Introduction

A couple of months after celebrating your baby's arrival, basking in the joy of watching their adorable habits and agreeing it was worth the stress, you notice something abnormal happening. When you wash your hair, many strands are lost down the plug hole. Do you wonder why this happens and how long it lasts?

This is called postpartum hair loss and is experienced by many women after childbirth. However, the duration depends on some factors you should know. This article answers some pertinent questions concerning postpartum hair loss, including how long it will last and what you can do to maintain the health of your hair. 

Why postpartum hair loss occurs

Postpartum hair loss, as the name implies, is the excessive shedding, thinning and decreased hair growth that occurs around two to four months after delivery.¹ Typically, there are four phases in the normal hair growth cycle:^{2, 3}

• Anagen phase – Characterised by substantial hair growth and typically lasts 1,000 days
• Catagen phase – Occurs when the hair detaches from the blood vessels and ceases to grow due to deprived blood flow and nutrients. This phase typically lasts for 10 days
• Telogen phase – This is the resting phase in which hair strands remain in their follicles but are not actively growing. This usually lasts for around 100 days
• Exogen phase – This is the final stage of the hair growth cycle in which individual hair strands are released from their follicles and fall out

During pregnancy, the anagen phase is prolonged and some follicles can remain in this phase throughout the pregnancy. However, all the overactive hair follicles enter the catagen phase simultaneously postpartum.⁴ This results in postpartum hair loss which occurs due to decreased oestrogen levels (that were maintained at high levels during pregnancy) and leads to telogen effluvium (TE). Postpartum alopecia is one of the causes of telogen effluvium. TE can also happen when entering menopause, surgery, abnormal thyroid function, iron deficiency, and starvation diets.⁶ Other potential causes of postpartum hair loss are fluctuations in prolactin levels or levels of thyroid hormone in the lactating mother.⁷

The duration of postpartum hair loss

Postpartum hair loss usually starts between two and four months after delivery and may last between six months to one year.⁵ The duration of postpartum hair loss depends on a variety of factors. Women without nutritional deficiencies or other chronic diseases can completely recover after six to nine months. Still, this condition can give rise to the development of alopecia areata in predisposed patients.⁸ The hair loss is rarely total but there is slower hair growth and reduced hair density.⁵

Factors affecting how long postpartum hair loss lasts

The risk factors that could prolong or decrease the duration of postpartum hair loss include:

• Anaemia
• Oral contraceptives
• Gestational diabetes
• History of hypothyroidism (underactive thyroid)
• History of hair loss in previous pregnancies or family history of hair loss after pregnancy 
• High-stress levels
• Endocrine disorders
• Autoimmune diseases
• Eclampsia and preeclampsia 
• Nutrition and exercise

The frequency of postpartum hair loss is higher in mothers with the above risk factors.⁹ Long-term breastfeeding and preterm labour can also significantly affect the duration of postpartum hair loss. This implies that oestrogen levels regulate postpartum hair loss.¹

How to manage postpartum hair loss

Management of postpartum hair loss depends on the trigger or risk factor. Anaemia is an effective factor in hair loss and its treatment in most cases.¹⁰ Therefore, supplementing with iron and biotin (vitamin B7) will improve the appearance, increase the root strength, make the scaling disappear, and accelerate the rate of hair growth. Hair health can be restored by increasing the intake of foods high in:

• Vitamin C
• Vitamin D
• Omega-3 fatty acids
• Magnesium
• Beta-carotene

Also, adequate protein intake and maximising sleep when possible can help manage postpartum hair loss.¹¹

Additionally, creating an appropriate environment for reducing stress among new mothers and training them on stress management techniques can positively influence the management of postpartum hair loss.⁹ Tight ponytails or hairstyles and some heat styling tools can exert pressure on your hair roots. Therefore, decreasing the frequency and temperature of hair styling tools are effective strategies to boost hair health and reduce postpartum hair loss.¹¹

Tips for improving healthy hair during the postpartum period

The following tips can help maintain healthy hair and reduce postpartum hair loss:

• Increase intake of functional foods:  The bioactive compounds in functional foods have natural antioxidants and antifungal and anti-inflammatory properties. These properties are responsible for their potency as an effective hair loss prevention strategy and maintenance of healthy hair.¹² These foods include egg yolks, honey, etc
• Greek yoghurt also helps maintain healthy hair because it contains vitamin B5. This enhances the texture of the hair and also contains probiotics which regulate the composition of the scalp microbiota. Probiotics can positively influence new mothers' immune and inflammatory responses when dealing with hair loss¹³
• Castor oil is rich in omega-9 unsaturated fats that assist enhanced hair development and act as a moisturiser. It is usually blended with warm almond or coconut oil and applied to the hair
• One of the best hair loss treatments is using a B-complex vitamin cleanser or conditioner improved with biotin, which can help significantly reduce hair loss
• Limit sugar intake and quit smoking. These have been known to reduce blood circulation which can affect hair growth, especially during the postpartum period

FAQs

Does hair grow back after postpartum hair loss?  

Hair typically grows back with time. However, the regrowth may appear thinner and finer, as the hair follicle often shrinks. This process is known as miniaturisation. Hair regrowth also depends on incorporating nutrients like biotin that support hair restoration. Hair loss that persists for more than fifteen months may be a sign of an underlying health condition with thyroid or anaemia. 

Can postpartum hair loss be prevented?

Unfortunately, no. Fluctuating oestrogen levels are mainly the reason for postpartum hair loss. You can care for your hair strands by using gentle hair care products and opting for protective hairstyles. You can also consider a post-baby haircut which can give you a new look and boost your self-confidence. 

Do all new mothers experience postpartum hair loss? 

Postpartum hair loss affects between 40 and 50 per cent of women after childbirth.¹ The condition is characterised by excessive shedding of the hair about four months following the birth of your child. Some of the tell-tale signs of postpartum hair loss are seeing excess hair in the shower drain or on your pillow when you wake up. The receding hairline is often more visible for people with long and thick hair.

Does cutting or trimming hair help with postpartum hair loss? 

The reality is that a postpartum haircut is a great way to fight the effects of postpartum hair changes and hide thinning hair by creating more volume. 

Can postpartum hair loss be diagnosed? 

Generally, there are no routine tests to diagnose postpartum hair loss. Laboratory testing or histological examination is conducted to determine any underlying hormonal abnormalities and risk factors that could exacerbate structural damage to the hair. For instance, levels of testosterone, dehydroepiandrosterone (DHEA), iron, and thyroid hormones can be used to identify underlying causes of hair loss. 

Summary

Postpartum hair loss is a natural and temporary condition that happens among many new mothers due to decreased levels of oestrogen after pregnancy. It can also be triggered by nutritional deficiencies, stress, anaemia, gestational diabetes, eclampsia and preeclampsia that can happen in different women. Postpartum hair loss usually peaks about four months after childbirth and lasts up to a year. Measures to improve nutrition, reduce stress levels and hair management techniques should be implemented to minimise hair loss and prevent its progression to total alopecia.