Ask Dr Gary: No cure all for hair loss in women

I seem to have excessive hair loss. I'm a healthy 57-year-old woman. When showering, my shed hair clogs up the drain and continually floats around in the air when gently brushing or combing. I have also noticed it over the pillow now. I have had a thyroid test done, which was normal. My scalp appears normal. Is there anything I could take to help with this problem? - M.K.

Around 40 per cent of women can expect hair loss by their fifth or sixth decade. It's less noticeable in women because, rather than a receding hairline, women have diffuse hair loss over the top of their scalp.

There are dozens of treatment options and supplements, but they work for only some people.

I'll give you the best studied example: minoxidil. It's a liquid you put on your bald spot twice a day and it hormonally stimulates hair follicles. After about four months, people using it may notice improvement. About 30 per cent of patients notice significant regrowth. Many of the rest will not see regrowth, but will see a slowing in the rate of hair loss. It's a lifelong treatment, as stopping causes the regrown hair to fall out and the thinning process to continue.

Your doctor, once they've ruled out autoimmune disease, thyroid disease, and hormonal problems, can talk to you about the various treatments. None are remarkably effective, and they each have their downsides. As for supplements, iron works for anaemia-related hair loss; but the rest of the concoctions out there haven't been convincingly shown to work. Maintaining a healthy weight (fat is very hormonally active) and preventing or controlling diabetes are two goals that will help prevent some cases of hair loss. And there's hair transplantation via follicular unit extraction, a newer and expensive, but effective option.

Most women will shy away from this as it requires the patient to have a 2mm haircut from the donor site (usually the back or sides of the head) prior to the procedure.

Gary Payinda, MD, is an emergency physician who would like to hear your medical questions. Email drpayinda@ gmail.com. This column gives general information and is not a substitute for the advice of your doctor.