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Postpartum Hair Loss - Avoidable or Inevitable?


If you've had a baby before, you'll know it doesn't take too long after their birth to recognise you're shedding extra hair. It's all over the bathroom floor, your hairbrush is full of it, you see extra hair come away when you're washing your hair and annoyingly, you see strands of your hair all over your baby/in their hands, neck, clothing (and sometimes nappy!)


This is because it is NORMAL!! Due to HORMONES!


When you're pregnant, your hair cycles change due to hormones (such as thyroid hormones, oestrogens and secondary androgen) rising! For example - progesterone increases approximately ninefold, oestrone (an oestrogen hormone known as E1) increases fourfold, oestradiol (an oestrogen hormone known as E2) increases eightfold!


During pregnancy, these hormones impact the body’s hair growth cycle by causing hair follicles to remain in the anagen phase longer than normal. This causes a reduction in the number of hairs that are lost, which increases hair fullness (hello gorgeous, thick pregnancy hair!).


Anagen phase

Lasts approximately 1000 days, is a period characterised by massive hair growth.


In 3rd trimester of pregnancy, only approximately 5% of hair follicles are in telogen phase, compared to 35% during the postpartum period.


Telogen phase

Hair follicles enter a “resting” phase lasting approximately 100 days. During this phase, hair will remain in its follicle until it's pushed out by the growth of a new anagen hair.

Between the anagen and telogen phases is the catagen phase, where hair follicles shrink and growth ceases; this transitional phase lasts approximately for 10 days.


There are multiple factors that can cause hair loss, some related to pregnancy/postpartum and other factors that are not (ie PCOS/excess androgens, anaemia, Thyroiditis).


This also includes:

- hormones

- cytokines (humoral regulators which modulate the functions of individual cells, and regulate processes)

- growth factors

- toxins/environmental factors

- deficiencies of nutrients, vitamins and eating too few calories.

- intensive physical exertion

- comorbidities

- drug use



Once you have given birth to your baby and the placenta, levels of progesterone and oestrogens return to normal within 4 days! The normalisation of these levels lead to hair cycles to become synchronised on the scalp. All the hair that wasn’t shed during pregnancy enters the “telogen-teloptosis process” and you have a mass migration of hair. (yey)...


Be confident knowing that for most, this hair loss only represents the additional hairs that were retained in the anagen phase, that were not lost during your pregnancy. To put it simply: your hair is playing catch up in the telogen phase and should return to its normal cycles very soon!!


If you notice however it does not, and you continue to lose hair or find bald patches, such as male pattern baldness (temples), hairline and lots of hair is coming out in the shower - please investigate with pathology testing of your thyroid function and iron stores. Iron deficiency anaemia can lead to hairloss.


In addition to requiring adequate iron stores for hair growth, we also need to ensure our diet is adequate in protein! Hair is made of a protein called Keratin. For our body to produce Keratin we require a bunch of cofactor nutrients, thus our diet is extremely important for hair growth. Minerals such as zinc, iron and copper are important as well as nutrients such as essential fatty acids, vitamin A, C, D and E, B vitamins and biotin (found in abundance in eggs).


Beyond thyroid issues, PCOS and anaemia, other nutrient/mineral deficiencies can manifest as slow hair growth. Electrolyte replenishment is really important for breastfeeding mothers, as a significant amount of electrolytes are passed through the breast milk to your baby.

Supplementing your diet with electrolytes (in your water bottle) whilst breastfeeding can be really helpful. Mineral rich drinks also include nettle leaf tea and coconut water. Eating a nutrient-dense diet will also supply a significant amount of minerals.


So please knowing the above, don't fall prey to supplements or products like shampoo's or hair creams that promise to reverse or positively impact postpartum hairloss, as you can see, it is inevitable and it is NORMAL! But if you have a hunch it is something beyond hormones from pregnancy and postpartum, please don't hesitate to have your health evaluated.


If keeping a diet nutrient-dense is something you're struggling with this postpartum, or you need help with your postpartum bloods and supplementation suitable for you - check out my program "The Fourth Trimester"!




references:

  1. Eastham JH. Postpartum alopecia. Ann Pharmacother. 2001 Feb;35(2):255-8. doi: 10.1345/aph.10153. PMID: 11215848.

  2. Gizlenti, S., and T. R. Ekmekci. “The changes in the hair cycle during gestation and the post‐partum period.” Journal of the European Academy of Dermatology and Venereology 28.7 (2014): 878-881.

  3. Trüeb, Ralph M. “The Hair Cycle and Its Relation to Nutrition.” Nutrition for Healthy Hair. Springer, Cham, 2020. 37-109.

  4. Pringle, T. “The relationship between thyroxine, oestradiol, and postnatal alopecia, with relevance to women’s health in general.” Medical hypotheses 55.5 (2000): 445-449.

  5. Eastham, J H. “Postpartum alopecia.” The Annals of pharmacotherapy vol. 35,2 (2001): 255-8. doi:10.1345/aph.10153

  6. Taha, R. “Hematological, biochemical and hormonal studies on postpartum alopecia in ewes.” The Journal of American Science 8.9 (2012): 968-972.







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