Forget the Grays—Hair Loss Is the Most Significant Change After 40

Two years ago, I had my first child. With the joys of a new babbling baby came the infamous postpartum hair loss—quite a bit of it. Think, clumps of hair falling out while pre-detangling, then more as I applied conditioner. It was a fun new plot twist in the emotional rollercoaster that is being a new mom.

My first big shed occurred a few weeks after taking down my protective box braid style, and the second was when I stopped breastfeeding (surprise!). Late night Internet scrolls only got me so far and generally only added to my panic. Should I take hair growth supplements? Did I need to switch up my style? Would I keep losing more hair forever? The questions, and potential solutions, felt endless.

New parent or otherwise, hair thinning and hair loss aren't new phenomena, especially as you age. Male pattern baldness, or male androgenetic alopecia (MAA), is already well-known and widely discussed in popular culture, affecting 30-50 percent of men by age 50. But a nearly equal number of women, 40 percent, will experience their own female pattern hair loss, or FPHL, by age 50. So why does it still feel so taboo to talk about it?

“Thinning hair can be more of a social stigma than graying hair, which is considered normal,” explains board-certified dermatologist Andrea Hui Austin, M.D. FAAD. “Research shows that thick, full hair is a sign of youth, health, and vitality.”

Trichologist Kari Williams, Ph.D, Head of Education at Cécred explains that whether you're 25 or 55, seeing your hair disappear can feel like you're losing control over an important part of your appearance, making it even more difficult to accept. “Knowing that it's a shared experience can help normalize the conversation and encourage seeking effective solutions,” she says.

Still, for me, it was shocking. I always had a healthy relationship with my hair and wasn’t obsessive about its length or fullness, so its rapid shedding sent me into something of a spiral to find a solution.

What Causes Age-Related Hair Loss?

The likelihood of losing your hair as you age is something of a numbers game. Hereditary hair loss—also known as androgenetic alopecia, or genetic hair thinning—is the most common type of hair loss in both men and women. It can begin at any age, from teenage years to your 40s or 50s, depending on your family’s DNA, and typically begins on the crown of your head.

If you’re starting to notice less hair in this area, you can’t just blame your mom or your maternal grandmother for your thinning temples. Rather, it’s a combination of factors and multiple genes from both family lines, according to Dr. Williams.

Dr. Austin encourages clients to do a little digging into their family tree, particularly with female relatives, to understand the possible outcomes for their hair as they age. “It is often helpful to future-proof against hair loss by understanding one's family history and preparing with simple additions to one's routine,” she says (more on that later).

Hormones and Your Hair

Hormonal shifts like giving birth or menopause, in addition to stress and illness, can trigger hair shedding and thinning. The hair is forced into a stage of the hair cycle called telogen effluvium, or resting stage. While stressful, this is a normal part of the hair growth cycle; hormones (including cortisol, also known as the stress hormone) can accelerate this phase and keep you there for longer.

Female pattern hair loss, particularly thinning in the form of your hair part becoming wider and/or your hairline receding, can start as early as your 20s or 30s. But it typically becomes more noticeable as women approach menopause, which typically occurs around age 52, due to a decline in estrogen and progesterone.

“These are hormones that help hair anchor better and grow faster, so the decline can cause slower growth, thinner, less anchored hair that easily falls out,” notes Marie Guanzon Averion, Director of Product Development & Clinical Affairs at The Rootist.

She adds that medications that affect hormone levels can also influence temporary hair growth and loss. “For example, spironolactone is commonly prescribed to treat hormonal acne, but some may experience increased hair growth. In contrast, [hormonal] birth control may cause hair thinness in some women.”

But hair changes aren't only due to your genetics or hormonal changes—that would be too easy. Many more factors, ranging from diet to styling choices, also make an impact.

Nutrition and Hair Loss

According to Dr. Austin, one of the most common causes of hair loss is iron deficiency. “Iron is necessary for the growth of healthy hair,” she explains. “There are often other symptoms, such as loss of energy and shortness of breath, that accompany iron deficiency.” She adds that biotin deficiency can also cause hair loss, noting that biotin is necessary for the production of keratin, the major protein in the hair shaft.

In addition to iron and biotin deficiencies, a diet lacking in vitamin D, zinc, B12, folate, copper, selenium, and protein can also lead to hair loss. Brooke Jeffy, M.D., a board-certified dermatologist, adds that rapid weight loss due to crash diets, medications like Ozempic, or surgery may also cause nutrient deficiencies that will negatively influence hair growth. “This happens because inadequate energy is supplied to the hair follicle,” she says.

So if you're eating right and communicating with your doctor about supplements and still experiencing hair loss? It might be time to take stock of your favorite hairstyle.

Hair Styling and Hair Loss

The beauty of hair is that we can use it as a means of self-expression. The downside is that certain choices about how you wear your hair, like tight braids, weaves, or ponytails can contribute to thinning, or worse, traction alopecia, a type of hair loss that occurs when hair is frequently under tension.

According to Dr. Jeffy, “Pulling of the hair consistently with these tight hairstyles leads to inflammation in the scalp and follicles which does not allow the hair to grow easily. Over time, so much inflammation occurs that scarring results which completely destroys the follicle.”

However, she says that it’s unclear how often you would need to wear these styles in order to cause such significant hair loss. A good guideline: switch up your styling to looser options with less tension in order to preserve the health of your hair and follicles.

Dr. Williams adds that chemical treatments like straightening or frequent coloring can weaken the hair shaft, making it more prone to breakage and thinning. So if you’re starting to notice thinning, it might be wise to skip that next relaxer or highlights appointment.

When to Seek Help

While the internet can be a great resource for finding solutions to your hair loss problem, a proper diagnosis from a professional is key, especially if you want to attempt to regrow your hair. If you experience symptoms such as sudden hair shedding (think more than 50-100 hairs daily), new-onset scalp itching or thick flaking, or scalp pain in addition to hair loss, book an appointment with a board-certified dermatologist or trichologist or to help determine the cause and offer treatment options like medication or in-office procedures.

Dr. Austin notes that if there are other medical conditions at play, such as thyroid dysfunction or hormonal imbalances contributing to your hair loss, a board-certified endocrinologist can also help create a thorough assessment and treatment plan.

Treatments for Hair Loss and Hair Thinning

PRP Injections

According to Dr. Austin, the most effective and promising treatment to regrow hair is PRP (platelet-rich plasma) injections. For this procedure, a medical professional will take a sample of your blood and separate the platelets and plasma from the red blood cells with a centrifuge device. This mixture is then injected directly into the scalp multiple times to help stimulate hair growth.

Estimated costs depend on your geographic area, and can run anywhere between $800-$1,200 per procedure. While the downtime is minimal, Dr. Austin notes that it often takes four to six sessions within a year to re-establish hair density, and maintenance treatments can vary depending on the cause of hair thinning.

Hair Transplants

For more severe hair loss or restoration of a youthful hairline (or even eyebrows), Dr. Austin reveals that hair transplants are the gold standard. “The number of sessions [required] depends on the severity of hair loss, and how many follicular units can be transplanted during one session,” she says, noting that one session can create a significant improvement, although some people require several sessions to achieve their hair goals.

Pricing can range anywhere between $10,000-$20,000 a session (typically up to three are needed). Not everyone is a good candidate (i.e those with chronic telogen effluvium or alopecia areata), so speak to your doctors for more details.

Exosome Therapy

Another option for regrowing hair is exosome therapy. Averion explains that this treatment entails injections of “biologically compatible bubbles” found in stem cells that transport actives into hair follicles to stimulate hair growth. The upside of this treatment is that it uses biologically similar materials, it’s minimally invasive, it can be combined with other hair loss treatments, and has shown promising outcomes in early studies.

As for the downsides, it’s a relatively new treatment (i.e. not FDA-approved yet), expensive, and traditionally multiple sessions are needed.

Low Level Laser Therapy

Low level laser therapy (LLLT) can be effective at supporting hair growth both in-office or at home, alongside dermarollers in combination with topical serums to stimulate hair growth.

“There are at-home products (helmets, combs, and even hats) that have been coming into the market, but they usually don’t have the same level of efficacy as in-office options,” says Averion. The number of times you’ll need to use them depends on the product, but generally, consistency is key to see tangible results.

Medications

According to Neera Nathan, M.D., MSHS, ingestible options like oral supplements (like low-dose minoxidil and spironolactone) can also help depending on the type of hair loss—most commonly FPHL. “Prescription hair growth medications help to improve blood flow to each hair follicle, which delivers more nutrients and oxygen for improved hair growth,” she says. “Spironolactone and similar medications such as finasteride and dutasteride help to block testosterone from causing hair to thin.”

However, like any systemic medications, there are side effects ranging from menstrual irregularities to fatigue, or more serious ones like kidney dysfunction, for those with pre-existing conditions.

Topical Products

Finally, scalp serums with concentrated actives are another solid option to combat thinning hair, but they can take at least three to four months of consistent use to see results, and they’re not always safe for use by everyone (like nursing mothers).

“Serums with stem cells and peptides targeting hair density can help thicken hair,” says Averion. “Fermented ingredients can also help deliver nutrients more readily to support hair thickness.” Her tip? Always look for clinical results from a third-party testing facility before investing in a hair loss product.

Below, we recap some of the best over-the-counter options across all price points.