Genetic hair loss or increased loss (chronic telogen effluvium) can happen to both sexes but the incidence increases in women prior to menopause. Men loose hair from their temples and crown and this is known as male pattern baldness, while women are more likely to loose hair from front hairline.

Around 10% of women suffer from genetic hairloss prior to menopause, compared with 60% of men in their lifetime. Female hair loss can increase at menopause (menopausal alopecia) because of an increase in a type of male hormone, androgen, similar to testosterone (dihydrostestosterone -DHT) and the fact that the usual protection of female hormones decreases at this time. Anti-androgen therapy can help prevent further loss but is unlikely to restore new hair growth.

Underactive thyroid or hypothyroidism, related to autoimmune disease also accounts for hair loss problems in women under the age of 45 and the likelihood also increases at menopause. Stress makes these problems worse and can also be a direct cause.

About 50% of women have post-natal hair loss in pregnancy which returns to normal without intervention. HRT can cause loss, particularly if it contains androgenic progestin. Other causes are emotional shock and physical stress, such as a serious accident, a lack of sleep and rest, chemotherapy and radio therapy for cancer; certain drugs such as cortisone, sedatives, tanquillises, barbituates, amphetamines, antibiotics; immunisation – either in childhood or for holidays, yo-yo dieting, a poor diet, smoking, eating disorders, misuse of hair products such as colourants, central heating, pollution, drandruff-like conditions that affect the rate of shedding.

There are a number of over the counter preparations and natural remedies but these tend to work by improving the condition of existing hair and the scalp and are not necessarily successful in regrowing hair. For women these include Cyproterone Acetate (brand name Diane), Minoxidil (Regaine) and Spironolactone (Spiroctan, Diatensec). For men – Finasteride (Propecia), Minoxidil and Dutasteride (Avodart). Hair grafting can be carried out by a specialist surgeon using micro-grafting techniques. Cloned hair follicles which can also be surgically implanted may be available in the next few years. The Trichological Society – www.hairscientists.org has lists of specialists in all areas of hair care and health.