Hair Loss in Ailing Women

The other day, we received an email through the SGU contact page from Jenelle, who is a skeptic faced with a dilemma that is probably more common among women than many suspect: what to do about hair loss following serious illness. Here’s her letter:

I’ve been a dedicated listener for over a year now, ever since my boyfriend found your podcast. I am a Ph.D. student in psychology, have Health Sciences Master’s and Undergraduate degrees, and work as a researchers for the Federal government. However, I am being faced with a personal crisis that threatens to overwhelm me with pseudoscience!

I was in the hospital for all of May and June due to Ulcerative Colitis. I had emergency surgery that did not go well and I spent 3 weeks in ICU on and off life support. It is not surprising that my hair almost completely fell out due to the trauma and malnutrition. My hair has started to grow back, but it is thin and basically awful. People are constantly recommending that I use various products (Rogaine and Nioxin being the forerunners) to thicken my hair and make it grow back faster. I’m a 27-year-old female and, I have to admit, having bad hair really bothers me. It is very tempting to try these products but quality research is difficult, if not impossible, to find. I don’t want to waste my money on products that won’t work and, on principle as a skeptic, I don’t want to buy into the pseudoscience (and the cosmetic companies’ ability to spin the pseudoscience rivals that of “alternative” medicine). Any help would be greatly appreciated!

Jenelle

I forwarded her letter to Lucia Gagliese, PhD, a very good friend of mine and one of the most compassionate and intelligent skeptics I know. She just so happens to have a lot of experience working with patients who are coping with problems like Jenelle’s. Her excellent response follows!

Hi Jenelle,

It’s great to hear that you are on the road to recovery and that your hair is growing back. I understand how difficult it is to have “bad hair”. For many women, our hair is key to feeling attractive and confident so it isn’t surprising that losing our hair is incredibly difficult, even when we know it will grow back. There are studies among women diagnosed with cancer that have shown that a major concern is chemotherapy-related hair loss. Sometimes, hair loss is the single most feared aspect of treatment. As you describe so well, this is a situation that is ripe for friendly suggestions, self-doubt, impatience with gradual improvement, and increased interest in potentially questionable treatments.

So, to the science:

The most important consideration is the cause of your hair loss. As you describe, it’s associated with a major stressor (surgery, ICU, complications) and malnutrition. This is one of the most common types of temporary hair loss in women, and the usual treatment is targeted to the underlying cause. I am assuming that you are being followed closely by your doctors in this regard.

The hair regrowth treatments that you are wondering about are not really targeted to this type of hair loss. They have mostly been tested for male pattern baldness. They may help some women with female pattern baldness or alopecia, although this has not been as extensively studied. Some of the treatments may not be safe for women of child-bearing age or who are pregnant, and they may have adverse side effects, including increased facial hair. Of particular interest to you, Janelle, is that although these treatments are topical (applied to the skin), some may have effects on your immune system which may be bad news for someone with ulcerative colitis.

The good news is that your hair is growing back. I urge you to try to embrace your new, thin hair as a sign of your improving health. Many brave women are coping with hair loss and online resources are available with tips and strategies for coping (e.g., http://www.breastcancer.org/tips/hair_skin_nails/coping.jsp). It is difficult when dealing with a symptom that impacts on our sense of self to stick with the evidence. I admire your strength in choosing this path to recovery.

Lucia Gagliese, PhD
York University & University Health Network
Toronto, Canada

Because Lucia is at least five different types of awesome, she has offered to respond to any other similar questions! If you have a question for her that you don’t mind sharing with the world (we can remove certain personal info if you’d like), use the Skepchick contact form to send it in. (Obviously, all serious medical inquiries should be directed toward your doctor.)

Rebecca leads a team of skeptical female activists at Skepchick.org and appears on the weekly Skeptics' Guide to the Universe podcast. She travels around the world delivering entertaining talks on science, atheism, feminism, and skepticism. There is currently an asteroid orbiting the sun with her name on it. You can follow her every fascinating move on Twitter or on Google+.

14 Comments

  1. Hey, Rebecca, just had a semi-related thought. We should also add a Medical tag for blog posts.

  2. You should also tag it “Chick Stuff”. Because, you know, chicks have hair.

    I am a Hedge

  3. @Im a Hedge: WTF?

  4. @Gabrielbrawley:
    (it’s a little joke… you know, the big thread last week about too much “chick stuff” at Skepchick)

    I am a Hedge

  5. Ooh, can I submit “why does it hurt when I pee?”

    :D

  6. I also have ulcerative colitis and almost had to have the same surgery this past Winter. Dealing with the disease and all horrible it things it does to your life is bad enough without adding other stuff.

    I don’t know exactly what procedure Janelle underwent because there are a couple of options for surgery. Most of them involve a 4-6 surgery to remove the colon with at least a week hospital stay (without complications). Then home to recover for 6-8 weeks, then back for another 4 hour surgery to reconnect stuff. Home for another 6 weeks of recovery. Not a pleasant way to spend 4 months, but better than suffering the symptoms of UC for a lifetime.

    I wish Janelle all the health and happiness in the world. I am impressed that she is trying to research her options. It can be very easy to fall prey to easy fixes when you’ve been through a traumatic experience.

  7. @DNAmom: Here’s hoping that you don’t have to go the surgery route.

    I hope Jenelle can keep her morale up until she’s fully healed. My thoughts are with her. Kudos to Lucia for offering her help to both Jenelle and the rest of us!

  8. @tkingdoll:
    Does that mean we’ll have to add Frank Zappa to the skeptical playlist?
    Not that there’s anything wrong with that.

  9. Jenelle, please let me comment on two levels,

    First, I have recently had internal heart surgery and then surgery to repair damage done by the first surgery. I can empathize with what you are going through. I, at first, was deeply affected by the side effects, both aesthetic and psychological. Then, one day, I just decided to say screw it and move on. Nothing changed about the side effects, but my outlook really improved. My guess is that your hair will gradually get better on its own, or you will come to embrace the new you in a way that reduces your concerns. Either way, hang in there; life will get better.

    Second, my wife suffers from hereditary thinning of the hair. She uses Nioxin and swears by it, finding it to be an amazing benefit. I, on the other hand, have to remove and clean out the shower drain at least once a month because it is clogged with hair. Choose as you wish between her beliefs and my experiences. Either way, you might find some comfort.

    Best wishes in your recovery.

  10. First, best of luck in your recovery Jenelle!

    This post could not have been more timely for me.

    I had gastric bypass surgery about 4 months ago, and am now starting to experience hair loss as a result. I was told going in that hair loss occurred frequently, and was really hoping it wouldn’t happen to me, but alas.

    My hair was thin to begin with, and just this past week, the shedding has increased to a point where I’ve started to feel a little panicky. At my surgeon’s suggestion I’ve increased my biotin and protein intake, but I was considering purchasing some Nioxin products in addition.

    Reading Dr. Gagliese’s response has encouraged me to forego the Nioxin for the time being. I guess if my hair thins too much, I’ll just have to invest in a fabulous wig!

    Now I’m wondering if the biotin increase is more woo than anything else, and if there is anything else I can do to help keep and regrow my hair.

  11. This article might be of interest to some:
    http://discovermagazine.com/2006/feb/when-women-go-bald

    Dr Christiano is one of the experts on the molecular and genetic basis of hair growth – she also experienced hair loss and hair texture changes. Prior to this experience she was one of the first to find genetic factors behind epidermolysis bullosa, a very nasty disease. She rocks.

  12. This is based on very little evidence, but it won’t hurt or cost any extra money.

    When I was younger, I was always trying to put on muscle weight. I tried all kinds of protein supplements and basically never saw much difference.

    But when I started mixing egg whites in with the protein powder, I saw one effect. My nails seemed to grow very fast. Not biceps, not lats, just nails.

    Since hair and nails are both made of keratin, and you have to eat anyway, I suggest throwing in some extra eggs once in a while if you’re trying to speed up re-growth of hair.

    Again, this isn’t based on much, but unless you’re allergic or something, it couldn’t hurt.

  13. Thanks to everyone for the encouraging comments! I find it touching that strangers take the time to leave such nice messages. It’s a nice upside to a bad situation.

    For those who mentioned protein intake, I believe it’s a good recommendation and I’ve already increased my protein intake substantially. I had a consultation with a clinical dietician and her recommendations basically included eating as much protein as possible, ensuring I’m getting enough iron, and taking a multivitamin, preferably a prenatal vitamin (it’s more potent) because my body is likely fairly inefficient at absorbing nutrients. And you’re right, Ken, you have to eat something anyway!

    DNAmom, my situation is a worst case scenario for a number of reasons, so I don’t want you to be more scared than necessary about the surgery, but check out UC to J-Pouch Story at http://ucstory.wordpress.com/ for some inside info.

  14. Jenelle,

    I am going through something similar. I found this site which has some really informative links including a section for women: http://www.hairlosscause.org. Maybe you’ll find something useful there.

    Best wishes,
    Marissa

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