Q: I am a woman in my 40s and my hair has been falling rapidly lately. Both my parents suffer from hair loss.
I have tried over-the-counter hair products but to little avail. I have read that minoxidil helps but requires daily use. Is there something that does not require lifelong use or am I destined to become bald?
A: Rapid recent (within the past six months) hair fall is very often related to a preceding stressful event such as an acute illness (usually a severe infection with fever), severe physical and/or emotional trauma, major surgery, or pregnancy and delivery. In these cases, hairfall gradually returns to its baseline rate within six to nine months.
Significant loss in body weight (such as crash dieting, intensive physical regimens) and intake of certain medication (for example, isotretinoin used for treatment of severe acne or beta-blockers used for treatment of high blood pressure) are also important causes.
Internal diseases causing acute hair loss are thyroid disease, autoimmune disease (especially systemic lupus erythematosus) and iron deficiency.
You need to see a doctor to have such conditions ruled out. Whether you have an underlying cause for your recent hair loss or not, it is highly likely that, based on your strong family history as well as your slow long-standing rate of hair loss, you have genetically-determined "female-pattern hair loss".
Minoxidil is probably the most effective, safe and best-studied medical treatment. It is lifelong, but even if you let your hair loss take its natural course, complete baldness is exceedingly unlikely to occur.
Dr Derrick Aw
Dr Derrick Aw is a consultant dermatologist at National University Hospital
This article was first published in Mind Your Body, The Straits Times.