What Is Postpartum Hair Loss

  • Monika MorenDoctor of Philosophy - PhD, Organic Chemistry, University of Stavanger
  • Priyanka ThakurBachelor in Medicine, Bachelor in Surgery (MBBS), DRPGMC, India
  • Regina LopesSenior Nursing Assistant, Health and Social Care, The Open University

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Overview

Postpartum hair loss also known as postpartum alopecia is classified as a form of telogen effluvium,1 a common and temporary condition that manifests in loss of scalp hair following exposure to stress or triggers.2 In the case of postpartum alopecia such precipitating factors are childbirth and subsequent hormonal changes in the body. The condition is very common among women.3

Recent cross-sectional research on exacerbating factors for postpartum alopecia showed that almost 92% of young mothers included in the study experienced postpartum hair loss.4 It usually begins two to five months after parturition and is reported to last for approximately six months2,5 with a maximum duration of a year.4 If a new mother experiences hair shedding for more than a year it is recommended to consult a healthcare provider.

Causes of postpartum hair loss

The activity of a hair follicle (a small pore in the skin from which a hair grows) is intermittent, and the cycle consists of three main phases:6

  • Anagen (the stage of growth) - the phase of active hair growth. The cells located in the hair follicle divide rapidly which results in forming a new hair followed by elongation of the hair shaft
  • Catagen (transitional phase) - the phase of resting. The hair in this phase stops growing due to inactivation of the hair follicle
  • Telogen (shedding phase) - after the resting stage, the hair is retained for a period before it is released from the follicle and shed. Following this phase, the follicle is ready to enter a new cycle of hair growth2

The duration of each stage of the cycle varies and depends on many factors such as hormonal fluctuations, individual health, age, environmental influences, and lifestyle choices such as diet and physical activity.7 In general, the longest phase of the hair cycle is anagen which usually lasts for two to eight years.7 Around 80-90% of all the hair follicles of a healthy individual reside in the anagen phase, whereas approximately 10% are either in the catagen or telogen phase at any given time.2

In the case of postpartum telogen effluvium, hormonal changes affect the hair in the stage of growth causing approximately 30-40% of hairs to prematurely enter the shedding phase, which results in diffuse, rapid, and excessive hair loss.2,5

The change in oestrogen level observed after parturition is believed to be the main cause of postpartum telogen effluvium. During the last months of pregnancy, the hair appears to look healthier, thicker, and more lustrous due to increased oestrogen levels. After childbirth the levels of oestrogen drop drastically, prompting the hair to prematurely enter the shedding phase of its growth cycle.3

Furthermore, it was reported that other factors such as anaemia, breastfeeding, gestational diabetes, history of hypothyroidism, or perinatal stress can contribute to a higher risk of developing postpartum hair loss.8

Common symptoms of postpartum alopecia

Women who suffer from postpartum alopecia experience excessive hair loss and thinning of the scalp hair following childbirth. They observe more loose hair on the hairbrush, pillows, clothing, or in a shower drain. After a few weeks, they might notice a receded hairline and significant hair thinning, especially in the temple areas. The loss of hair is diffuse but not total, and the symptoms subside after several months, usually without any medical intervention.5

When does postpartum hair loss occur and how long does it last?

Postpartum telogen effluvium begins just after childbirth, with decreasing oestrogen levels causing the hair to prematurely enter the shedding phase of the hair growth cycle. However, the symptoms and excessive hair loss are reported to be noticeable two to five months after parturition. An important piece of information is that this condition is temporary. It usually lasts for approximately six to twelve months, after which the symptoms subside and the hair naturally regrows, although experiences vary among individuals.4

How does postpartum hair loss affect young mothers?

Postpartum alopecia does not affect the physical health of a young mother. However, it can significantly affect her psychological and mental well-being. During the difficult time following childbirth, she might feel more susceptible to emotional challenges and encounter bouts of anxiety and depression.

Postpartum hair loss can cause additional stress and concern for the young mother due to the changes in her appearance caused by pregnancy, one of which may be hair loss. Therefore, it is of significant importance to provide her with emotional and psychological support. An understanding and supportive partner, family members, and friends can bring relief and create a soothing environment crucial for the recovery.2

However, providing sufficient education and raising awareness of the problem among future mothers, ensuring that they understand its temporary nature, along with available treatment options and management strategies, are also essential.

Managing postpartum hair loss

Most cases of postpartum hair loss do not require any pharmacological treatment. The symptoms usually subside within six to eight months, and the hair regrows. However, there are tips that can help the hair recover and prevent further damage.

  • Choosing proper hair care products - cosmetics based on natural products containing natural oils and vitamins that can help to revitalise and nourish both hair and scalp
  • Gentle hair care routine - gentle washing and combing, as well as avoiding tight hair ties will prevent further hair damage. Soft scalp massages might also stimulate hair regrowth
  • Avoid other stressors. Many factors can cause hair loss. It is important to ensure that the only triggers are hormonal fluctuations and perinatal changes. A healthy diet, active lifestyle, avoiding stress and maintaining good sleep hygiene will help manage the effects3

Managing the effects of hair loss can be a relatively long and demanding process. However, the changes caused by postpartum telogen effluvium are temporary and reversible.

Treatment and recovery

In cases of prolonged or severe hair loss, it might be necessary to seek an opinion and help from a dermatologist or trichologist. It might be necessary to consult a healthcare provider if hair loss does not subside six to eight months after the first symptoms were observed.

It might be possible that the alopecia is caused by accompanying health conditions, for instance, iron deficiency or thyroid disease which can also manifest in loss of hair.3 In severe or prolonged cases, after contacting a healthcare provider, the pharmacological treatment might be applied:

  • Vitamins and supplementation such as biotin (vitamin B7), niacin (vitamin B3), vitamins D and C as well as microelements such as iron and zinc

Each of them combats the problem in a different way, attacking from different angles. Some of them stimulate hair growth while others regenerate follicles. It is important to mention that in many cases supplementation is not necessary and a healthy balanced diet is sufficient to ensure proper levels of the essential vitamins and microelements.

Furthermore, before starting any supplementation, it is essential to consult a healthcare provider to determine if there are any significant deficiencies that need addressing by dietary supplements.

  • Over-the-counter medications such as minoxidil (Rogaine®) available as a liquid or foam applied directly on the scalp to help reduce hair loss and stimulate growth2

Any pharmacological treatment should be consulted with a healthcare provider to ensure there is no risk of negative health effects or interference with other used therapeutics. However, even after taking medications, improvement of hair condition usually takes a few months due to the possible prolonged duration of the hair growth cycle.

Support and resources

Support groups and forums for young mothers where they can exchange experiences, receive support, and finally find stories shared by others who suffered from postpartum hair loss and happily recovered could serve as valuable resources for them. However, the emotional support and reassurance received from the family and close friends are probably the most important parts of the recovery process.

Summary

Postpartum alopecia is a common dermatological condition experienced by many women following childbirth. It is caused by hormonal fluctuations following parturition, mainly a rapid decrease in oestrogen levels.3 This affects the hair growth cycle, forcing the hair to prematurely enter its final resting phase, which results in excessive hair loss.2 However, other factors have been reported to be associated with postpartum telogen effluvium such as anaemia, gestational diabetes, breastfeeding, or experiencing severe stress during or after childbirth.8

The symptoms of postpartum alopecia include excessive loss and thinning of hair that typically begins two to five months after childbirth and usually lasts for approximately six months. The symptoms typically subside and the hair regrows when the hormonal balance is restored and usually does not require any pharmacological treatment.5 Postpartum hair loss does not affect physical health, however, it influences the mental well-being of the young mother. Therefore understanding and supportive family members and friends are crucial for recovery.2

There are no known methods to prevent postpartum alopecia. However, choosing proper hair care products that nourish and revitalise the hair and scalp, applying a gentle hair care routine that prevents further hair damage and stimulates its growth, and finally avoiding other stressors that cause alopecia, all can help minimise the effects of postpartum telogen effluvium and reverse the changes caused by hair loss.3

It might be necessary to consult a dermatologist or trichologist in cases of severe or prolonged hair loss. Typically, pharmacological treatment is not needed, however, in some cases, the application of over-the-counter medications or vitamins and microelements supplementation might be considered beneficial.2

References

  1. Samrao A, Mirmirani P. Postpartum Telogen Effluvium Unmasking Traction Alopecia. Skin Appendage Disord. 2022 Jan 28;8(4):328–32.
  2. Cleveland Clinic [Internet]. [cited 2024 Apr 20]. Telogen Effluvium: Symptoms, Causes, Treatment & Regrowth. Available from: https://my.clevelandclinic.org/health/diseases/24486-telogen-effluvium
  3. Cleveland Clinic [Internet]. [cited 2024 Apr 20]. Postpartum Hair Loss: Causes, Treatment & What to Expect. Available from: https://my.clevelandclinic.org/health/diseases/23297-postpartum-hair-loss
  4. Hirose A, Terauchi M, Odai T, Fudono A, Tsurane K, Sekiguchi M, et al. Investigation of exacerbating factors for postpartum hair loss: a questionnaire-based cross-sectional study. Int J Womens Dermatol. 2023 Jun;9(2):e084.
  5. Eastham JH. Postpartum Alopecia. Ann Pharmacother. 2001 Feb;35(2):255–8.
  6. Ebling FJ. The biology of hair. Dermatol Clin. 1987 Jul;5(3):467–81.
  7. Natarelli N, Gahoonia N, Sivamani RK. Integrative and Mechanistic Approach to the Hair Growth Cycle and Hair Loss. J Clin Med. 2023 Jan;12(3):893.
  8. EbrahimzadehArdakani M, Ansari K, pourgholamali hesan, sadri zahra. Investigating the prevalence of postpartum hair loss and its associated risk factors: A cross sectional study. Iran J Dermatol [Internet]. 2021 Dec [cited 2024 Apr 20];24(4). Available from: https://doi.org/10.22034/ijd.2020.248619.1217

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This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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Monika Moren

Doctor of Philosophy - PhD, Organic Chemistry, University of Stavanger

Monika is a medicinal chemist with a strong background in research and scientific communications. She holds advanced degrees in medicinal chemistry and biotechnology and has extensive experience in scientific and medical writing. Currently pursuing a PhD at the University of Stavanger (Norway), her research focuses on developing new treatments for diabetes and neurodegenerative disorders.

Monika has a talent for transforming complex scientific information into clear, accessible content for diverse audiences. The passion for advancing scientific knowledge and fostering innovation in medicine drives her work, making her a valuable contributor to the fields of medicinal chemistry and medical communications.

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