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What Causes Severe Hair Loss In A 35 Year Old Woman Post Delivery?

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Posted on Fri, 15 Jul 2016
Question: Hello Doctor,
I am writing to get some advise for my wife's hair loss condition.
She is 35 years old and we have twins (girls 15 months old), my wife has severe hair loss, particularly in the front area in the head but overall she loses hair when she bushes them, after bath, and generally throughout the day. The rate of hairfall is like she loses atleast 100-500 strands of hair every time she brushes.
She has no medical conditions like PCOS, Diabetes, HT etc.
She has been taking Iron tablets (autrin) regularly for a couple of months now and has
been exercising daily to relieve stress.
After delivery she was not lactating (very less sectrtion).
We've tried a few medications in the past (before pregnancy) like folic acid and folifast, they worked a bit but later we were back to same condition.

Can you please help recommend a solution to this?

Thanks,
XXXXX
doctor
Answered by Dr. Dr. Kakkar (35 minutes later)
Brief Answer:
Minoxidil solution along with oral biotin and finasteride

Detailed Answer:
Hello. Thank you for writing to us

I am Dr.Kakkar(Dermatologist). I have gone through your query and I have noted your concern.

I would keep a possibility of Telogen effluvium superimposed on female pattern hair loss.

Telogen effluvium (acute) is common in females post partum i.e after delivery (post partum hair loss). This usually starts the third or fourth postpartum. This is a temporary phase. During pregnancy the increased levels of estrogens in your body makes your hair thick and lusturous, hair that would normally fall out stays put, resulting in thicker hair. After delivery the reverse is expected to happen i.e increased hair shedding. However, this phase usuallly ends by 6-8 months post partum. Rarely, hair fall may continue longer, this is known as Chronic telogen effluvium (the reason being that hair cycle seems to have been reset permanently, resulting in a shortened hair growth phase/ anagen).
Secondly, thinning mainly from the central part of scalp is a feature of female pattern hair loss/ androgenetic alopecia. This may be unmasked by precipitous hair fall in acute telogen effluvium which in her case is still continuing (chronic telogen effluvium).
So in her case, her hair has been worst hit as a result of cummulative effect of Telogen Efluvium (Acute followed by Chronic) superimposed on female pattern androgenetic alopecia.
I suggest her to use 5% Minoxidil solution(Mintop forte) 1ml, twice daily at scalp skin, with the help of a dropper. In addition she may continue with Biotin supplement (Tab. Revilus Or Tab H- Vit forte), once daily. Since she is not breast feeding she may safely take an oral antiandrogen which has a role in androgenic alopecia in female i.e tab. finax 5 mg (Finasteride) once daily.

Regards
Above answer was peer-reviewed by : Dr. Veerisetty Shyamkumar
doctor
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Follow up: Dr. Dr. Kakkar (27 hours later)
Thanks for the detailed explanation Doctor.

Is this Telogen effluvium reversable completely?
How long does she have to take the medication?
Is there any known side effects to this that we should be aware of?

Thanks.
doctor
Answered by Dr. Dr. Kakkar (13 hours later)
Brief Answer:
Advice regarding hair fall

Detailed Answer:
Hi.

Revovery is a slow process.
She needs to apply and take oral medicines for at least 6-12 months for noticeable improvement. There are no side effects of minoxidil topical application except that it may cause mild dandruff in dime individuals. She should apply just 1ml, twice daily. She can use an antidandruff shampoo if required.
Finasteride tablet is to be avoided during pregnancy and lactation which is anyways not the case with her.

Regards
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Dr. Kakkar

Dermatologist

Practicing since :2002

Answered : 9612 Questions

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What Causes Severe Hair Loss In A 35 Year Old Woman Post Delivery?

Brief Answer: Minoxidil solution along with oral biotin and finasteride Detailed Answer: Hello. Thank you for writing to us I am Dr.Kakkar(Dermatologist). I have gone through your query and I have noted your concern. I would keep a possibility of Telogen effluvium superimposed on female pattern hair loss. Telogen effluvium (acute) is common in females post partum i.e after delivery (post partum hair loss). This usually starts the third or fourth postpartum. This is a temporary phase. During pregnancy the increased levels of estrogens in your body makes your hair thick and lusturous, hair that would normally fall out stays put, resulting in thicker hair. After delivery the reverse is expected to happen i.e increased hair shedding. However, this phase usuallly ends by 6-8 months post partum. Rarely, hair fall may continue longer, this is known as Chronic telogen effluvium (the reason being that hair cycle seems to have been reset permanently, resulting in a shortened hair growth phase/ anagen). Secondly, thinning mainly from the central part of scalp is a feature of female pattern hair loss/ androgenetic alopecia. This may be unmasked by precipitous hair fall in acute telogen effluvium which in her case is still continuing (chronic telogen effluvium). So in her case, her hair has been worst hit as a result of cummulative effect of Telogen Efluvium (Acute followed by Chronic) superimposed on female pattern androgenetic alopecia. I suggest her to use 5% Minoxidil solution(Mintop forte) 1ml, twice daily at scalp skin, with the help of a dropper. In addition she may continue with Biotin supplement (Tab. Revilus Or Tab H- Vit forte), once daily. Since she is not breast feeding she may safely take an oral antiandrogen which has a role in androgenic alopecia in female i.e tab. finax 5 mg (Finasteride) once daily. Regards