Hair Health During Pregnancy And Postpartum Period
Written by
Morgan German

Male vs. Female: What makes their hair different?

There is no difference between males and females regarding the hair structure and cycle. However, gender dependence could lead to some clinical consequences of hair biology disturbance. Due to distinct configurations of a male and a female body, many factors emerge and alter their hair significantly in different ways throughout their life. 

On one hand, women's hairs are subjected to fewer oil glands thanks to having a lower testosterone level. It means that their scalp area is less sweaty, leading to a smaller amount of build-up, including oil, dust and dirt. Hence, women may not need to wash their hair as regularly as men do.

On the other hand, compared with men, women suffer from diverse phases of life with dramatic hormonal changes. Menstruation, pregnancy, post-delivery or menopause, all are ordinary things happening to any woman; meanwhile, they could induce a severe imbalance of hormones. These changes could impact their hair health negatively and significantly.

As for men, they are more susceptible to androgenetic alopecia. It could happen to men right after puberty and eventually lead to total alopecia. With that said, this type of hair loss mostly makes women's hair smaller, finer, shorter with visible depigmentation, rather than more noticeable balding. 

 

Pregnancy Period And Hair Health

Thicker and fuller hair 

During pregnancy, women could experience fuller hair because of an increase in the hair's mean shaft diameter. This change usually starts at the beginning of pregnancy. In addition, the amount of anagen hair rises from 85% in the first trimester to 95% in the second trimester. In the second and third quarters of pregnancy, the hairs in the telogen phase are about 10% only; while in normal conditions, it is from 15 to 20%.

This percentage will change from the second week postpartum. From the sixth week postpartum, the number will drop to 77%, lower than the non-pregnant women's. That is to say, during pregnancy, the conversion of hair from anagen to telogen slows down; however, it is accelerated through postpartum, accounting for the decrease in the percentage of anagen.

Less hair shedding

Besides, there are hormone-related changes when women are pregnant, for example, an increase in the levels of androgens and estrogen. Studies have shown that these hormonal shifts could influence the hair cycle, thus altering pregnant women's hair.

In some cases, women with pattern hair loss can see an improvement in their hair health when their scalps become less oily and the amount of hair shed stops increasing temporarily during pregnancy.

Yet, more hair loss in sight 

Another noticeable change is the higher cortisol levels produced during pregnancy and post-delivery, and research has discovered a positive association between these periods and hair cortisol concentrations. There is evidence showing the side effects on skin and hair health due to excess cortisol. For example, it induces a breakdown of skin components and reduces the function of hair follicles, leading to a high possibility of postpartum hair loss. The cortisol levels are significantly higher in the third trimester of pregnancy compared to the first one. And during the first week of post-delivery, the cortisol levels can be 200% higher than that of non-pregnant women. 

 

Postpartum Hair Loss

Is postpartum hair loss real?

Postpartum telogen effluvium (PPTE) is known as hair loss after delivery. However, according to research in the field, there is no strong and consistent evidence showing that this PPTE is a well-defined entity with its exact frequency. It might happen with some people after giving birth, but causes, mechanisms, and occasions still require further investigations. 

However, the postpartum hair loss, if existing, usually continues up to 6 months and rarely lasts to 15 months. This hair loss type may reduce the number of hair cycle regeneration in each hair follicle yet does not cause permanent damage to them

Why does it happen?

There are some possibilities that could explain the condition. First, it can be an exaggeration of women who are psychologically stressed due to their body changes after delivery.  

Secondly, estrogens are at a higher level during pregnancy, causing hair follicles to stay in the anagen phase longer. As a result, the exogen phase is delayed, hairs also fall out less than before. After giving birth, women might suffer abundant hair loss due to a drop in estrogens. It happens since hairs had been maintained in the anagen phase and had not shed through gestation. In fact, after three months postpartum, the number of telogen hairs will reach up to 30%. In this case, postpartum hair loss happens as a result of the synchronization of hair cycles on the scalp with a contemporaneous telogen-exogen process. 

In addition, as mentioned above, an increase in the production of cortisol in post-delivery period can also cause hair loss. Studies have indicated that excess cortisol can reduce the synthesis and accelerate the breakdown of proteoglycans, one kind of protein that plays a critical role in the normal function of hair follicles. 

Interestingly, for women, breastfeeding more likely reduces hair loss thanks to the effects of prolactin. Lactating women usually have an increased anagen-to-telogen rate four months after delivery, compared with the nonlactating ones.

 What you should do about it?

With that said, postpartum hair loss can subside by twelve months after delivery, whether breastfeeding or not. Your hair will return to its normal cycle, and any excessive hair shedding should stop by then. It means that you don't need to worry too much about this temporary phenomenon.

However, it's best to always consult with a doctor whenever you have any doubts about your hair issues.

 

Conclusion

Hormonal changes are a regular contributor to the hair health of women in terms of both quality and quantity. Thus during pregnancy and post-delivery, women most likely experience several hair issues. 

Research has found an increase in the levels of androgen, estrogen, and cortisol during pregnancy. While pregnant women might see fuller hair, the rising cortisol level could lead to functional damage of protein that is necessary for hair growth.

Similarly, one of the reasons explaining why postpartum hair loss happens is the change of cortisol secreted. In addition, while the hormones lead to more anagen hairs during pregnancy, excessive hair loss occurs after giving birth because of the synchronization of the hair cycle with a back-to-normal telogen-exogen process.

Noticeably, although decreasing the number of hair cycle generations, postpartum hair loss does not cause permanent hair damage and can disappear from the fifteenth month after delivery, showing that the hair cycle returns to its normal status.

 

References 

Camacho-Martinez, F. M. (2009). Hair loss in women. In Seminars in cutaneous medicine and surgery (Vol. 28, No. 1, pp. 19-32). No longer published by Elsevier.

Emin Ozlu and Ayse Serap Karadag (2017). Telogen Effluvium, Hair and Scalp Disorders, Zekayi Kutlubay and Server Serdaroglu, IntechOpen, DOI: 10.5772/66975. Available from: https://www.intechopen.com/chapters/54176

Lynfield, Y. L. (1960). Effect of pregnancy on the human hair cycle. Journal of Investigative Dermatology35(6), 323-327.

Mirallas, O., & Grimalt, R. (2015). The postpartum telogen effluvium fallacy. Skin appendage disorders1(4), 198-201.

Piérard-Franchimont, C., & Piérard, G. E. (2013). Alterations in hair follicle dynamics in women. BioMed research international2013.

Thom, E. (2017). Pregnancy and the hair growth cycle: anagen induction against hair growth disruption using Nourkrin® with Marilex®, a proteoglycan replacement therapy. Journal of Cosmetic Dermatology16(3), 421–427. https://doi.org/10.1111/jocd.12286

(2009) Hair and Nails. In: Obstetric Dermatology. Springer, Berlin, Heidelberg. https://doi-org.libproxy.tuni.fi/10.1007/978-3-540-88399-9_3