With pregnancy there comes a lot of symptoms, from nausea to swelling to rapid weight gain. Then you finally have the baby and you’re introduced to a whole new batch of changes in your body.
Women will experience the postpartum period, sore breasts, night sweats and of course the infamous postpartum hair loss which reportedly affects around 40% of women in the six months of giving birth, according to the Lloyds Pharmacy.
HuffPost UK spoke to hair doctor Anabel Kingsley, the Trichologist at Philip Kingsley to understand what causes the hair loss as well as what you can do about it. She explained everything you need to know about postpartum hair loss.
What causes postpartum hair loss?
The most common, and the most well-known, reason for PP hair loss is the hormonal shifts that occur when we give birth. When we’re pregnant, oestrogen levels rise which extends the anagen (growth phase) of the hair growth cycle — oestrogen is very hair supportive. We hold on to more hairs than usual and shed much less – perhaps losing only 10-40 strands a day, with the norm being between 80- 100. Many women say they have the best hair of their lives in their 2nd, 3rd and 4th trimesters.
Increased progesterone during pregnancy also probably plays a role as it is anti-androgenic. Androgens (testosterone and its hair-damaging metabolite dihydrotestosterone/DHT) are not scalp hair supportive and can shorten the growth (anagen) phase of the hair growth cycle – especially if you have follicles that are sensitive to the presence of them. So, the drop in progesterone postpartum could add to hair loss.
When oestrogen levels drop after giving birth, all of those extra hairs retained, plus those that would naturally, go into the telogen (resting phase) of the hair growth cycle, shed en-masse three to four months later. This type of hair loss is called telogen effluvium. Hair fall resulting from that drastic drop in oestrogen generally lasts three to four months.
Other factors
There are many things that can exacerbate hair loss postpartum and cause it to go on for longer than it should.
While having a baby is joyous, the postpartum period can be challenging both mentally and physically. Hair is incredibly sensitive to general health, stress levels, mental health, thyroid hormones, sex hormones and nutrition – and all of these can go helter-skelter. If eyes are the window to our soul, hair is a window to our health.
Our hair is the last part of us to receive nutrients and the first to be withheld from. Hair cells are also the second fastest dividing cells our body makes – meaning its energy requirements are very high. As such, hair is incredibly sensitive to any deficiency, even small ones that may not impact our general health.
The demands of growing a baby can leave us with already low Vitamin D, B12, Zinc, Iron and Ferritin (stored iron) levels — so your hair may be on a back-foot even before you give birth. As hair doesn’t fall out right away, part of the hair loss women see in the postpartum period is often unrelated to hormones.
It can be challenging to eat well in the postpartum period when you are looking after a newborn due to lack of time and fatigue. To compound this, sadly many women also feel pressure to ‘bounce back’ and restrict what they are eating – from the conversations Anabel has had with her clinic clients, restrictive dieting right after they’ve stopped breastfeeding, or immediately postpartum if they don’t breastfeed, isn’t rare and this can result in further shedding.
Iron & Ferritin (stored iron deficiency)
One of the most common causes of telogen effluvium in women is low ferritin – and it’s even more common postpartum. Blood loss from both vaginal and C-section births can deplete our iron and ferritin levels and, depending on when you get your period again, iron levels can be further taxed.
Breastfeeding
Breastfeeding can also play a role. Hair loss can be triggered or made worse when breastfeeding if you are not nourishing yourself and/or supplementing adequately- breastfeeding requires a lot of extra nutrients and energy.
Stress
Lack of sleep, traumatic births, stress, postpartum depression and lack of support with a new-born can impact hair cycling and scalp health. The impact that stress can have on hair growth should not be underestimated.
High fevers from mastitis and certain antibiotics can cause hair shedding.
Both hypo and hyperthyroid cause hair loss
Thyroid imbalances from pregnancy may remain unresolved if you aren’t being monitored, or a new imbalance can appear postpartum and be undetected for months, or longer. Lack of energy, constipation, lethargy and feeling not yourself are often put down to being a ‘normal’ part of postpartum life, but from the women Anabel has consulted to with hair loss, it’s not uncommon for it to be thyroid related.
Anabel thinks severe and prolonged hair loss in that first year after birth (sometimes beyond) could many times be avoided if women were looked after better and were encouraged to have regular blood tests in those first 6-12 months after birth — and also if more awareness was raised.
How long does it take to stop
Uncomplicated PP hair loss usually lasts from three to four months, sometimes up to six. The good thing about hair shedding, although it is monumentally distressing while it’s occurring, is it’s a sign your hair is re-setting. After telogen (resting) and exogen (when hair is released), anagen (growth) starts. There’s a new hair at the heels of a one that’s just fallen out, so you can expect to see regrowth quickly. Depending on the length of your hair, it will take a little while to see it benefit your mid-lengths and ends. Hair only grows half an inch a month.
If your hair shedding is chronic/recurring (i.e. lasting for longer than 6months and stopping only to restart again), your hair will recover once the underlying cause is found and treated.
What you can do about it:
Health check:
Anabel strongly encourages any woman to have comprehensive blood tests carried out at 6 weeks and then again at 12 weeks postpartum to catch any deficiencies or thyroid hormone imbalances. Not only will this help to curb avoidable hair loss, but it also will benefit your general health.
Take a supplement
Ultimately, it’s best to speak to your doctor about postpartum supplements as your requirements may be unique. Many GPS recommend taking a breastfeeding specific supplement if you’re breastfeeding, or your regular prenatal vitamin, in the months after giving birth. Anabel also loves Philip Kingsley’s Density Healthy Hair Complex which contains most of the nutrients we are commonly deficient in postpartum and at the right levels to support hair growth.
Products
There are no shampoos or conditioners that will help treat postpartum hair loss. However, a gentle volumizing shampoo can do wonders for your hair’s appearance while you’re waiting for it to recover its thickness. Anabel loves the Philip Kingsley Density Shampoo and Conditioner.
She also encourage women to use daily scalp drops to help support their hair growth cycle. These won’t stop hair loss that is already occurring (the trigger is in the past), or treat nutritional or thyroid related hair loss, but they do encourage new hairs to grow to their best ability. With both of Anabel’s pregnancies she has used the Density Preserving Scalp Drops which are clinically proven to reduce hair shedding.
Shampooing regularly is important - cleansing your scalp keeps it clear of dead skin cells, pollution, sweat and old oils which will help to support the growth of new hairs. We know a flaky, oily scalp worsens hair shedding and can increase oxidative stress. Anabel says she knows it is distressing to shampoo when you’re losing your hair, but it really will help.
In terms of improving hair condition, manageability and shine, use a pre-shampoo conditioning treatment 1x per week, like the Philip Kingsley Elasticizer. Anable says she loved this postpartum as it can be left on all day to multi-task with.
If you suspect that you have hair diameter changes (female pattern hair loss), prescription drops containing Minoxidil can help.
In all instances where hair loss has been occurring for more than 6 months, make an appointment to see a trichologist. Or come in to see Anabel sooner at the clinic and relevant blood tests and assessments can be arranged if anything else might be going on.