Losing Hair During Pregnancy: Causes, Treatment & Prevention

Losing hair in pregnancy isn’t common, but it can be scary on top of all the other bodily and hormonal changes you’re experiencing. Generally, women lose an average of 50 to 150 hairs over a 24 hour period [1].

During this exciting but intense time of emotional and physical upheaval, the last thing you want to be dealing with is hair loss. What if you’re experiencing hair loss before delivery? This article will explore the possible causes and treatments for hair loss during pregnancy.

Causes of hair loss in pregnancy

Postpartum Telogen Effluvium

Postpartum telogen effluvium (meaning excessive shedding) is quite a common condition, affecting women between 1 and 6 months after childbirth. Losing hair after pregnancy is due to fluctuating hormone levels. 

For most women, hair follicles remain in the anagen (growth) phase for longer periods [2] during pregnancy. Your estrogen levels rise steadily during the first two trimesters of pregnancy, peaking around 32 weeks. They’re 6 times higher than they will be post pregnancy. Increased estrogen is believed to promote an increase in blood flow, essential for nourishing your growing baby. 

Hormone levels return to normal within 3-6 months of delivery, with hair returning to the telogen (resting) phase, with an accompanying sudden drop in levels of estrogen and progesterone. 

This can result in hair shedding, known as postpartum telogen effluvium. This is a normal process which usually resolves without treatment, about 6 months after the birth. Learn more about postpartum hair loss. 

This short-term phase of hair shedding isn’t limited just to pregnancy – telogen effluvium can occur after a shock, immense amounts of emotional stress, trauma, and even Covid-19. It’s where up to 70% of anagen hairs enter the telogen phase, resulting in noticeable hair loss, which can be very traumatic. Telogen effluvium is the most common cause [3] of diffuse hair loss. 

Hormonal fluctuations 

During pregnancy, your body goes through a lot of stress and upheaval. Though you may not feel stressed, because of the extensive changes the body is undergoing, it reacts the same way.

Additionally, there is a wealth of anecdotal evidence that coming off oral contraceptives can cause hair loss. This can be something to consider if you’ve become pregnant quickly after ceasing to take the pill. It’s the resulting change in hormones that can trigger hair loss. 

However, the scientific evidence is mixed, suggesting that the effect of oral contraceptives is insignificant [4] but may suggest a causal relationship. The answer may lie in genetics – the study goes on to say that genetically susceptible women may experience hair loss related to oral contraceptives [4].

Progesterone is a hormone which regulates the menstrual cycle. It can also cause hair to become drier, and therefore more prone to cracks and breakage. If it breaks off near the root, this can be mistaken for hair loss. 

It’s also important to remember that 40% of women experience hair loss by the age of 40 – so hair loss may be unrelated to your pregnancy, and instead caused by other factors. 

If you’ve been dealing with long-term hair loss and may be considering a hair transplant after your pregnancy, why not take a look at our before and after gallery of successful transplants. We’ve helped over 10,000 patients achieve their hair goals. 

Hypothyroidism 

As we’ve already established, hormones can play havoc with your hair during pregnancy. Along with estrogen and progesterone, thyroid hormones are essential for the normal development of your baby’s brain and nervous system [5]. At the beginning of your pregnancy, your growing baby is dependent on your body’s supply of thyroid hormone. 

The thyroid is a butterfly-shaped gland at the base of your throat, just in front of your windpipe. It produces hormones which affect nearly every organ in your body, including how fast you burn calories and how fast your heart beats. Hypothyroidism means the thyroid gland is underactive, so it’s not producing enough thyroid hormone.  If you have thyroid issues, you can still have a healthy pregnancy and protect your baby by having regular thyroid function tests [5]. Thyroid function is often assessed as part of hair loss blood tests.

Common symptoms of hypothyroidism include signs of a slowed down metabolism. These can include feeling cold when the temperature is normal, muscle weakness, constipation, a fast and irregular heartbeat, pale and dry skin, and dry, thinning hair. Hypothyroidism affects up to 3 percent of women during pregnancy, so it’s not uncommon. 

Hair loss associated with thyroid disorders can involve the whole scalp, causing hair to be uniformly sparse [6]. Hypothyroidism can also cause telogen effluvium, and as mentioned above, the hair shafts will present as dry and brittle [7]. Strangely, hyperthyroidism, also a risk during pregnancy, can have negative effects on hair, also resulting in telogen effluvium, and thinner hair. Hair can become brittle and greasy [7].

Vitamin and dietary deficiencies 

Iron-deficiency anaemia is a common global issue, affecting up to 52% of pregnant women [8]. Many women go through their entire pregnancy without attaining the minimum required intake of iron, as the volume of blood you require in pregnancy increases. Therefore, the amount of iron you require increases too. Your body will use iron to make more blood – this blood supplies oxygen to your baby. 

Iron deficiency is when you’re lacking in red blood cells, so oxygen can’t get to different tissues in the body. If your body is lacking in iron, it inhibits the production of haemoglobin, which is essential for hair growth. In pregnancy, when your body is already redirecting blood and iron to help your baby grow, this can be exacerbated. 

Without crucial oxygen, your hair follicles are unable to function, and hair may begin to fall out. Symptoms of iron-deficiency anaemia [9] to look out for include pallor, breathlessness, palpitations, hair loss, headaches, vertigo, leg cramps, cold intolerance, dizziness, and irritability. 

Vitamins for hair growth are becoming increasingly popular, so you may be tempted to go out and purchase a few different supplements. However, these supplements aren’t treated as pharmaceutical products. That means there’s scant research on their effects, and they’re primarily unregulated.

An increasing number of hair vitamins on sale are counterfeit. While there’s a definitive link between vitamin deficiencies and hair loss (which we’ll go into in more detail in the Treatment section), very little evidence exists that targeted supplements help hair growth, or limit hair fall.

An unrelated condition

Sometimes, hair loss in pregnancy can be completely unrelated to the pregnancy itself. Autoimmune conditions such as polycystic ovary syndrome – which over 20% of women suffer from – can cause hair loss. It’s estimated over 4 million people in the UK are living with at least one autoimmune disease, causing white blood cells to attack your follicles and prevent them from producing hair. 

You may not know you’re suffering from an autoimmune disease until your hair starts falling out. Autoimmune diseases stem from white blood cells believing the body’s own, healthy cells are invading the body. It’s an overactive immune response, causing conditions like alopecia areata, characterised by bald patches not just on the head, but also on the eyelashes, eyebrows, and body. 

It’s thought this stems from an inflammatory response, interacting with the hair follicles. 

Viral and bacterial infections can be a trigger for alopecia areata, along with inherited genetic predispositions. 

How to treat pregnancy-related hair loss 

Minimise stress and anxiety

We know – it’s a tough ask when you’re preparing to bring new life into the world, and going through nausea, morning sickness, breast changes, and other surprising effects of becoming pregnant. However, maternal stress and anxiety can have long-term implications that go beyond hair loss. Studies show an increasing link between pregnancy stress and anxiety, and negative consequences for child development and outcomes [10].

If you have a supportive partner, ask them to pick up the slack. If that’s not an option, ensure you’re being supported by loving family and friends. Don’t be afraid to ask for help. Pregnancy can be an amazing and exhilarating time, but for some expectant mothers it can feel isolating. 

Eat a balanced diet 

Eating a balanced diet may be the last thing you want to do when you’re suffering with morning sickness during pregnancy (or those strange cravings that just won’t go away), but it’s super important when you’re pregnant. Especially if you’re suffering from any of the conditions we’ve listed, or have unexplained hair loss that doesn’t seem to resolve itself. 

Choose foods high in protein like Greek yoghurt, lean meats, and eggs. Poultry is a great source of dietary iron – just be careful what you have with it, as iron from meat isn’t well absorbed by the body. Try to steer clear of added sugar, as it can impact hair growth due to increased stress levels. It’s all about balance, especially when you’re nourishing new life. 

To maximise the absorption of iron from dietary sources, have a glass of orange juice with your meal. The high vitamin C content boosts absorption. Calcium inhibits iron absorption, so be careful of having milky drinks with your iron-rich foods. Oily fish like salmon, mackerel contain healthy omega-3 fatty acids, essential for maintaining long, beautiful locks. 

Make sure you’re taking in plenty of calories throughout your pregnancy – though low-carb diets don’t cause hair loss directly, low calorie diets can. Intermittent fasting (where you moderate your diet to include longer fasting periods) is a mixed bag in terms of research. Although some evidence suggests it can help with hair growth, it does send the body into a state of shock through big dietary changes. This comes with a risk of telogen effluvium. Probably best avoided while you’re pregnant. 

Ensure your vitamin intake is balanced. Although vitamin A is essential for healthy, shiny hair (as well as teeth, bones, skin, and organs), too much can build up in your body and be toxic. It can cause hair follicles to reach the end of the growth phase too quickly and fall out. 

During pregnancy, you require at least 27 milligrams of iron a day (12), so it can be worth taking prenatal vitamins, as advised by your doctor. Iron requirements rise throughout your pregnancy in accordance with the growth of the baby and your body weight (13). If you’re an iron deficient vegan or vegetarian, leafy green vegetables such as spinach and kale, chickpeas, brown rice and fortified cereals are all excellent sources of iron. 

Get tested by your doctor 

A simple blood test can determine whether you’re suffering from hypothyroidism, and the doctor can give you advice on how to treat it. The same goes for iron deficiency anaemia and autoimmune conditions like alopecia areata, which has no direct cure but can be managed with treatment. A trained medical professional can help you evaluate the cause of your hair loss, and suggest treatments which are safe for you and your baby. 

Medications like minoxidil are traditionally prescribed for female hair loss, but they’re not suitable for use during pregnancy. If your hair loss doesn’t resolve during the pregnancy, minoxidil is considered safe to use after you’ve given birth, so the treatment can start while you’re breastfeeding. 

Some over the counter or online treatments are considered unsafe for the baby, so never take anything before checking with your doctor first. 

Prevention – treating your hair gently 

Sometimes prevention is the best cure. Some of your trusted haircare rituals may actually be doing more harm than good. Blow drying your hair religiously at a high heat damages hair, causing breakage and dryness. In some cases, using very high heat can cause hair loss. Straighteners can be even worse, causing irreparable damage which then creates a need to straighten more, damaging the cuticle and causing frizz. If you’re styling with heat, always use heat protection spray and don’t turn up your styling tools to the maximum setting. 

Treat your hair gently while putting it up too. Tight ponytails and bun hairstyles can pull at the root, causing hair to fall out and creating what’s called ‘traction alopecia’. 

Excessive brushing can also cause hair fall. We all seemed to absorb the ‘100 strokes a day’ myth to keep hair lustrous and shiny, but too much hair brushing is actually super damaging. Cheap brushes will cause tangles, split ends and damage, so invest in a high-quality brush that detangles hair easily. 

While treating your hair gently may not directly prevent hair loss during pregnancy if it’s caused by hypothyroidism or other conditions, it can give you more confidence. While your body changes, styling your hair gently and keeping it healthy will boost your self-esteem when you look in the mirror. 

Experiencing pregnancy hair loss that lasts longer than 6 months? If you’re feeling concerned about your hair loss and you’re struggling to find the cause, our team of dedicated specialists can help. Call us on 0207 395 1861, or contact us here.

Sources: 

1. Hair Shedding In Women: How much is too much?
2. The changes in the hair cycle during gestation and the post-partum period
3. Telogen Effluvium: A Review
4. Hair loss and contraceptives
5. Thyroid Disease & Pregnancy
6. Hair loss and thyroid disorders 
7. Thyroid Hormones Directly Alter Human Hair Follicle Functions: Anagen Prolongation and Stimulation of Both Hair Matrix Keratinocyte Proliferation and Hair Pigmentation
8. The impact of maternal iron deficiency and iron deficiency anaemia on child’s health
9. Iron Deficiency Anemia in Pregnancy: Novel Approaches for an Old Problem
10. Emotional Stress During Pregnancy – Associations With Maternal Anxiety Disorders, Infant Cortisol Reactivity, and Mother–Child Interaction at Pre-school Age
11. Hair Loss – NHS website 
12. Are You Getting Enough Iron?
13. Iron requirements in pregnancy and strategies to meet them