Sharon Hutchinson suffered from thinning hair since her 30s, but recently found a solution that worked for her. Hair loss in women is more common than many realise and there are various causes and treatment options available. Female pattern hair loss, also known as androgenic alopecia, is the most common cause of hair thinning in women. Female hair loss has made the headlines in recent years as a number of celebrities, including Gail Porter, Jada Pinkett Smith and Viola Davis have chosen to speak publicly about their struggles. However, in the cases of these three women, the cause of their hair loss is a different condition — the autoimmune disorder, alopecia areata, in which the body’s immune system mounts an attack against the hair follicles. The more common female pattern hair loss is largely due to genetics, which can be inherited through both the maternal and paternal line. Female pattern hair loss is relatively unusual in young women, but rises in incidence in middle age. Hair thinning can also be exacerbated by menopause. Though female pattern hair loss is related to the body’s response to androgens, also known as male sex hormones, most women who suffer from it have normal hormone profiles. It was Sharon Hutchinson’s 12- year-old son who, with the guileless honesty of a child, broke the news to her that she was suffering from female pattern hair loss. Until that moment, she had been “totally unaware” of the problem. “I was walking down the corridor in our house… and I just heard him say, “Oh, mum’s going bald.”
Her husband had noticed too, but had kept quiet about it because he said, “I didn’t want to upset you”.
That was over three decades ago. Sharon was 34 years old at the time. “I never had brilliant hair, but it had covered my head,” she says. In that moment, the confidence that her hair “did the job”, something she had always taken for granted, was lost. And for most of the years since, Sharon’s hair has been a dominant and troubling preoccupation.
Sharon was born in England but grew up in Ireland, before moving back to the UK in her 20s with her husband, television producer Coleman Hutchinson and their three young children.
Her first step when she realised she needed to get help for her hair, was to visit a specialist on Harley Street, who diagnosed her with female pattern hair loss. “He did a lot of tests and I was losing 300 hairs a day instead of about 70,” she says.
The specialist found that her ferritin level was very low, she remembers. “He put me on iron tablets and my iron crept up and my hair I think improved a little bit, but it was always an issue, because it never came back fully…. I struggled keeping my ferritin levels up all those years, I had to have iron infusions… Life was very stressful. That doesn’t help either. But I struggled on.”
In the meantime, she says, she dealt with her hair loss by “just trying to manage it… I always put my hair up, that kind of thing. And tried to hide the bits. I got mirrors and checked. And I’d say to my husband, ‘how are the baldy bits?’ and all of that”.
Through all of this, the issue “rarely ever left my head and I never felt comfortable,” she says. “It was constant in my life. My hair — it was like a little movie always playing in the back of my head: ‘how’s my hair, how’s my hair? Will people notice?’.”
Despite the iron supplementation and later, treatment with the topical medication minoxidil, Sharon’s hair loss continued to progress.
“It got to the point, it had gotten a bit thinner again and I was finding it hard to disguise the areas,” she says. “And I would worry, if I was walking down the street on a sunny day, that people would be able to see my scalp, and I might cross the road. Or if I was on an escalator or something I’d think, the person behind me can see my head.”
Dr Dimitri Wall is an Irish dermatologist who specialises in hair loss. Through his work in practice at Hair Restoration Blackrock, in Dublin, he has developed a sensitive understanding of just how emotionally devastating female pattern hair loss can be. “It’s not a vanity issue,” he says emphatically. “In a lot of cases, it’s an identity issue. And seeing your identity dissolve before your eyes — knowing what your hair used to be like and how it frames how you see yourself and how other people see you, that triggers a really visceral emotional response at different points in different patients.
“It’s a huge spectrum — there’s a really significant emotional component to it. But it’s the kind of thing that, when it does hit you, it often occupies a lot of your brain space and it’s not the kind of thing you can consciously shut down.”
Female pattern baldness is extremely common, according to Dr Wall. “There was a study done in Australia years ago and it suggested that by the time you are about 60 or 70 years of age about 56pc of women will have very clinically visible hair loss. It’s a very small proportion who are in their 20s or 30s, but it gets progressively more common as you increase up the decades.”
The causes of female pattern hair loss, he says, remain to be fully elucidated. “There’s always been debate about the contribution of hormonal therapies… We think that testosterone is a contributor, but a direct relationship isn’t as clear cut as it is with male pattern hair loss.”
Sharon Hutchinson tried a few remedies before finding one that worked for her. Photo: Jonathan Goldberg
The received wisdom that baldness is inherited through the maternal line is an oversimplification. “People come in and say, I think it’s on my mum’s side, it’s on my dad’s side. To be honest there are a couple of hundred genes that have been associated with female pattern hair loss. The inheritance pattern is very complex.”
Sometimes, an abrupt increase in hair shedding can occur after the body undergoes some kind of stress or major hormonal shift. This is called telogen effluvium. “It’s essentially where the hair cycle has been kind of shortened. More of the hairs get forced into their kind of sleep stage. And then what will typically happen is that the hairs will all start growing again. It’s often a reversible thing,” he says.
It’s this phenomenon that is usually to blame when women experience hair loss postpartum. But it can also follow an acute illness, and an emerging cause of telogen effluvium, he says, is infection with Covid-19. Dr Wall has been involved in conducting research on this subject. “There are some women who have recently seen “a significant bump in hair shedding and think, ‘oh, I wonder do I have female pattern hair loss?’. And it may not necessarily be — it could be Covid-induced hair loss, which resolves in time.”
Another common cause is the autoimmune condition alopecia areata. “We don’t know what triggers it. There’s been lots of different causes theorised, ranging from hormonal to post-viral, even post-vaccination,” he says. In these cases, following a trigger, the body’s immune system “attacks the growing part of the hair so that hair falls out. But if you control that degree of inflammation you reduce the impact and you can see people regrow their hair,” he says.
While alopecia areata can be dramatic, as recent high-profile cases such as Jada Pinkett Smith and Gail Porter have shown, the good news is that “about 67pc of patients who ever get alopecia areata will grow it back spontaneously,” he says.
And for those who continue to suffer, a drug approved this year by the FDA offers new hope.” For the first time ever, we’ve seen a systemic drug that you take by mouth that has been approved for the treatment of severe alopecia areata.”
For Sharon Hutchinson, a year ago she decided to pursue an alternative strategy to manage her hair loss and hasn’t looked back since. She’d been to the hairdressers and was looking in the mirror when she noticed a totally bare patch over her right ear. “It was quite big, a few inches long and a couple of inches deep,” she remembers.
It was a shock. And one that propelled her into action. She had heard about a hair loss replacement system created by the British hair consultant Lucinda Ellery. Called intralace, it is a hair prosthesis, constructed from ultra-fine mesh and human hair from Russia. It is gently laced into existing hair. Unlike a wig, it is worn all the time, and can even be worn swimming.
Sharon has been thrilled with the results. “It’s just changed my life,” she says. “To have something that has worried you half your life ju
st taken away, it’s just amazing really. It’s like somebody has just waved a magic wand.”
Even the regular appointments she attends every five to six weeks to maintain the system have changed her outlook on hair loss.
“You’re sitting in this room where everyone is in the same situation, and it’s very freeing — it’s not a club I’m glad I’m in, but you suddenly realise the amount of people — these salons are full every day with hair loss sufferers. There are an awful lot of people going around with hair systems on.”