We've grown accustomed to seeing men lose their hair as they get older. These days, it's not only socially acceptable for a man to be bald - it's physically appealing. Celebrities such as Sean Connery, Bruce Willis and Vin Diesel have made bald sexy.
But what about hair loss in women? We rarely see female celebrities go bald. Women don't flaunt our bald spots - we hide them.
Up to 40 percent of hair loss sufferers are women, yet there's a double standard in the way female-pattern baldness is perceived, says Dr. Sandy Tsao, a dermatologist at Massachusetts General Hospital and instructor in dermatology at Harvard Medical School.
"Culturally, it just hasn't become as socially accepted in women," she says.
Hair loss treatments also tend to favor men.
"The medications and treatment options that have been available for men tend to not be as available or effective for women," Tsao says. "So we deal much more with having to camouflage hair loss."
Men vs. women
When men lose their hair, the first strands typically fall from the front of the head, near the temples. The next hairs to go are on the back of the head. Eventually the two balding areas meet, leaving a horseshoe-shaped ring of hair around the perimeter of the scalp.
In contrast, "Women lose hair throughout the scalp," Tsao says. Instead of developing large bald spots, women typically get widespread thinning.
What causes female-pattern baldness?
Genes are often at the root of hair loss. They affect the way the body responds to male hormones (androgens) - which both men and women have. Too much of these hormones in the hair follicles can slow the growth of new hair and make the hair that does grow in shorter than it was before.
Hair loss in women also can result from a number of conditions, including:
•An underactive thyroid gland
•A significant illness
•A stressful event (negative or positive), such as an illness or death in the family, a move, or a divorce
•Certain medications, such as chemotherapy for cancer.
When your hair falls out, you need to treat it like any other medical symptom and see your doctor. Blood tests can frequently detect an undiagnosed thyroid problem or other health-related cause.
"If we're not able to discern what the cause is, taking a biopsy of the scalp can often give a more conclusive diagnosis," according to Tsao.
Restoring lost hair
If a thyroid problem or other medical issue is making you lose your hair, treating the condition should stop the hair loss. Eventually, your hair should grow back in.
Treating hair loss that doesn't have a clear medical cause is trickier in women.
"There are so few treatments available that have actually proved effective in women," Tsao says. Oral finasteride (Propecia), which is a staple of treatment in men, doesn't have the same results in women.
The best hair loss medication for women is topical minoxidil (Rogaine), which comes in 2 percent and 5 percent solutions. When you apply it twice per day, topical minoxidil can help preserve the hair you have and can even regrow hair. The only catch is you have to keep using it indefinitely. Also, topical minoxidil can cause itching, dryness, and scalp irritation, which you can combat by conditioning every time you shampoo your hair.
Another option is to try a hair transplant - a technique that moves hair follicles from a thicker part of the scalp to a thinning patch. However, because of the widespread pattern of hair loss in women, hair transplants may not be as effective at permanently restoring hair as they are in men, Tsao says.
The procedure also can be expensive, costing several thousand dollars, depending upon the amount of hair being transplanted. If you're considering this option, Tsao advises, "Go to a hair transplant specialist who treats a lot of women. Talk with women who have undergone the treatment."
Several newer techniques for treating hair loss are in development, including the laser hair comb - a handheld device that emits a low-level laser light, which is supposed to stimulate new hair growth. Tsao calls it "a compelling and very possible means of regrowing hair."
However, laser combs haven't yet been studied well enough to determine whether they're effective. Until the results of more clinical trials are released, Tsao recommends you "save your money, but keep it in mind."
Camouflaging bald patches
A number of techniques can camouflage hair loss. One is to wear a wig that matches your hair color and style. Another is to have your hairdresser cut and style your hair in a way that conceals bald patches.
To hide hair loss and preserve the hair you still have, you can also try these tips:
•Be kind to your hair. Don't wear tight buns, ponytails, or other styles that pull on your hair and cause it to fall out even faster. The same goes for overtreating hair.
"Try to minimize a lot of the procedures that make your hair more brittle, such as straightening and perming," Tsao suggests.
•Supplement thinning hair. Ask your doctor about taking biotin, a vitamin that strengthens hair. Just don't exceed the recommended dose, which is 30 micrograms daily.
•Try a spray-on hair product. It might sound silly (especially if you've seen the infomercials for one of these products), but spraying a matching shade onto your scalp can quickly hide bald spots.
"It immediately gives the illusion of thicker hair," Tsao says.
Getting past the stigma
Rarely do we talk openly about hair loss in women or see women represented in commercials for hair transplant companies and hair-loss medications. The gender bias surrounding this condition can make us hesitant to ask for help when our hair starts to thin.
Don't let preconceived ideas prevent you from getting the treatment that could stop - or even reverse - your hair loss. Even though you may not see other women openly dealing with hair loss, you're definitely not alone.
"Hair loss is a very common concern among a majority of women," Tsao says. "Don't be afraid to address it. Though the options may not be as broad as they are for men, hair loss in women can be treated. And it's important to make sure there isn't an underlying medical cause."