This article was written by Dr Ingrid Wilson, a portfolio GP in Cheshire and a Trichologist. She is the Director of Crewe Hair and Skin Clinic.
Wondering how menopause can affect your hair's health? Well, like our skin, our hair changes with age. This includes changes in the diameter, lustre and even texture of our hair.
There are also changes going on in the scalp and hair follicle. The hair follicles sit within the dermis, the lower layer of the skin under the epidermis. As we age, the skin’s collagen structure becomes disorganised and there are less hair follicles. And there are certain genes that are expressed more as the hair follicle ages e.g. MMP1,SERPINE2, which are natural values of androgen.
Androgens are present in both men and women and are a group of hormones that play a role in male traits and reproductive activity. Although androgens are often called ‘male hormones’ don't let that confuse you – both men's and women's bodies produce androgens, just in differing amounts.
Our hair follicles are sensitive to changes in androgens and oestrogens, and the local metabolism of both hormones at the follicle influences hair growth. At the time of the menopause, the oestrogens decrease and there is a relative increase in androgens which
is associated with a decreased rate of growth of the hair, changes in the hair diameter and time spent in the growing phase. This will present as hair thinning, which is why many people find their hair changes during menopause.
Menopause Hair Loss/Thinning: Symptoms & Treatments
So, now we know that hair loss and thinning is common during menopause, it’s time to deep dive into why this can happen.
As we mentioned as we age there are changes that can occur. Age associated changes in the human hair follicle include loss of pigmentation, which uses hair growth rate, hair thinning, reduced activity of hair follicle stem cells and thin and brittle hair.
Sebum (our body’s natural oil) production decreases in the post-menopausal period which may affect hair quality and texture. So it’s important to make sure that you keep on top of moisturising your hair with the LOC/LCO methods.
Women will be more likely to start to experience female pattern hair loss which can be general diffuse hair thinning, seen most easily at the crown, where there is a widening of the central parting while still maintaining the frontal hairline.
There is some evidence that an early menopause is associated with the hair loss condition called frontal fibrosing alopecia which presents as a smooth wide hairline at the front.
There is an other hair loss condition called lichen planopilaris which presents most commonly in white women post menopausally and is generally seen in women aged 30 to 60. This is seen as a type of scarring hair loss.
Menopause Hair Loss Prevention – Can It Be Prevented Or Lessened?
The truth is that menopause is a biological fact of life which cannot be escaped, so unfortunately we cannot prevent it. There are often several different factors driving hair loss, so if you are unsure about all the options available to you, please book an appointment at Crewe Hair and Skin Clinic. The approach is that the process is a journey, so following your initial consultation of 30 to 60 minutes, there will be a follow up within one month and then a further follow up within 6 to 12 months.
If you decide to get HRT there are hair friendly versions available from your GP, however, it’s important to ensure that a healthy lifestyle is maintained. This includes good mental health, stopping smoking, exercise, weight control and good Medical Care.
The environment in which the hair follicles sit is also important. There is some evidence that ageing of the skin of the scalp and ageing of the hair follicle go hand in hand. Hair thinning in women is commonly associated with the menopause and corresponds with other age related changes in the skin.
It is well established in the skin care world that exposure to the sun is linked to ageing regardless of skin type, which is why it is important for the darker skin types to use sunscreen to prevent skin ageing. But don’t forget that prolonged exposure to the sun including UVA and UVB rays can also damage the hair cuticle. Signs of hair damage include discolouration, dry and brittle strands, broken or split ends.
And on that note, try to avoid stress on the hair itself such as with excessive processing and tension this will help to slow down any damage.
There are several ways to help with hair loss around the time of the menopause including medical and topical cosmetic treatments which can be helpful. For more information about treatments available to help with hair loss or other more serious hair issues, the Crewe Hair and Skin Clinic can be directly contacted for more information.
Does Menopausal Hair Affect Black Women Differently Or Present Differently?
There are some hair loss conditions that are more commonly found in black women. CCCA which stands for central cicatrising centrifugal alopecia is thought to affect one in 20 women of African descent. It is a gradual form of hair loss which starts at the crown and spreads out gradually and tends to look more shiny.
NB: It's important to deal with any kind of hair loss at an early stage, so please consult a trichologist or your GP if you are concerned.
About Dr Wilson
Dr Wilson is a portfolio GP in Cheshire and a Trichologist. She is the Director of Crewe Hair and Skin Clinic. She completed her medical training in Liverpool, qualified as a General Practitioner in 1999, and qualified as a Consultant in Public Health Medicine in 2006. She has a Masters in Public Health and is a Fellow of the Faculty of Public Health. Having had personal experience of hair loss she was struck by how little training GPs received in diagnosing and treating hair loss, and was aware that some hair loss conditions were more commonly experienced in black people. She struggled to find a suitable course for GPs. She decided therefore to study trichology with the Institute of Trichologists between 2010 and 2012. She gained a distinction in both years and won the John Mason Memorial prize. Upon completing the course she realised that there was a need to better connect the diagnostic, prescribing and referral resources available for hair loss by GPs and connect it with customers’ cosmetic hair care needs though camouflage and wigs. As a black woman she was aware that there was a need to create an environment that was sympathetic to their specific hair care needs and was able to give people the best chance of slowing down the progression of hair loss at an early stage.
She took voluntary redundancy from her Public Health consultant post in 2012 and since then has been working towards building her clinic while continuing as a part-time GP.
She is very aware that there are gaps in the NHS to help people tackle hair loss medically without resorting to surgery – particularly for black women. Her clinic also caters for people with cosmetic skin care concerns including unwanted hair acne, pigmentation and ageing. The clinic uses home care programmes, electrolysis and skin camouflage.
She has written articles on hair loss for a number of publications and holds memberships at:
- British Hair and Nail Society
- Affiliate Trichologist Member: British Association of Hair Restoration Surgery
- Member of the International Association of Trichologists
- Member of the Society of Cosmetic Scientists
- Medical Member of The Trichological Society