Welcome to the 2021 Hair Loss Club

If you’re a woman losing your hair, you’re part of a much bigger group than you think. There's a community across all ages—and there's a lot you can do to take back control.

Tessa was 18 when she started noticing her hair loss. It was gradual, and there was no obvious cause, and so she told herself that nothing was wrong. “Denial,” she says now. A few months later she got COVID—a serious case. After that, hair started coming out “in droves.” She would softly run her fingers through her hair, and strands would fall all around her. 

Tessa says her doctor still doesn't know why her hair started falling out—but any extreme stress event, including COVID, can cause hair loss. We’ve all heard that stress can cause illness, though shedding massive amounts of hair makes it feel less like a spa slogan and more like an emergency. Doctors and leaders in the women's hair loss community have a message: Don't panic, and know that you are not alone. 

“Watching all the hair fall to the floor—it really changed my outlook on my appearance, and my confidence,” she says. When Tessa was around 10 years old, she cut off all her hair and donated it to Locks of Love. “I didn’t care what people thought of me,” she says. “But as I got older, social media started to really make me believe that I had to look a certain way. I learned that hair is a part of being feminine.” 

For months Tessa wore hats and didn’t tell any of her friends or family what she was going through. But recently she found community online. She shared pictures in a private Facebook group for women with hair loss. “This is absolutely devastating to me,” she captioned her photos. “My hair was my number one source of confidence and my veil to hide behind.” Dozens of empathetic responses rolled in, from some of the tens of thousands of women in the group. Tessa’s hair loss had left her feeling completely alone—but she is part of a big, big club.

“Hair loss affects 50% to 70% of men and women,” says Jenny Liu, M.D., a professor of dermatology at the University of Minnesota. At least 50% of women will experience hair loss of some kind before the age of 50. “It’s not an insignificant number of the population,” says Dr. Liu. “It’s definitely under-talked-about.” And it’s definitely happening. Hair growth supplements—neatly packaged for the generation that used to shop at Claire’s and now shops Zillow—sit, sweet and appealing, in drugstore aisles. Silk and satin pillowcases, said to reduce hair loss, are everywhere. More and more products promise not just thicker, healthier hair, but more hair growth.

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The perception that hair loss is mostly a problem that men deal with, or that women lose hair only in much later years, just isn’t accurate. Women and girls of all ages lose hair, and often experience it with tremendous anxiety and shame. Part of what’s so maddening about hair loss is working out the cause—all of a sudden you’re a deranged Sherlock Holmes, clutching a fistful of loose hairs and interrogating your shampoo bottles. “Hair loss is super tricky,” says Dr. Liu. There are a lot of possible causes: an autoimmune disorder, female pattern hair loss, polycystic ovarian syndrome (PCOS), and more.

But one of the most common reasons women lose hair is called telogen effluvium—essentially, your scalp’s response to trauma. “It is basically a temporary state where your hair is shedding, often due to a traumatic event, like stress, divorce, postpartum,” says Dr. Liu. “Often it is not permanent, and it is reversible over time once the underlying issue is corrected. It often presents three or four months delayed after that inciting event.”

That may be why so many people have reported losing hair lately—both people who have had bad cases of COVID and people who have lived under intolerable stress during the pandemic. Carolyn Goh, M.D., a dermatologist at UCLA Health who specializes in hair loss, explains it to patients like this: “Your body has only so many resources and so much energy to take care of itself, and if anything is going on, then it might try to pull some resources from, in this case, your hair. The energy that is put into growing your hair needs to be used somewhere else.”

Sometimes hair loss is part of a bigger health concern, but even when it isn’t, Dr. Goh says hair loss can have a potent effect on a woman’s mental health. “I went through the egg retrieval, and also radiation, and then chemo,” Haley Spangler, a 21-year-old being treated for cancer, tells Glamour. “And losing my hair was the worst part for me.” To a person without a cancer diagnosis, this might be shocking. But for Spangler, it makes sense. “It was part of my identity,” she says of her hair. Every woman who spoke to Glamour for this article used identity or a similar word to describe hair. “I have women who don’t leave the house because of their hair loss,” says Tahnee Brown, known online and to her customers as The Hair Mama.”They’re insecure and depressed.”

Brown has struggled with hair loss since she was a teen, as a symptom of PCOS. A few years ago she suffered a series of huge life traumas—pregnancy with twins, the death of a child, and then kidney cancer. “My hair just started literally falling out in clumps,” she says. “I think a lot of people don’t realize that trauma can cause hair loss. It’s not always something like cancer or alopecia or some kind of disease. Real, everyday women who have stress and trauma in their life are losing their hair.”

Hair loss shrinks the world down, forcing a kind of myopia, a total focus on one part of your appearance. Losing hair feels like losing control. The average human scalp has strands in the six figures, so if you are worrying about hair loss, you are worrying about 100,000 things. Hair loss can be debilitating, but talking about it doesn’t always receive sympathy. The hair you are mourning—protein made up of dead cells—is technically nothing. But in the world we live in, that just isn't true. “Hair is everything,” screamed Phoebe Waller-Bridge’s character in Fleabag, confronting a stylist over a truly heinous haircut, and millions of us knew what she meant. 

Spangler’s TikTok about losing hair to chemo received countless heartfelt comments from strangers who were eager to share her pain. But some people left comments that said something to the effect of: It’s just hair. Spangler does her best to ignore these comments. “Most people who say that,” she points out, “have hair.”

“I hear that all the time,” says Dr. Goh. She sees women of all ages in her office, including plenty of women in their 20s and 30s. More than anything, she says, they’re anxious. “A lot of people have preexisting anxiety, but it is exacerbated by the hair loss, or sometimes just brought on by the hair loss,” she says. “I think it just speaks to what hair means to people, because anxiety is a social issue—it’s an issue of how you feel in terms of your role in society. And I think hair is a big part of our social well-being.” The visual trickery of social media and celebrity styling doesn’t help. Most of us know that celebrities have personal trainers, makeup artists, dental work, and stylists. “What people don’t realize is that all these celebrities, like the Kardashians, they’re all wearing wigs!” says Brown. To add insult to the injury of hair loss, most of us are comparing our hair to hair that isn’t even growing out of a head.

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Your hair loss could be the result of extreme stress. It could be an underlying problem. Or it could be a combination of multiple things. “The most important thing is to try to keep calm, and make an appointment with a board-certified dermatologist,” says Dr. Goh. Dermatologists are usually associated with skin, so you may not know that they are trained to treat issues related to skin, hair, and nails. A dermatologist will do things like examine your scalp and test your blood—things you and Google can’t do together. It’s important, says Dr. Goh, to set up an appointment, even if you can get one that's months in advance. Cicatricial alopecia, the scarring form of hair loss, is irreversible and treatment is time-sensitive. And for many women their anxiety is reduced by talking to a professional who can walk through treatment plans. “We talk about what the process is, what’s going on, and they feel better just by understanding,” says Dr. Goh.

When you’re losing hair, panic-buying everything in sight feels like the easiest step. But you may be missing one simple drugstore buy. “Honestly, anybody that’s experiencing hair loss should give topical minoxidil a try,” says Liu. “Because here’s the thing: It is the only FDA-approved treatment—the only well-researched product that has shown to regrow hair.” Minoxidil is the generic form of Rogaine, and Liu compares it to tretinoin, or Retin-A—one of the only medications that has been shown to have an effect on aging skin.

Retin-A and its nonprescription alternative, retinol, have been enthusiastically embraced by the beauty community. Rogaine, which is heavily associated with and marketed toward men, has not. Even though, as Dr. Goh points out, “it’s the only thing that has strong scientific evidence that it helps.” The direct-to-consumer company Hers is trying to change minoxidil’s public image—it has enlisted J.Lo as a spokesmodel. “I don’t necessarily say, ‘Just start minoxidil right away,’ but I think if it’s been going on for some time,” says Dr. Goh. “If there’s one thing you should try, I think it should be minoxidil. A lot of people come in and say, ‘I’ve tried everything! Everything!’ And I ask if they’ve tried minoxidil, and they say no. And I laugh because it’s the only thing that’s FDA approved, and it’s the only thing they haven’t tried.”

What about biotin? What about the sweet promise that swallowing velvety supplements will lead to thick, lustrous hair? “There is really a lack of evidence behind these supplements, for example, biotin,” says Dr. Liu. Some might not hurt and could even help, but they’re just not rigorously evidence-tested like other treatments. “I do think it says a lot about just wanting to take something that will fix everything,” Dr. Liu says of hair supplements. It’s true that minoxidil isn't a cure or a quick fix—it can take six months to see results, and if you do, you need to keep taking it. But that’s not a reason to skip it. “All of those issues about minoxidil are things that are really just about hair loss in general!” says Dr. Goh. “That’s the problem, not the medication that’s trying to fix the problem.”

There’s hope for women losing hair. There are experts and products and more options than you think. But there are also communities offering support, whether you’re waiting for your hair to come back or accepting that it won’t. “Your hair doesn’t have to be a part of your femininity,” says Tessa. “You can be completely bald and be just as much of a woman as you were, even with long hair.” In between rounds of chemo, Spangler has become an expert on wig styling. “I’ve gotten different varieties, different styles and colors I never thought I would try,” she says. Her natural hair is brown and wavy. Her favorite wig is made of auburn curls that hang down to her waist. She jokes that she can’t stop buying wigs.

Brown, who recently took the plunge and shaved her head for the first time, knows the feeling. Her business, which sells and styles trendy wigs and toppers, hears from women from all over the world who are dealing with hair loss. “When they find our community, it’s like a whole new world is opened to them and they're amazed at how many women are struggling with it,” she says. Together these women are working to spread awareness and eliminate shame. 

“I just want everybody to know,” says Brown, “that there is something out there that could help them.”

Jenny Singer is a staff writer for Glamour. You can follow her on Twitter. 

This story originally appeared on: Glamour - Author:Condé Nast