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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 Janelle,

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.)

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