Postpartum Hair Loss Management And Treatment

If you have recently given birth and are noticing excessive hair loss, you might be a part of 40-50% of women who experience postpartum hair loss or postpartum alopecia. Postpartum hair loss should not be a cause of concern as it is a temporary process that t resolves naturally within a few months to a year. 

Although the cause of this condition has not been fully confirmed, it seems to be related to hormonal changes during and after pregnancy, which affect the hair follicles’ cycle. Some precautions can be included in your daily routine to take care of your hair and scalp. You can also discuss some options with a healthcare professional that might speed up the hair growth process if considered clinically suitable for you.

What is postpartum hair loss?

Postpartum hair loss (also known as postpartum alopecia) is a very common condition experienced by over 90% of women after giving birth. It usually starts 2-4 months postpartum and can last for 6 months to 1 year.¹ Unfortunately, there is no significant data from research that can provide consistent information regarding the timing and prevalence of this condition.

Postpartum hair loss can affect women differently in terms of severity and length of time and can influence their life and confidence due to the esthetical discomfort, making them anxious about showing themselves in public and leading to avoidance of social interactions.

Hair follicle cycle and the postpartum effect 

The hair follicle cycle is characterised by 3 phases:

• Anagen: active hair growth. An average of 87% of hair can be found in this phase
• Catagen: apoptosis (or falling) phase. It affects less than 1% of hair
• Telogen: resting phase. It usually lasts for about 2-3 months before proceeding with the new anagen phase and involves 13% of hair²

Postpartum hair loss seems to be linked to some variations in the hair cycle that can occur during pregnancy. During this time, the anagen phase is prolonged and some follicles remain active even for the entire duration of pregnancy. Once pregnancy is over, all these active hair follicles switch from anagen to catagen phase at the same time, causing a disproportionate and uncontrolled hair loss (also named postpartum telogen effluvium or postpartum alopecia).¹ 

Once hair fall occurs, the follicles are found to be retained in the telogen (resting) phase for longer.from normally only involving 13% of hair, in the postpartum period the telogen phase can affect about 30-40% of hair, thereby postponing the beginning of a new cycle with the anagen and regrowth phase.^1,2

Does everyone get postpartum hair loss?

Postpartum hair loss is a common condition that, as stated also by Dr Michele Green, can affect about 40-50% of women after giving birth. In a study conducted in Tokyo on 331 postpartum women, over 90% experienced postpartum alopecia.¹ 

What causes the postpartum hair loss?

It is not fully known what exactly triggers postpartum hair loss, but it may be caused by certain hormonal changes experienced after giving birth, such as:

• lower progesterone and estrogen levels
• fluctuations of the prolactin levels
• variations in thyroid hormones in breastfeeding mothers

However, the relationship between hormone levels detected in blood and the hair loss severity has yet to be demonstrated as there are no studies available to prove it.¹

Other possible associations have been considered to be:

• breast-feeding
• lack of vitamin intake during pregnancy
• postpartum depression
• iron deficiency

However, there is not enough data that can demonstrate a correlation between these factors and postpartum alopecia.²

How long does postpartum hair loss last?

Postpartum hair loss usually starts around 2-4 months after giving birth and tends to be diffused over the scalp, but it never causes total hair shedding. The severity of this condition can vary in women depending on their general health. It usually lasts for about 3 months and can take up to 6-9 months for hair to return to normal. However, it may take longer for hair to grow back again in case of any nutritional deficiency or comorbidities that might influence and slow down the natural hair follicle cycle.²

What are the treatments available for postpartum hair loss?

There aren’t specific treatments that can miraculously prevent or quickly treat hair loss after giving birth. It is a normal and common condition that can affect half of postpartum women and that will gradually improve over time, within a few months to a year.

However, there are possible medical options you can first discuss with healthcare professionals and daily precautions you can include in your daily regime to slow down the hair fall and improve hair quality and health, which can have a positive impact on the overall severity and duration of postpartum alopecia.

Daily care

Before getting worried when you see that you are losing an excessive amount of hair after pregnancy and seeking advice for medical treatments, know that there are some tips to take care of your hair.

Improve your diet

You would want to integrate food rich in nutrients like vitamins C, D, and E, zinc, iron, biotin (vitamin B7), and Omega-3 (essential fatty acids).³

Manage your stress levels

Although it has not been fully demonstrated how stress and the related hormone cortisol directly influence the hair growth cycle in humans, studies conducted on mice showed that subjecting them to mild stress over weeks led to an increase in the levels of corticosterone, thereby slowing down the hair growth process. These findings could warrant further investigation in humans.⁴

Sleep enough

Lack of sleep and rest can influence hormone levels and impact your hair quality and growth.

Be gentle with your hair

Handle your hair kindly and avoid tying it in a tight ponytail or hairstyle which might pull your hair and cause daily stress. Use mild shampoos that are not too harsh on your hair and scalp, and avoid straightening and dying your hair. Gently massage your scalp to improve microcirculation and use hydrating products for both scalp and hair.

Treatments

Some additional interventions might be available to help reduce hair loss after giving birth and speed up the hair growth process. Always consult healthcare professionals like your family doctor and pharmacist, or specialists like dermatologists or trichologists before considering any of the following suggestions and discuss the best possible option that is clinically suitable for you. Be particularly careful if you are currently breastfeeding.

Topical steroid lotion 

A study was conducted on 6 patients who were experiencing hair loss. These patients were first given an estradiol lotion to massage their scalp 3 times a day for 3-4 weeks. Two patients showed a slight improvement in their hair loss. Subsequently, the same patients used a lotion containing estradiol and progesterone. One of the two patients previously showing signs of improvement, had a definitive positive result this time, the other two patients showed slight improvement, and the rest showed no change.²

Hormonal treatments

The participants in a study conducted in Germany that did not show any improvement after being allocated to the placebo group that did not initially take any medication, were subsequently administered an oral contraceptive containing 2.5 mg of lynestrenol and 0.075 mg of mestranol. Eleven postpartum women experiencing hair loss were treated, and nine of them had visible improvement 3-6 months after starting the treatment with oral contraceptives.⁵

Minoxidil

There are topical products available containing the active ingredient minoxidil. Minoxidil functions by increasing blood circulation in the hair follicles, thereby stimulating the anagen phase and hair growth. ⁶ However, if the application of these products is stopped, the results obtained during the treatment will be lost within a few months after the interruption. Products containing Minoxidil should not be used if you are pregnant or breastfeeding.

Supplements

Pregnancy can cause a lack of vitamins and other nutrients that are the key to the quality and health of your hair. If you are experiencing postpartum hair loss and your diet doesn’t provide you with enough of these nutrients, you can consider taking supplements to compensate for the deficiency caused by pregnancy, after consulting a healthcare professional.

Low-level laser therapy (LLLT)

Another possible option to consider is to use low-level-laser therapy (LLLT), which uses laser light to stimulate follicle activity by inducing cellular regeneration and repair in the tissues.⁷ It is usually used as a method to stimulate the anagen phase in people with androgenetic alopecia, but it could be considered as an option to treat postpartum alopecia.

Which doctor should I see for postpartum hair loss?

Postpartum hair loss is a common physiological consequence of the hormonal fluctuations experienced during and after pregnancy that will influence the hair follicle's natural cycle. It naturally resolves within a few months to a year. However, if it is taking longer for your hair to grow back to normal or if you simply have questions and concerns, you can ask your doctor or seek advice from a dermatologist.

Summary 

Postpartum hair loss ( known as postpartum alopecia, or telogen effluvium) affects half of women after giving birth. It seems to be a natural consequence of hormonal fluctuations recorded during and after pregnancy that influence the hair follicle cycle, and it should not be something to worry about. This condition usually starts at about 3 months after childbirth and can last up to a year, depending on the mother's health and nutritional levels. 

It tends to resolve naturally but modifying your daily habits such as having a healthy and balanced diet or being gentle with the way that you handle your hair, might prove to be beneficial.

Besides these, there are also some medical treatments you could consider after consulting a healthcare professional to evaluate what option would be the most suitable for you.