The truth is that hair loss is a really complicated subject and we still don't know a lot about how exactly someone's genetics might play a part.
It’s Alopecia Awareness Month. A month that is poignant for me as I spent many years as a woman with unexplained hair loss, unaware that I actually had Androgenic Alopecia. After ruling out any underlying health conditions that could have caused my female pattern hair loss, I decided to forgo expensive hair loss treatments and invested in a wig instead. I didn’t know if genetics caused my hair loss, or hormones, or my years of flat-ironing my hair as a 2000s teenager. All I knew was that my hair was falling out and I needed to keep living my life.
While I’m not ashamed of my hair loss, as a woman it is valuable to me to be able to move through the world without my insecurities about my hair on display. Wigs and toppers saved me a lot of pain as I adjusted to my new normal. Hair loss can be very isolating and women don’t often talk about it, making it an even more challenging area to research. I’ve often asked: why me? With no obvious explanation as to why my hair loss became chronic, I've sometimes wondered if my hair loss is hereditary. However, no one in my family has ever experienced hair thinning as young, nor to the extent, that I have. Or at least, that’s what I thought until I started talking about my hair loss with my family and took a closer look at our family tree.
But first, what is Androgenic Alopecia?
Androgenic Alopecia, otherwise known as male or female pattern hair loss, is an extremely common form of Alopecia. Androgenic Alopecia presents through hair thinning or balding, typically at the hairline and crown, as well as through miniaturization of the hair (meaning individual hair strands become finer). Many people can go the majority of their lives without knowing they have Androgenic Alopecia, but environmental factors and medical processes can unmask the condition earlier, like it did for me. Because Androgenic Alopecia is closely linked to hormonal processes in the body, I always suspected that my Androgenic Alopecia was uncovered when I decided to stop taking hormonal birth control, which led to a dramatic bout of Telogen Effluvium and my hair never grew back.
Before I decided to finally see a doctor about my hair loss, I’d known for a while that my hair had become thinner. However, I didn’t realize the extent of my hair loss until a saw a photo of the back of my head, taken from above. In the picture, I was sat down with a friend and my head was tilted back in laughter. My parting was very wide and a large patch of hair loss was apparent at my crown where you could see my scalp. Unfortunately, by the time you can see scalp through someone’s hair, they’ve likely already lost about 50-70% of their hair. This is very difficult and expensive to recover from, and instead of going down the path of medical intervention, I decided to start wearing wigs and tried to move on with my life. But I always wondered if my hair loss was somehow my fault, since I didn’t know anyone else my age who had it too.
So, is pattern hair loss hereditary?
Androgenic Alopecia, or Androgenetic Alopecia, is thought to be linked to genetics. However, female pattern hair loss is, unfortunately, polygenic. This means that female pattern hair loss involves more than one gene, which makes it challenging to identify exactly what genes are involved at the root cause of women’s hair loss. Female pattern hair loss, while potentially hereditary, is not directly correlated with genetics. People can have both parents with thinning hair or balding and never develop hair loss themselves, or the other way around. In our current understanding of the genes involved in Androgenetic Alopecia, either gender can inherit the condition. This is because the genes that are linked to pattern baldness are carried on the X chromosome, meaning men or women are just as likely to carry it.
Ultimately, genetics are an unreliable tell for whether or not someone will develop hair thinning or balding because there are many factors as to how and why someone may lose their hair, such as vitamin deficiencies, styling practices, or hormonal changes brought on by thyroid conditions, menopause, or pregnancy.
I never realized I had a family history of pattern baldness because my own experience of it as a woman has been so different. I always wrongly assumed you had to inherit hair loss from someone the same gender as you. On one side of my family, the men all have had a widow’s peak that has begun in their late twenties and early thirties, then progressed later in life. My brother has it, my uncle has it, and my grandfather had it. It’s easy to trace my brother’s small experiences of hair thinning because there’s a line of men who share it, in the same pattern and age range. Men’s hair loss, while still stigmatized, is also more widely accepted as a part of life. No one tends to wonder if there’s something wrong with a man who is going bald; if he’s ill or if he did something to mess up his hair. It’s just a fact of life that as men age, and sometimes even when they’re young, they can lose their hair.
Why don’t we know more about female pattern hair loss?
For women, it’s not so simple. Women, particularly before the days of Google, had to seek advice from an actual person if they suspected they were losing their hair. Considering I used to only seek out advice on my Androgenic Alopecia on Incognito Mode, I can only imagine how many women this deterred from finding answers about their hair loss.
Which is why I was so surprised to hear during a recent conversation with my mom that my paternal grandmother had, in fact, shown some signs of hair loss. My grandmother was of the era of women that coveted platinum blonde hair and she turned to at-home peroxide treatments to achieve it for years. It’s possible the hair dying and treatments could have contributed to her hair loss, but even in the years beyond her dying it, her hair did, anecdotally, show some signs of thinning.
When I think of my grandmother, I picture her in a figure-hugging outfit, with bright red lipstick, and her dark hair pushed back dramatically from her face. She never showed her part or the crown of her hair with this style. It’s possible she just liked this hairstyle, but it reminded me of how I would wear my hair in a deep side parting or up in a bun to disguise my own hair thinning before I started wearing wigs.
My grandmother was an extremely proud, warm, and striking woman who would never have spoken publicly about her hair loss, if she had experienced it, even with her loved ones.
It doesn’t surprise me that her hair was never brought up previously as, honestly, there were so many more fascinating things about her, such as her love of and dedication to her career as a defense lawyer in Britain. In the UK, lawyers wear wigs, as a symbol of anonymity and displacement of personal identity and opinion in favor or truth and justice. I think my grandmother was, in some ways, most herself when she was in a court of law in her robes and wig. I wonder if a part of it was because she didn’t have to think about her femininity and how she looked in this setting. She was free.
We still don’t know exactly what causes Androgenic Alopecia, but it can be treated.
Androgenic Alopecia can be treated, through topical and oral medications, and even cosmetic procedures, particularly if it is caught early and diagnosed by a certified dermatologist who specializes in hair. However, there isn’t a cure yet for Androgenic Alopecia.
Ultimately, I decided to wear wigs and found an incredible community of women online who understood how I feel. Unfortunately, I can’t ask my grandmother if she had the same female pattern hair loss as me and I’ll never know if she had it, too. I’ll never know how she felt about her hair. If she was a bigger baddie than me and didn’t give two flips about it, or if maybe sometimes it made her feel undesirable and alone like I felt before I found my confidence again. I can’t help but daydream about us spending a day out wig shopping. I wonder what she might have chosen, if she’d have gone back to her blonde days or chosen something totally eccentric and colorful, like who she was as a person.
The truth is I’m still the only woman, to my knowledge, in my family history that has had Androgenic Alopecia and whose hair began thinning in her late teens and twenties. I will likely never know if my hair loss was caused by my genetics. That said, I hope the things I pass on are the more important things I got from my family: love, compassion, tenacity. But if I’m not the last woman with hair loss in my family, at least the next girl will know who to turn to.
Special thanks to Dr. Kumar Sukhdeo from Nupello.com for speaking with us for this article and video. You can follow him @drkumarsuhkdeo and check out the interview in the video at the top of this page!