The hair growth cycle and aging
As we age, our hair's growth cycle changes. The hair on our head grows in three phases: anagen (the growth phase), catagen (a transitional phase), and telogen (the resting phase). With time, the anagen phase shortens, and the telogen phase lengthens. This means that hair stays in the growth cycle for a shorter period, and more follicles enter the resting phase, leading to overall less dense hair. While this happens to everyone, it becomes more noticeable in postmenopausal women due to hormonal changes.
The role of hormones in postmenopausal hair loss
Menopause brings significant hormonal shifts, especially a decline in estrogen and progesterone. These hormones help hair grow faster and stay on the head longer. As their levels drop, the hair growth cycle is affected, leading to finer, less dense hair. This hormonal change also increases the relative influence of androgens (male hormones like dihydrotestosterone, or DHT), which are naturally present in women. In women with a genetic predisposition, DHT can cause hair follicles to shrink, resulting in a condition known as female pattern hair loss (FPHL), or androgenetic alopecia.
Female pattern hair loss (FPHL)
FPHL is the most common cause of hair loss in older women. Unlike the receding hairline often seen in men, FPHL typically presents as a widening of the hair's center part and overall diffuse thinning over the top of the scalp. A woman's hairline usually remains intact, and complete baldness is rare.
Other potential causes of hair loss in seniors
While hormonal changes and genetics are primary drivers, other factors can also contribute to hair loss in a 70-year-old woman. It is important for a medical professional to rule out other causes, as treatment can vary widely depending on the root issue.
- Stress (Telogen Effluvium): Significant physical or emotional stress can shock the hair cycle, causing a large number of hairs to enter the resting phase simultaneously. This can result in noticeable shedding about two to three months after the stressful event. This condition is usually temporary, with hair growth returning to normal once the stressor is removed.
- Medications: Many prescription drugs can cause hair loss as a side effect, including those for high blood pressure, cholesterol, depression, and arthritis. If a new medication coincides with increased hair loss, it is worth discussing with a doctor.
- Nutritional Deficiencies: A lack of key nutrients can affect hair health. Iron deficiency and anemia are well-documented causes of hair shedding. Deficiencies in protein, zinc, and vitamin B12 can also play a role, and absorption can become less efficient with age.
- Thyroid Conditions: Thyroid disorders, which are more common in older women, can lead to hormonal imbalances that cause hair shedding. Both an underactive and overactive thyroid can affect hair growth.
- Traction Alopecia and Styling Habits: Lifelong styling habits like tight ponytails, braids, or frequent use of chemical treatments and heat can lead to cumulative damage. This damages the hair follicles over time, leading to permanent hair loss in some areas.
- Autoimmune Conditions: Alopecia areata, a condition where the immune system attacks hair follicles, can cause patchy hair loss. Scarring alopecias, such as frontal fibrosing alopecia, can also occur, particularly in postmenopausal women.
Normal shedding vs. hair loss
It can be difficult to tell the difference between normal age-related thinning and a more serious condition. The average person sheds between 50 and 100 hairs daily as part of the natural hair cycle.
| Feature | Normal Shedding | Progressive Hair Loss (FPHL) |
|---|---|---|
| Pace of Change | Temporary increase, often linked to an event (illness, stress) | Gradual, chronic thinning over months or years |
| Pattern | Hair sheds uniformly across the scalp | Widening hair part, diffuse thinning on top of the scalp |
| Regrowth | Hair often regrows on its own once the stressor is gone | Regrowth is compromised as follicles shrink; hair becomes finer |
| Associated Symptoms | None, other than the shedding itself | None, other than the thinning; scalp is typically normal |
Management and treatment options
For women experiencing hair loss, several options can help manage the condition and improve hair health. A dermatologist or trichologist can provide an accurate diagnosis and create a personalized treatment plan.
- Minoxidil: This is the only FDA-approved topical medication for female pattern hair loss. Available over-the-counter as a foam or solution, it is applied directly to the scalp to stimulate hair growth and slow down further loss. Consistency is key, as any progress may be lost if treatment is stopped.
- Prescription Medication: Oral medications like spironolactone, an anti-androgen, or finasteride (off-label for postmenopausal women) may be prescribed to address hormonal causes.
- Gentle Hair Care: Adopting gentle habits can minimize breakage. Avoid harsh chemical treatments, excessive heat styling, and tight hairstyles that pull at the hair. Use mild shampoos and a good conditioner to maintain moisture.
- Nutritional Support: A balanced diet rich in iron, zinc, and protein is crucial for hair health. Your doctor may recommend blood tests to check for deficiencies and suggest supplements if necessary.
- Laser Therapy: Low-level light therapy devices, such as brushes, combs, or helmets, have been shown to help with pattern baldness by stimulating hair follicles.
- Other Treatments: More advanced options, including platelet-rich plasma (PRP) injections or hair transplant surgery, may be suitable for more severe cases.
How to cope with hair loss
Beyond physical treatments, the emotional toll of hair loss is significant, especially for women. Many women feel isolated and experience a blow to their self-esteem. Seeking support is vital for emotional well-being. Talking to friends, family, or joining a support group can help manage the emotional impact. Some women also find success with cosmetic options like volumizing hair products, strategic hairstyles, wigs, or hair extensions to feel more confident.
Conclusion
While a degree of hair thinning is a normal part of aging for a 70-year-old woman, noticeable or excessive hair loss is not just an inevitable sign of getting older. Hormonal changes from menopause and a genetic predisposition to female pattern hair loss are the most common causes, but other medical conditions, stress, medications, and nutritional deficiencies can also be contributing factors. The good news is that many effective treatments are available to manage and even reverse certain types of hair loss. Consulting with a dermatologist is the best first step to get a proper diagnosis and treatment plan tailored to your specific needs. Understanding the cause is the key to managing the condition and maintaining confidence as you age.
For more information on the most common hair loss condition in older women, consult the American Academy of Dermatology's guide on female pattern hair loss.
