongly suggest not taking rogaine or minoxidil now. Wait until your doctor says you can use it. A lot of folks don’t know the science behind these treatments and assume it’s oK because it’s otc. You have to be very consistent with application (like very day) and understand that if you stop using it your hair will start falling out again. So basically, you commit to using it for the rest of your life.

While you are waiting for your diagnosis, something safe that you can do is take supplements. Nutrafol and Viviscal are the only two supplements that are backed by a true scientific study (per my derm).

If you can, try looking at your diet. Your problem may not be autoimmune, but if you can reduce dairy, gluten, and processed foods, I would do it.

You can also try using something like L’Oréal root concealer spray. It is great for covering thin spots where you see the scalp. There’s also other versions that are almost like eyeshadow. That is a bit easier to apply than the spray. Use these two sparingly and expect that it is not completely waterproof. It you don’t fuss with your hair, you’ll be fine. Search for root concealer.

I won’t go into much more to try because honestly you should be getting that infor from your doctor after a real diagnosis. Thinning on top can be androgenic alopecia or hormone related. If it was in patches, I would say it’s alopecia areata which is auto-immune. Having a bad illness, high stress, or another significant medical event (like surgery) could mean TE. Don’t try to guess! See the doctor!

Lastly, know that the process to treat hair loss is a long term thing. There is no overnight cure. Some of it is trial and error and each person has a unique set of factors.

I hope you are able to find a solution!
posted by jraz at 10:54 AM on May 31, 2022


Rosemary oil may work as well as Rogaine in regrowing hair (see study mentioned here- I think it takes several months). The scarves from this Etsy seller are pretty.
posted by pinochiette at 11:00 AM on May 31, 2022


The only look I like so far is wearing a silk scarf / bandana as a headband, so it covers the thin area and sticks my bangs flat on my forehead. But I need other fashion options, especially ones appropriate for the office or nicer occasions.

I like this look a lot and I've gotten my favorites from Garlands of Grace, who, fair warning, are aimed at Evangelical Christian women who cover their hair for modesty reasons. That said, their products are good. They're designed to be hair accessories, they come in a ton of different styles (including some "revealing" ones) and some very pretty patterns, and IDK if this applies to you, but as a white woman I don't feel like I'm dressing up as someone of another race or culture when I wear them.

Also, what to do with the fringe. Do I grow it out and hope that will be less noticeable?

Yeah, I don't have a fringe. I grow the front long and let the scarf push some loops of it forward, so that it swoops down over my forehead before going back with the rest of my hair. (Most of the pics on the site I linked to show this style.) It still hides my natural hairline, but it makes the look a bit more feminine/less utilitarian.
posted by nebulawindphone at 11:18 AM on May 31, 2022 [1 favorite]


Definitely swept-back hair is best, but the fringe may be less noticeable to others than yourself, since people have fringes of varying thickness. Depending on your hair colour, dry shampoo for dark hair may mask the scalp.

One thing a dermatologist may prescribe before minoxidil is a short course of topical steroids if you have any scalp inflammation. I had a complicated schedule of alternating it with minoxidil before going to straight minoxidil only. There are also various strengths of both, so a good consult is worth it.

Do note that minoxidil may cause a week or three of more intense hair loss as it gets rid of all hair that was about to fall out anyway in one go. But about six weeks in you should start getting noticeable baby hair, which works wonders to make everything look thicker and healthier.
posted by I claim sanctuary at 11:28 AM on May 31, 2022


for temporary disguise you can bring all your hair up from the back & sides and pin it loosely on the top of your head. and/or twist the short front part back up over the part you're worried about. given enough grippy hair things it's easy to make a visually indecipherable mass on the top of your head. neatness & smoothness are your enemies in this endeavor. this may not be your preferred style (I think it looks great, personally) but it will work for the purpose.
posted by queenofbithynia at 11:52 AM on May 31, 2022


To hide the thinning, you can darken your scalp with powder eyeshadow, “root touch up” coloured hair spray, or Toppik (little tiny synthetic hairs that you shake on like pepper and they cling to your real hair answer scalp).

And a lot of female celebrities with thin hair wear hair toppers - like a toupee that blends into their hair, often but not always with bangs. Christina Hendricks is wearing a red one here. Mindy Kaling often wears one that starts about an inch back from her real hairline. Likely Zooey Deschanel’s bangs are clipped on, and many others. Once you know how to spot them you can see them on many celebs. Look closely at their part and hairline, it will often look subtly “wiggy”
posted by nouvelle-personne at 11:56 AM on May 31, 2022 [1 favorite]


If you're comfortable asking around for a new dermatologist, preferably a woman, do it - you can make a throwaway account on reddit if that's what you want, or a sock account here if you don't want to say where exactly you are. I would avoid talking to your doctor about diet unless they bring it up first, as doctors often have very little knowledge of nutrition and food issues and may find it off-putting even though it is very real.

With regard to changing your hair color, bleach will absolutely make this worse - I bleached my (very short) hair out on Sunday and definitely noticed more of it coming out / breaking off than usual.

How do you feel about wigs? If you can't grow your own hair the way you like it, it's fine to buy some that you do.
posted by bile and syntax at 1:41 PM on May 31, 2022


Definitely see a good dermatologist about the hair loss. I'm currently suffering from a rare form of alopecia that sounds similar to yours. Sadly my loss is permanent, but my dermatologist has helped stop the spread with medications.
posted by j810c at 2:15 PM on May 31, 2022


Growing Out Fringe Hack by amtho:

A kind of French braid of the fringe incorporating more hair as you go across, ending in a small braid down the side of your face OR bigger braid(s) on either side. Totally fixes the awkward in-between half-grown-out fringe problem.

It's been a while since I "invented" this in high school, so a quick google for [braided hair fringe] brought me this photo.
posted by amtho at 2:16 PM on May 31, 2022


Clip in bangs have come a long way and chances are you can find some that really match your hair and desired style with a little searching. Even if you decide to grow your fringe out, you can use clip in bangs to bring it back when you want to! Ultimate flexibility.

There are so many reasons your hair could be doing this, and so many ways to get it back depending on the how’s and the whys. For the doctor, make an office appointment to discuss the issue. Start with it right off the bat “this is the thing I need to talk about today, what kind of diagnostics need doing for it and what other kind of medical professionals do you suggest I see (dermatologist, psychiatrist, nutritionist, etc)” Talk about it like there is never even a question that this is a problem your doctor will be taking seriously. Channel that mediocre white man energy!

As for diet, if you are now eating a varied and well rounded amount of foods with the full rainbow of produce, different seafoods, nuts, seeds, and eggs, you should be good. If you don’t eat eggs there might be some little things here and there to watch out for and you might want to talk to a doctor or nutritionist about testing and supplements or adjusting what you eat to compensate, since eggs are such an easy source of many things an otherwise limited diet might lack. But also, time with your better diet. Hair grows slowly and the scalp needs time to heal. You can’t just magically make nutrients go to your head, you know? And if hair loss is an outward sign chances are something else in your body needs healing too. I know it’s frustrating to hear, but try not to stress about it for a while as your improved diet and lifestyle choices do their work.
posted by Mizu at 2:17 PM on May 31, 2022


Vitamin A rich foods, carrot juice, dark green leafy vegetables. Yellow, orange and red vegetables. Vitamin A is oil based and you can overdose. Just get on a more fresh food regemin. Stressing, "the verb," is hard on the body. Don't worry about how anyone else perceives you, just be you and don't stress. If you recently changed shampoos, go back to the last one with which you weren't losing hair. Read all the side effects of all the meds you take, eliminate the med, or meds causing it.
posted by Oyéah at 4:52 PM on May 31, 2022


Definitely do not bleach or lighten your hair! You are right that this will make it worse.
posted by Bottlecap at 6:24 PM on May 31, 2022


Anne Helen Peterson just posted a question in her instagram story asking about delayed stress and trauma symptoms from the past two years and there are so many people posting about hair loss, so you are definitely not alone.

Here are some recent links on hair loss Hair Loss After Covid (includes links to studies): The Year America's Hair Fell Out.
posted by mogget at 6:51 PM on May 31, 2022 [1 favorite]


As for advocating with your doctor(s), I found a photo of myself with thick, curly hair and took it to every appointment after I lost 3/4s of my hair after bypass surgery. Because I still had a decent, by normal standards, head of hair, my doctors shrugged me off ... until I pushed that photo under their nose. My cardiologist, who had never met me until after surgery, suddenly took the photo , looked at it, then at me and said: okay, now I see what you are talking about. He immediately adjusted my medication. Wasn't a total cure but it was a start -- more importantly , it was a better way of explaining/showing the problem. Just a thought.
posted by alwayson_slightlyoff at 7:51 PM on May 31, 2022 [2 favorites]


In addition to the medical pieces, I'd recommend talking to your hairstylist about adjusting your bangs to minimize any visual cues re: the hairloss. Depending on where your hair loss is focused, middle-parted swoopy curtain bangs blended into a layered cut could be one option (and very on trend right now)? Or maybe wispy or baby bangs?

I have some thinning/loss in my corners, and these are the cuts that I've had with various hair dressers to make the loss virtually un-noticeable -- but I can empathize how hard and shitty it feels. Sending you good vibes and energy as you tackle this <3
posted by kylej at 10:01 PM on May 31, 2022 [1 favorite]


My friend was experiencing hair loss years ago that turned out to be a thyroid thing. She got her thyroid sorted and the hair loss cleared right up. Lots of women have hair loss for a while and it gets better, and yours probably will too. What you're describing doesn't sound like alopecia or genetic hair loss to me, and I suspect that it will either get better on its own or clear up once you find the cause.

It sounds like having bangs is stressing you out, so I'd suggest going to a good stylist and asking them what will look best. Maybe there's a way to keep your bangs, or maybe there's another style that will work better for you right now. One thing to bear in mind is that a lot of conventionally attractive women actually have a rather thin hairline. Sarah Silverman, for example, has a hairline that might read as "balding" on a man, but on a woman it just looks like a normal head of hair. We can sometimes negatively obsess over aspects of ourselves that other people aren't even aware of. Even if your bangs look sad and wispy to you, it's quite possible that people who see you every day haven't noticed anything different.
posted by Ursula Hitler at 10:06 PM on May 31, 2022 [2 favorites]


Anecdata: my stylist told me that COVID causes hair loss in everyone. They're seeing tons of hair loss in the salons. If that is the cause, it will grow back eventually.
posted by purple_bird at 10:53 AM on June 1, 2022 [1 favorite]


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