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Hair Loss/Female hair loss


QUESTION: I am a female, 56 years old. I have a strange hair loss since I was 16. It started suddenly after a slimming cure. Not a lot of hair loss, not a full hand of hair, but definitely hair loss. It has never stopped. My hair today looks healthy and it is shining but I have lost 40-50 % since it started. It is the same amount hair i loose now as when I was 16. Not much regrowth. It is a diffuse hair loss but since the beginning I have lost more hair in the temple, in each side of the forehead and in the back of my neck.I understand now that I have had too low iron level perhaps in a lot of years. S ferritin was 6 nine years ago. 1½ year ago it was 103. I have no periods any more.
I have treated the hair loss with minoxidil which I have very good help of, but I can not continue because of the side effects. It is something with the lymph system. I got swellings in my forehead.
I am really confused. What type of hair loss do You think I have? Is it CTE or AGA ? What do You think have happened here?
And what can be done now after so many years ?
I am from Sweden. I hope you can understand my english. Very grateful to have an answer.

ANSWER: You have not told me whether you had heavy irregular periods which would indicate you may have had a low ferritin because of the heavy periods and a high testosterone level for most of your life. I would also like to know if your father was bald and if your mother had thin hair or brothers who are bald. From your history my guess is that you inherited some bald genes and have AGA , and my guess is that you had PCOS - polycystic ovary syndrome - which led to a higher testosterone level which made the AGA worse than it would have been. To add to that the low serum ferritin of 6 prevented you from being able to grow your hairs back properly and may have led to a CTE. Just having a CTE will cause an early onset of AGA. It is possible for women with PCOS to end up having hair which looks as thin at 50 as it would have looked at 80 without PCOS.
 Here is an example of what repeated Telogen Effluvium can do - it is from Chapter 4 of my book "Hair Loss Answers"


Stress can cause a type of hair loss called telogen effluvium. This condition is not caused by the general accumulated stress of ordinary interactions with people at home and at work, but rather by sudden severe emotional or physiological incidents. Severe stressful events can cause some or most actively growing hair follicles to prematurely shift into the regression phase, and then the resting phase, during which the hairs fall out easily.

There is usually a delay of a few weeks to a few months before the shedding is noticeable, but after this delay the shedding seems to occur quite suddenly. Because the shedding is delayed, this type of hair loss is often a mystery to the person suffering the condition. The stressful event that triggered it is frequently forgotten, and it is rarely thought to be connected with the “new problem.”

Examples of sudden severe emotionally stressful events include the death or terminal illness of a family member or close friend, marriage, divorce, and unexpected job loss. Severe physiological stressful events shock the body, and some examples are heart attacks, major surgery, and illnesses with prolonged high fever such as malaria, viral pneumonia, and severe cases of the flu.

In most cases of telogen effluvium, the hair follicles recover and soon shift back to the regular growth cycle.

However, repeated instances of telogen effluvium can result in premature hair loss in people predisposed to lose their hair late in life. The average growth cycle of a hair follicle takes about five years, but each follicle is “genetically programmed” for only a limited number of growth cycles. For example, if a particular hair follicle were “genetically programmed” for only ten growth cycles, after about fifty years that follicle would stop producing new hairs. When all the follicles at the hairline or crown of the head are “genetically programmed” this way, a receding hairline or bald spot appears after all the growth cycles for the follicles in those areas have been cycled through.

Each incidence of telogen effluvium uses up one “life” of the affected hair follicles. So instead of having a receding hairline or bald spot at age fifty, the hair loss may occur a few years earlier. This is not a significant issue if telogen effluvium occurs once or twice in a lifetime; however, accelerated hair loss can result from repeated severe stressful events, if each instance triggers a new round of telogen effluvium.

I had a patient who was totally bald when I met him at age seventy, and he had lost all his hair by age twenty-two. He had worked on the Panama Canal fifty years earlier, and for two straight years starting when he was twenty he suffered repeated bouts of severe fever from episodes of malaria. Each time he suffered from malaria induced fever he experienced telogen effluvium, lost what hair he had, and his hair follicles lost another “life.” After ten or fifteen malaria stress cycles, at the age of twenty-two, he had the hair he would have had at age seventy. Which unfortunately for him was no hair at all.

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QUESTION: Thank you for a quick answer. I have not had irregular periods. Just heavy periods from about age 35. I lost a lot of blood. Not from age 16. I don´t know exactly (never tested) but I think I had normal iron level before the heavy periods begun. When my periods stopped a few years ago the S ferritin went up to 103 without medicine.
My father is 88 years old and is not bald at all. He has a lot of hair. My mother is 85 and has thin hair today but she is on a lot of medication-  beta blockers, waran etc. She has not have thin hair earlier. Her father though was bald. I have no brothers and my sister is dead.
If it is AGA do you think Nisim is a good treatment for me? Just started with that some days ago. I have also started with laser (X5) at home. Something else to try?

I still think you have AGA inherited from your mother which has shown up very early due to repeated TEs. Laser as Low Level laser light therapy has been found to be as good as minoxidil in stimulating hair to grow. Your unit puts out the right wavelength light but you will have to apply it more often and for longer periods of time than with other units to get results.
I am not familiar with Nisim products but from a brief look at them on the internet it would seem it may help.
Take a bottle to your dermatologist so that the ingredients can be checked to see if there are active ingredients which can help.

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Peter J. Panagotacos, <B>M.D.</B>


I have 30 years experience in the field of medical and surgical Hair Restoration and am Board Certified in Dermatology and Hair Restoration Surgery.


I have 30 years experience in the field of medical and surgical Hair Restoration and am Board Certified in Dermatology and Hair Restoration Surgery. More information can be found at my website

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