Postpartum Hair Loss: Why, When & How to Treat It

Posted by Katherine Mugan on

You might have started to notice that your plughole is clogged with hair when you shower, or your hairbrush is completely filled up with stray hairs every single time you brush your hair. You'll be relieved to hear that it's completely normal for new mums to suffer from hair loss after giving birth, but it can be quite dramatic and disconcerting!

There are lots of myths around postpartum hair loss as to why it happens and what you can do about it. Let's take a look at what real medical and scientific evidence there is.

Why am I losing hair after giving birth?

The two factors in postpartum hair loss, or alopecia, are thought to be:

  1. Changes in hormone levels
  2. The stress of childbirth

Changes in hormone levels and the hair growth cycle

It's a totally natural side effect of your pregnancy ending. While you were pregnant, your hormones kept any hairs that were at the end of their natural lifespan healthy and growing. Your placental oestrogen stopped the normal shedding, so you built up lots and lots of 'old' hairs that were being kept alive beyond their normal life. Once your hormones start to calm down in the weeks after you've given birth to your baby, these hair follicles start to move on to the next phase of the hair lifecycle and begin to shed their hairs (source). 

Another factor is that your body has adjusted to higher oestrogen levels during pregnancy. A drop in oestrogen levels leads to hair loss. And that's exactly what happens after you've given birth. Your oestrogen levels will only drop back to normal, pre-pregnancy levels, but that's enough to trigger hair loss (source).

You might hear the medical term for this, which is telogen effluvium. To understand what this means, let's look at the 3 stages in the hair growth cycle:

  1. Anagen - the growing stage, which typically lasts 3-5 years per hair. Hairs that would normally be moving to stage 2 are preserved in the anagen phase during pregnancy.
  2. Catagen - the intermediate stage where the hair follicle prepares to rest, lasting a couple of weeks.
  3. Telogen - the resting or shedding stage, in which no growth occurs and the hair will fall out. This stage usually lasts for 3 or 4 months. About 10% of your hairs are in this phase at any one time.

Telogen effluvium is when lots of hairs enter the telogen phase early and so fall out. When it's specifically caused by pregnancy and childbirth, it's referred to as telogen gravidarum.

A small 2014 study of 116 women looked at the percentage of hairs that were in each stage of growth to find out if there were differences between normal hair growth, that during pregnancy and the same postpartum. They discovered that there was a statistically significant increase in the number of hairs that are in the anagen phase by 9 months pregnant. And then a significant decrease in anagen phase hairs and a matching increase in the hairs that are in the telogen phase 4 months postpartum.

The stress of childbirth

Hair loss can be triggered by the stress of delivery on the body. It's thought that this can trigger hairs that were previously growing to stop and enter the resting/shedding phase.

How quickly after birth will I lose my hair?

Not all women suffer from postpartum hair loss. If you're going to, it's almost certain to start between 2 and 4 months after birth. 90% of women who lose some hair observe it starting in this timeframe. A rare 10% see it starting sooner or later.

The outcome

These processes together mean that you suddenly start to lose a large number of hairs. It really can seem like a torrential flood of hairs falling out. I've always had naturally very thick hair and I didn't notice it getting any thicker during pregnancy. But postpartum, from three to six months, I've not been able to shower or brush my hair without getting covered in hair. And I really mean covered in hair. I spend half of my (very limited - with a small baby) showering time trying to disentangle long hair washed off my head from my fingers. I'm not a fan of being hairy in that sense!

With all those hairs falling out in a much shorter, concentrated period of time, and after you might have got used to that luscious thick pregnancy hair, you might be surprised by your new thinner do.

Hair loss across your body

Your shedding isn't going to be confined to your head. Your hormones affected your entire body. Your pubic hair might thin out. And you might be relieved to hear that if you've grown dark hairs on your stomach around your belly button or along the linea nigra (the dark line up to your tummy button and sometimes beyond, which darkens in pregnancy), these hairs will probably fall out too. Phew!!

Is postpartum hair loss caused by breastfeeding?

A lot of people believe that your baby is 'sucking the nutrients out of you'. Someone actually said that to me the other day when they saw me breastfeeding in a cafe. They say that leads to your poor decrepit body shedding hair because it's in such a poor state. That's just not at all true! You're still healthy and your hair loss isn't anything to do with breastfeeding.

In fact, when doctors investigated the hair growth states of breastfeeding women versus new mothers who weren't breastfeeding, at 4 months post-delivery, the lactating women had a higher percentage of actively growing hairs than those not breastfeeding.

I've heard that postpartum hair loss doesn't really exist

A 2016 review of previous studies claims that postpartum hair loss could be a myth. Any woman who's suffered with it will be pretty clear on that fact that it does exist. The point that this study is making is that there hasn't been much research done into the subject and those that have been done are fairly small. This makes it hard to scientifically prove beyond any doubt that it's a real phenomenon and to explain when or how it presents.

While the authors believe that there hasn't been enough proof as to how to exactly show how often postpartum telogen effluvium (PPTE) occurs (if at all) or to characterise how it presents, it's a sensational leap to go on to say 'we dare say that PPTE does not exist'.

There's a clear distinction between something that hasn't yet been proven by science versus something that has been disproven. The existence of postpartum hair loss certainly hasn't been disproven.

Can I prevent postpartum hair loss?

Unfortunately, no. No one has yet found a way to prevent postpartum hair loss.

However, if you're finding that your hair is breaking and thinning out for this reason, you can try to improve its condition ahead of giving birth using some of the recommendations below.

Is it permanent? Will my hair grow back?

It's only temporary and your hair will grow back on its own. One of the original studies into postpartum alopecia in the 1960s showed that 98% of women studied regrew their hair to its previous thickness. The other 2% had other underlying conditions that inhibited growth that wasn't related to their postpartum hair loss. In that study, two-thirds of women returned to normal growth in 4-6 months.

How to treat postpartum hair loss

There are lots of recommendations as to what to do to treat or prevent your hair fall. If you don't want to just sit back and wait for your hair to grow back naturally, let's take a look at which remedies are worth trying and which are just old wives tales with no medical sense.

First, let's distinguish between the different ways your hair can thin out after pregnancy to look at how you can address each one to minimise the impact of your hair loss.

  1. Your hair falls out at the follicle - traditional postpartum hair loss.
  2. Your hair breaks a lot due to poor condition.
  3. Your hair falls out due to other causes like poor diet or anxiety and this adds to postpartum hair loss or continues to thin your hair even after it's naturally started regrowing after birth.

Use with caution

Whether you're still pregnant, or if you're breastfeeding, be very aware than anything that you ingest or put on your skin will pass through to your baby in your bloodstream or breastmilk. Always do your research and take medical advice if you want to use any of these remedies if there's a risk of passing the substances on to your baby.

Also, note that a number of the studies that have been carried out were on animals, not humans and none were on pregnant or breastfeeding women.

Promote new hair growth

Onion juice

A very small study of 38 people found that crude onion juice was more significantly more effective than tap water at promoting hair growth in people suffering from alopecia areata - a condition where bald spots appear. The effect was more pronounced on men than women.

Herbal medicine

A trial on mice proved that a mixture of traditional Cfhinese herbs that included Indian gooseberry (Amla), pine needles and ginger was as effective as the leading hair-regrowth medication.

Peppermint oil

Another trial on mice found that topically-applied peppermint oil was more effective at promoting hair regrowth than leading medication and was less toxic with fewer side effects, for example, avoiding weight gain. You could try massaging peppermint oil into your scalp every day.

Green tea

While often recommended, I haven't been able to find any evidence that green tea is effective. It's generally proposed as a cure for male-pattern baldness as it may have an effect on the body's production of a substance that causes men's hair to fall out as they age.

A clinical trial of a possible new medication to treat age-related baldness that contained a small amount of green tea alongside other compounds like omega oils claims to see significant results. 

Fenugreek seeds

A randomised-controlled trial tested a supplement that contained fenugreek seeds and micronutrients on hair loss sufferers. It was found to be effective against hair loss and to promote hair regrowth.

Liquorice

A study on female rats found that a hydro-alcoholic extract of liquorice was more effective at promoting hair growth than leading medications.

Medication

Minoxidil (branded as Rogaine or Regaine), Pantogar, Viviscal are hair-promoting medications that are used for treating severe cases of alopecia and age-related female-pattern baldness. They aren't generally considered appropriate for postpartum hair loss as it's a temporary condition. There are also warnings that you shouldn't take them while pregnant or breastfeeding. They can have a variety of side effects on even healthy non-pregnant or breastfeeding people. As postpartum hair loss is known to be temporary, it's probably not worth going down the route of full-on medication unless it's really bothering you. It could be worth trying some of the natural remedies above first.

Spread out the shedding

Your hair loss might be less noticeable if you're careful with your hair and try to leave as many of the resting hairs in place for as long as possible. Eventually, they'll fall out on their own regardless, but you don't need to help them along!

Don't brush excessively

Don't pull out knots. Instead, use a gentle brush like a Tangle Teezer. Don't brush too often.

Disguise thin hair

Use volumising hair products

Try a volumising shampoo and conditioner to give your remaining hair more bulk.

Style it out

To avoid your hair looking thin, don't straighten it. Try styles that look more voluminous, like waves or curls, or try backcombing.

Improve the condition of existing hair

To prevent breakages, make sure you've got a good diet and you're taking care of your hair.

Don't bleach

Bleaching hair dries it out and makes it easy to break.

Use a nourishing or moisturising care routine

To keep hair healthy and stop it from drying out. Look for shampoos, conditioners and hair oils that are designed to care for damaged and dry hair.

Use coconut oil-based products

Coconut oil has been proven to prevent hair damage in multiple studies. Mineral oils and sunflower oils do not have the same impact, despite being widely used in hair products.

Eat a good diet

Hair experts recommend that you try dark leafy greens (for the iron and vitamin C), sweet potatoes and carrots (for the beta-carotene), eggs (for the vitamin D), and fish (for omega-3s and magnesium). Try cucumber skins and pepper skins for silica. Eat protein and take vitamins. This is all good advice for your diet anyway, so with a try if your hair is particularly prone to breaking.

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Postpartum Hair Loss: Why, When & How to Treat It | You might have started to notice that your plughole is <span>clogged</span><span> with hair when you shower, or your hairbrush is </span><span>filling up </span><em>every single time</em><span> you brush your hair. It's completely normal for new mums to suffer from hair loss after giving birth, but it can be quite dramatic and disconcerting!</span>

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