5 Science-Backed Steps to Stop Female Hair Loss and Regrow Your Hair

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0:43Find Oli's sleep solutions for the whole family at Oli.com. That's O-L-L-Y dot com. You're in the right place if you've been noticing more hair in your brush, more shedding in the shower, or your part slowly widening. You may be experiencing female pattern hair loss if this is what's happening for you. So what is female pattern hair loss? It's one of the most common concerns that I hear from women. They're over age 35, they have PCOS, they're coming off the pill, or anyone who's going through transitions like perimenopause. Now by the end of this episode, you'll have a complete plan for hair growth and a full step-by-step weekly routine that you can implement.

1:28I'm going to walk you through the science-backed protocols that help target the five key areas to help prevent hair loss and help you grow your hair back. Now, before we dive in, if you can take just 30 seconds and leave me a review wherever you're listening to this right now, that helps center female voices in women's medicine. And you are the whole reason the show gets out to the people who need it. So thank you for taking just a quick minute to leave me a review. With that said, let's start with the science because hair loss in women is rarely just a genetics issue. There's usually a lot more going on.

2:05So the first thing we have to look at is dihydrotestosterone sensitivity or DHT. So female pattern thinning is often caused by follicle sensitivity to DHT. DHT is a very potent androgen. Androgens are like testosterone. DHT shrinks the follicle over time. And so the hair follicle itself is undergoing miniaturization. So what you'll notice is you have thinner hair. So the hair itself is getting thinner. You're having shorter growth cycles. So your hair is just falling out sooner and you're not getting the length that you want. Women will often notice a widening part. Now that part can be on the top of their head, like down the center.

2:56But sometimes they can notice the sides of their head. That's also where things are thinning. And in women with PCOS, that's polycystic ovarian syndrome, elevated androgens are even more exaggerated, and that exaggeration can speed up this process even more. Now, the second area we have to look at are hormonal shifts that happen after age 35. Estrogen is very protective of the hair follicles, and it helps keep them in their growth phase longer. That's why maybe if you were pregnant once, you noticed your hair got longer. after age 35, maybe even after age 45, but in the perimenopausal window, estrogen fluctuates a lot and then it declines.

3:40And that leaves follicles more vulnerable to DHT and inflammation. Now, the third area we have to talk about is stress, cortisol, and that inflammation. So chronic stress shortens the growth phase and increases shedding. Inflammation on the scalp disrupts normal growth cycles. And this can be when your estrogen declines, but really at any point in your life, you can have HPA dysregulation, hypothalamic pituitary adrenal access dysregulation, and notice hair loss. If you have major stressor, you get an infection, you might have a short-term amount of hair loss that comes three months after that, and then your hair starts growing back.

4:22But if you're under chronic stress day after day, you can start to destroy the hair follicles. Now, the other area we have to address, and I definitely have a protocol for you, is reduced blood flow. So as your follicles become thinner and smaller, blood flow is decreasing. I'm with it. That means oxygen's decreasing and nutrient delivery is decreasing. And speaking of nutrients, we also need to look at nutrient deficiencies and I would say thyroid dysfunction. So if you have low ferritin, which is the stored form of iron. You have low protein intake. Seeing that with a lot of GLP-1 users, low vitamin D, or your hypothyroid, these can all be major contributors to hair loss.

5:02And that's why there's no single product, no single serum or shampoo or supplement that's enough on its own. It really takes a multifaceted approach. Hair growth requires layering multiple strategies. So let's get into some of those strategies. I'm going to go through what actually works and I'm going to categorize it by mechanism. And I will put this all in the show notes at drbrighton.com, D-R-B-R-I-G-H-T-E-N.com. So if you're someone who's like, I'm having a hard time keeping up with this full episode or I need to see things laid out, I will have that resource available to you. And if you're one of my email subscribers, that's going to come direct to your inbox.

5:44So let's go through how to address the root causes of female pattern thinning. That's going to be things like follicle stimulation, reducing scalp inflammation, blocking DHT or trying to modulate it, improving blood flow, and supporting your scalp environment so your hair can actually grow. And to simplify this, I'm going to break it all into categories so you know exactly why each step belongs in the protocol. So the first thing we want to do is we want to stimulate growth, right? You're like, yes, give me my hair. Let's do it as fast as possible. So first thing, let's talk about stimulating growth.

6:20Minoxidil, 5 % every day. This is one of the most researched topical treatments for female pattern hair loss, and it works. So I want to say alternatively, there's also taking oral minoxidil, but that can have higher side effects than the topical one. So what does minoxidil do? It's going to prolong the growth phase, except that initially you're going to have hair loss happen. You're going to have more shedding in the first two weeks to, well, it can be the first two to eight weeks. And then after a couple of months, we're going to see that hair is sticking around longer. It also can help enlarge shrinking follicles.

7:03So helping combat that miniaturization. But we also have to like address the DHT. So we're going to get there too. Menoxidil is also known for improving oxygen and blood supply to the hair, which is really important, especially if you're going to take something like a prenatal or a multivitamin. We got blood flow coming in. We're going to help deliver those nutrients. And it's also helping stimulate growth factors. Now, menoxidil comes in both a foam or liquid topically, both work, but many women prefer the foam because it's less irritating and it's not going to like spill down your face and cause hair growth in places you don't want it.

7:42Now, the other thing that can be helpful outside of minoxidil is peptide serums. These support follicle stem cells and signaling pathways that help with hair growth. So some of the options that are out there, The Ordinary makes a multi-peptide serum, which is pretty affordable. Peptides are not very affordable in general if we're being real, but when you look at what they are and how you produce them, it makes sense, but that's a pretty affordable one. Another one that a lot of people like is the Act Plus Acre stem cell peptides, and Vegamore Grow makes another really good product. I have no affiliation with any of those, and if you have a peptide product for topical hair growth, drop it in the comments.

8:27Especially like YouTube, like you guys tend to be like such a resource on the YouTube, but drop others because there's definitely others. And I would say like if you're looking at ingredients, copper peptides have a lot of research going for them. And so there's another one, I think it's Divi scalp serum that has copper peptides, but if you have one that you like as well, just drop it in the comments. I'd love to hear from you. Now, the benefits of using peptides is that it can help with stronger follicles, reduce shedding, improve density, and so it's going to really help you keep that hair around longer.

9:06Now, the other thing we have to look at on top of hair growth is blocking DHT or modulating DHT, bringing on anti-androgenic support. So for women, I like to use Saw Palmetto Plus. Saw Palmetto has been shown to help with 5-alpha reductase activity. 5-alpha reductase is the enzyme that takes testosterone into DHT, and so it helps support your body get that level evened out. Studies have also shown that Saw Palmetto regular use can help with hair density, especially when you're combining it with things like minoxidil. Another thing to consider on top of saw pomido is nizerol shampoo. It's a ketoconazole and 2 % tends to be what works best.

9:54This is used twice weekly. Ketoconazole has both anti-inflammatory and mild anti-androgen activity, but it's being delivered directly to the scalp. It can dry you out and it can irritate the scalp, which is why it is not something you use every day. It's a twice a week protocol only. And so that's going to be a shampoo. You apply it, you leave it on for five minutes, and then you rinse it out. Now we also need to increase blood flow. And a lot of people now are using microneedling, 0.25 to 0.5 millimeters once weekly. So rolling the derma roller over their scalp. This is a very powerful way to stimulate regrowth because microneedling is creating micro channels that can enhance minoxidil penetration.

10:42So people roll, then they put on the minoxidil. You have to clean your derma roller every single time. So you can get an alcohol spray and spray it, but you definitely need to clean it every time. You don't want to get an infection that will set your hair growth back big time talking about spiking inflammation. We do not want that. But even just derma rolling on its own, that triggers a wound healing signal to the body and that can awaken dormant follicles in some cases. So follicles that are just like sleeping, being kind of lazy, roll it out and some of them can get stimulated. The other thing about derma rolling is that it's going to boost circulation.

11:23So that's another benefit to it, but I really cannot emphasize enough. You want to make sure that you have a clean scalp and a clean derma roller. Often when people are losing hair, they opt not to wash their hairs often. If you have curly hair like me, you know you can't wash your hair that often because getting dried out is like the curly hair default. I mean, even today, it's super dry outside, no humidity, and my hair is like, I hate this weather so much, but you want to have a clean scalp. You want to have a clean derma roller. And then when you roll, you want to make sure that you're going through the scalp and not pushing super hard.

12:01You don't have to be super aggressive. Often what my patients find helpful is to derma roll and then wait like 10 minutes and then they apply the minoxidil only if your scalp tolerates it. If your scalp gets irritated, then don't be doing this. And I'm a doctor, but I'm not your doctor, so check with your doctor. And what I often have patients do, Dermarol, do the foam, Minoxidil. It's nice because you can part your hair, spray it right through there. And then I will tell them, get a toothbrush you don't care about, not one that you've used, because we want it clean. And then use that to distribute it into your part so that you're spreading it in there.

12:37And I mentioned if you're sensitive, don't do this. But if you are sensitive, then you could wait and use minoxidil the next morning. Now, the other thing I highly recommend people doing is a scalp massage, three to five minutes every day. This is going to improve circulation. It's going to reduce tension around the follicles. And it's nice to add something like a rosemary oil to the scalp massage. So rosemary oil in one study has performed similarly to 2 % minoxidil. Remember, we want to use 5 % minoxidil. And you're going to use it like two to three times a week. And so you can make it yourself.

13:12You can buy essential oil and then dilute it in a carrier oil and massage it in the scalp, or you can just buy one that's already rosemary essential oil. Some people I know will simmer rosemary down in a pot and also do rosemary washes through their hair and massage their scalp. So there's a very economical way to leverage rosemary. Okay, so the next category, and remember, I'm going to go through this, like how to do this and what your weekly routine will look like. But the next thing we got to look at is just getting the inflammation down. Inflammation disrupts every stage of the growth cycle.

13:47And so we've got to bring down that inflammation. Remember I said that 2 % ketoconazole shampoo twice a week can help with lowering inflammation. The peptide serums I already mentioned can also help with lowering inflammation. don't you love it when one product does multiple things and then we also want to be regularly washing our scalp and cleansing our scalp there are some like special cleansers out there that are just for scalp cleansing and I think they can work but I feel like this protocols a lot already so I'm not going to go into that I'm going to talk about just like shampooing your hair regularly if you miss one day that's fine but don't go two to three days without shampooing your hair that can actually lead to DHT buildup around your hair follicles.

14:35Microneedling is another thing that can help with inflammation. As long as it's controlled, you're sterilizing and you're not being aggressive about it. So again, once a week is about where it's at for most people. And then we need to look at protecting your hair and repairing the hair shaft itself. Often when people are losing hair, their hair is also getting brittle. If your hair is getting really brittle, that's definitely a sign we need to check your thyroid. So even if your follicles are producing new hair, you have to protect the strands because they can break off. We want elasticity to the strands.

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15:51That's myalloy.com, M-Y-A-L-L-O-Y.com and the code DRBRYTEN, D-R-B-R-I-G-H-T-E-N. Share your symptoms and you'll get a fully customized treatment plan and unlimited messaging with your doctor. Plus, you'll get$20 off your first order today. That's M-Y-A-L-L-O-Y dot com, code Dr. Brighton. Things you can do is like hydrating masks. You can buy a hydrating mask or sometimes something like things I will do is avocado, banana, egg yolk, castor oil, olive oil, into a blender with some honey and I'll use that as a hair mask. K18 is a product a lot of people like because it can help repair damaged hair.

16:44If you're someone who dries your hair in the winter, I totally get it, but we want to limit heat or maybe you want to use a product that protects your hair from heat exposure. But we don't, if someone's experiencing hair loss, we don't want to be straightening hair, whether it's chemical straightening or just doing iron straightening because that can be really damaging to the hair. I would also avoid tight hairstyles. So really tight braids. Alopecia, traction alopecia is a thing. Too tight of hairstyles actually causing you to lose hair. And then something else that's really easy in your kitchen is using a light oil like coconut oil on the ends, not on your scalp, because it does have some antimicrobial property where you don't want to be stripping the microbiome of your scalp.

17:31But if you guys have followed me on social media, you know, I always apply coconut oil to my hair before I go snorkeling. I love snorkeling, but being out in the salt water totally just ravages my hair. And so I apply coconut oil, so I have a barrier to it. But I'll also apply coconut oil like halfway down my hair like once a week. So with that said, and talking about weeks, let's go into a weekly protocol and go by like a day-by-day plan that you can follow to implement all of this and want this to be actionable. I want you to take action if you are losing hair. Now, most peptide serums are going to say use them ideally overnight, but if you're using minoxidil, most people, I advise they use that overnight because the peptide serum, you can style your hair and then apply the peptide serum and it doesn't mess with your hairstyle as much as minoxidil.

18:22So on Monday, Monday morning, wash style your hair. Peptide serum is going to go in. And in the evening, you're going to use minoxidil on the scalp and then do a hydrating mask in the evening. You can wrap up your hair. You can wear a silk bonnet. Ideally, if not a silk bonnet, then you're sleeping on a silk or satin pillowcase. And then you want to take Saw Palmetto Plus. You've got to take Saw Palmetto Plus every single day. That's got to be with you to help with that DHT regulation. On Tuesday, repeat the same thing, but you're going to use rosemary oil as a scalp massage. And when you do that, you're going to put the rosemary oil on like 10, 20 minutes before you get in the shower, before you're going to shampoo your hair that day.

19:10So you're going to apply the oil in. You can do finger scalp massage. You can buy one of those handheld scalp massagers. I'll put these in the show notes or there's like the work your business, like mechanical scalp massagers. and then you're going to want to wash your hair, style your hair, put on your peptides, and then that night you're doing minoxidil. Now Wednesday, that's going to be your ketoconazole day. So you will wash your hair that day with a 2 % ketoconazole. You're going to leave that on for at least three to five minutes, get your hair wet, get it all on your scalp, three to five minutes, come out, style your hair, peptides go on, that night, minoxidil.

19:49On Thursday, we're doing the same thing with the peptides and the minoxidil, so that's not changing, but that's a good day to do a scalp massage. And if you're like, I don't want to do the rosemary scalp massage again, then a little trick is put a little bit of peppermint essential oil in your shampoo and shampoo your hair, and that can help with more blood flow and circulation. Now, Friday, let's make that the microneedling day. So we're going to cleanse our scalp, make sure that our scalp is clean that day. We do our peptides or we can skip them that day. You don't have to do peptides every single day, but that night you're going to do your microneedling and then you're going to apply minoxidil.

20:30Remember the microneedling is going to be at max 0.5 millimeters. We're not going for super deep. We're not pushing super hard, being aggressive. We're not rolling over the same area over and over and over. We're rolling through and then giving yourself five, 10, maybe 15 minutes, and then you're going to put your minoxidil on. Again, if you're using the foam, it's like way easier. You're going to put that foam or you're going to just separate your hair and make little parts in it, put the foam along there and use a toothbrush to massage that in. But if you are someone who is sensitive to minoxidil, then instead we're going to apply the minoxidil Saturday morning.

21:08So Friday, derma rolling and minoxidil. If you want to skip massages, you want to skip, you know, doing the peptides that day and you're like, this is just the derma roller minoxidil day, that's totally fine to do. But I would say most people are going to get better results if they're using those peptides every single day. But I also know life gets busy and sometimes you're like, I just need a break from this business. Now, Saturday, 2 % ketoconazole day again. So I'm going to wash the hair three to five minutes. You're leaving that ketoconazole on your scalp. You cleanse it off. You do your conditioning.

21:45Peptides after you style or just after your hair's dry. Minoxidil in the evening. And optionally this day, you can use a hair repair like doing a homemade hair mask or you can do a K18 treatment. Something to help strengthen the hair shaft itself. And then Sunday, we're just going to make it like really easy. If you don't want to shampoo that day, you can skip it. Peptides, minoxidil in the evening, coconut oil on the ends. But if you are planning on shampooing that day, then I would say good day for a rosemary oil scalp massage. And what I typically recommend with that rosemary oil scalp massage is just first thing, get that on there, massage your scalp, go about your business.

22:32Like maybe you go eat breakfast, then you come back, you heat up the shower, and then you go ahead and shampoo that off of your head. You want to cleanse the scalp, but you don't have to try to strip it all out. Some of that oil can be really nice to brush through your hair and have some hydration. It depends on your hair type. If you already have an oily scalp, you have very thin hair, and it's straight, then that oil might be too much. I have curly hair. The more oil I can put in my hair, the better. So if you're someone with curly hair, then you're going to be like, oh yeah, I'll just like cleanse it once and then brush it through.

23:11You might have to cleanse twice if you use a lot of rosemary oil or the type of carrier oil if you use a castor oil. That might need a double cleanse on your scalp. So just be warned for that. Okay, let's talk about like realistic expectations. So what to expect? We're going to lose hair if we're using minoxidil. We're going to start shedding more hair initially. That's six to eight weeks later, reduced shedding should happen. Less hair in the hairbrush, less hair coming out in the shower, less hair on your pillowcase, less hair when you pull out your ponytail. Not too tight of a ponytail, remember?

23:47Then about three to four months later, you're going to see baby hairs and regrowth along your part, along your temples, like where you're applying that minoxidil. And then it's going to take like a good six months before most people notice some density increase. So take photos before you start this protocol of your part, because sometimes you're like, it's been six months, I don't think it's really helping. And then you look back at the photos and you're like, oh, wow, no, that's really helped. When we will see maximal improvement is going to be 12 months. so it's going to be week after week sticking to the protocol best you can and a year later you should see maximal improvement your hair should be longer hopefully too and I know it's super frustrating so like why does this take so long Dr.

24:34Brighton because hair grows really slow so the women who see the best results are the ones who stay consistent not perfect okay you don't have to be perfect every time if you go on vacation and you miss a couple nights like you missed a couple But staying consistent week after week, that is what's going to help. Now, I do want to talk to you about when to test your hormones, when to check things out, because I think it's important to recognize that, you know, if you're someone who has cystic acne, you're having irregular periods, and all of this is going along with the thinning hair, that could be a sign of polycystic ovarian syndrome.

25:10You don't need an ultrasound to diagnose it. All you need is clinical symptoms of hyperandrogenism, which acne, thinning hair, hair growth where you don't want it. That's enough to check that box. And then irregular cycles, which is a sign of ovulation being inconsistent. That's enough to diagnose PCOS so long as you've ruled out other things. Like you don't have hypothyroidism contributing to these irregular periods or it isn't that you have a fungal infection causing acne. So there are things we have to rule out. But if you are experiencing all that, we want to see if this is PCOS. If you have sluggish digestion, you're constipated all the time, you're experiencing weight gain, cold intolerance, fatigue, you have dry skin, you are feeling really sad or anxious, you're sleeping all the time, but you don't feel rested, that's a sign of thyroid disease.

25:58We got to get that checked out. If you see increased shedding postpartum, welcome to the club, that's totally normal and that will come back, okay? That will come back. But if you see increased shedding after age 35 and you're having other symptoms as well, that could be a sign of perimenopausal changes. And as we see perimenopausal changes, loss of estrogen not challenging that DHT, we can see hair loss and thinning. So things we might want to test. We might want to get a thyroid panel. If you have anything that's caused you to lose a lot of blood, like heavy periods, you have adenomyosis, you have fibroids, getting a ferritin checked.

26:36But honestly, We should be checking ferritin in most women. I would say all women, honestly, because that's your stored farm of iron. And if your ferritin is below 50, I expect you're not going to grow hair and you may even be losing hair. I also like to test androgens, total free testosterone, DHA sulfate. That is coming from your adrenal glands. I like to look at DHT in the blood as well. And I like to look at it against sex hormone binding globulin. Because if your sex hormone binding globulin is super low and your testosterone and free testosterone are pretty normal, then we've got to help modulate that sex hormone binding globulin and bring that up.

27:14I mentioned vitamin D earlier. If your vitamin D is in at least 50, then we want to get that up. But usually when it drops below 30, we can see hair loss occurs in women. If any of these are abnormal, then you want to address them on top of a hair protocol to improve hair health. Now, the last thing I would say is that I do recommend most women take a multivitamin or a prenatal. You need these nutrients to grow your hair. Your nails make great skin. So definitely check your nutrient status and then consider, should I be on a multivitamin like women's twice daily or prenatal plus to help support my hair?