“Within a year of getting affected by PCOS, I lost 1/4th of my hair on my head.”
“I have diffused thinning of my hair. The sides and the back of my head are where the thinning is worse.”
“I have developed a really wide parting, like you can see my scalp. And I worry that the situation is worsening.”
These are only a few comments about PCOS hair loss on a popular online forum, SoulCysters. While there are other, equally serious symptoms of PCOS, hair loss can be a nightmare for most women. As someone who has done a lot of reading on this subject, I want to tell you that there is hope. You can recover from PCOS hair loss once you understand the cause of it, and make the right changes to your diet and lifestyle.
Why Are You Losing Hair in PCOS?
In general, women lose hair due to a variety of other reasons. These reasons include certain drugs, anemia (primarily due to iron deficiency), a drop in estrogen levels, especially during menopause, and other illnesses and infections.
It isn’t abnormal to lose around 100-150 hair per day. This is a normal turnover process in which old hair fall off to be replaced by new, young hair. So it generally takes around 20-25% of scalp hair loss before the woman realizes that she is losing more hair than usual. Many women also suffer from hair loss shortly after giving birth. Normal hair loss pattern resumes 3-4 months later.
PCOS hair loss follows the pattern of hair loss as seen in males. Because the main cause of PCOS hair loss is an excess of male hormones in the body. This means you start losing hair around the frontal region of your scalp. It is therefore advisable to be aware of hair loss patterns while combing and washing.
Women with PCOS have excess amounts of the male hormone testosterone. Testosterone is converted to dihydrotestosterone (DHT). DHT is also made from a female hormone called DHEA. While women have DHT in small quantities, an excess of DHT clogs hair follicles and affects the normal process of hair growth.
Medical Treatment for PCOS Hair Loss
Medical management of PCOS hair loss is very difficult. Drugs available for treating male pattern hair loss are successful in slowing hair loss and not reversing it. As a first step, your doctor will prescribe drugs to treat the overproduction of male hormones.
Drugs Prescribed For PCOS Hair Loss Include
- Oral contraceptives: (birth control pills or BCP) in combination with spironolactone
- Combination of BCP and 5-alpha reductase inhibitors: 5-alpha reductase inhibitors are a class of compounds that have anti-androgen (male sex hormone) activity.
- Combination of BCP and flutamide: Flutamide is a non-steroidal anti-androgen.
- Minoxidil: Minoxidil opens potassium channels and widens blood vessels. This helps better transport and supply of nutrients to the hair follicles thereby stimulating hair growth.
- Finasteride: This drug blocks the conversion of testosterone to DHT.
- Metformin: It is mainly used as an adjunct (helper) along with any of the above-mentioned drugs. The insulin-sensitizing activity of metformin may help other drugs work better.
Some doctors may also advise a hair transplant for PCOS hair loss. While this does not address the root cause of the problem, it is an attractive option for young women who do not wish to wait for too long to reverse their PCOS hair loss. It is especially helpful in combating a receding hairline or hair loss on the top of the scalp.
Diet And Lifestyle Changes To Stop and Reverse PCOS Hair Loss
Diet and lifestyle changes play a big role in dealing with PCOS. Even mainstream doctors consider diet and lifestyle changes as an essential first line of therapy for PCOS hair loss.
We are what we eat, literally and figuratively. Our diet is more closely linked with our wellbeing than we give it credit for. Eating a real meal that is cooked at home with fresh vegetables, whole grains, legumes, lean meats and high quality fats can work wonders for PCOS hair loss.
Eating and sleeping on a schedule might seem like a no-brainer for good health. But they have a deeper relationship with PCOS hair loss. Sleep is controlled by two hormones – melatonin and serotonin. A lack of sleep will cause an imbalance in the levels of these two hormones. This will, in turn, imbalance other hormones, including insulin. Regular eating will help in keeping your insulin levels normal.
In case you smoke, you need to kick this habit to reverse your PCOS hair loss. Apart from its many horrible health hazards, cigarette smoking also increases male hormone levels. And since PCOS hair loss is caused by excess male hormones, it makes sense to avoid things that increase their levels.
- Fish oil: The omega-3 fatty acids in fish oil help lower male hormone levels. It can also help lessen the severity of other PCOS symptoms like acne and excessive hair growth, especially on the face, arms, legs, back, and chest.
- Biotin: This water-soluble B vitamin is essential for the health of hair and scalp.
- Metylsulfonylmethane (MSM): This chemical is present naturally in our body. It is essential in producing keratin, the protein that makes up hair and nails. Supplementing with MSM strengthens hair follicles and controls hair loss.
- Rosemary essential oil: This oil helps improve blood circulation in the scalp and rejuvenates hair follicles. Add a couple of drops of this essential oil to your shampoo and massage gently onto scalp.
- Spearmint tea: This refreshing tea reduces testosterone and improves insulin sensitivity.
- N-acetyl cysteine: This supplement reduces testosterone levels and improves insulin sensitivity in women with PCOS.
- Apple cider vinegar and baking soda: A mixture of these two can be applied on top of your hair to stop PCOS hair loss. You can also drink this solution.
- Saw palmetto: A natural testosterone suppressant, saw palmetto helps in reversing PCOS hair loss.
- Jojoba oil: This oil improves the quality of hair, prevents hair loss and even helps hair to grow. Massage a pre-warmed teaspoonful of jojoba oil onto your scalp. Wash with shampoo and rinse thoroughly.
Exercises For Weight Loss
Excess weight is the reason behind insulin resistance, the key reason behind excess male hormones in women with PCOS. Physical exercises that help in weight loss can help in managing PCOS hair loss.
When you are stressed, your body responds by increasing levels of cortisol, the “stress hormone.” Cortisol worsens your hair loss. It can also increase your risks of more serious health complications like hypertension, increased weight, lowered bone density, weakened immune system and heart disease. Stress also increases the risk of insulin resistance.
Hair Care Tips To Deal With PCOS Hair Loss
In addition to diet and lifestyle changes recommended above, here are some hair care tips for managing PCOS hair loss.
- Shampoo your hair daily and rinse them thoroughly to ensure that no shampoo remains in the hair or on the scalp.
- Use a good quality conditioner to remove tangles and make hair manageable.
- Do not use a brush with sharp bristles. Use a smooth comb.
- If you are blow drying, keep the dryer at a distance of 6 inches from the hair. As the hair begins to dry reduce the heat so as not to damage hair with excess heat. Dry the remaining dampness naturally. Too much blow drying will lead to brittle, dry and frizzy hair that are difficult to manage.
- Use rollers carefully. Do not bind them too tightly. Do not put pins and clips too often and always remove them before going to bed.
- If you are using elastic bands and barrettes to tie your hair, do not bind hair too tightly. Do not pull hair from the forehead while tying them. This leads to traction alopecia, a condition in which hair become weak and may cause severe breakage.
- Many women have a habit of compulsive touching and pulling hair. This must be avoided.
PCOS hair loss is an emotionally draining issue with any women. If you have tried all of the above and are still losing hair, you should get your thyroid tested. There is a strong correlation between PCOS and hypothyroidism. And an under-performing thyroid is known to cause hair loss.