Hair loss after childbirth

Increased hair shedding a few months after childbirth is one of the most common and at the same time least announced changes of that period. It surprises almost every woman it happens to. In dermatology it is described as postpartum telogen effluvium and, in its typical form, it is a temporary phenomenon.

Why it happens

To understand what happens after childbirth, you need to know how hair normally grows. Follicles are not synchronised: each has its own rhythm. At any moment about 85 to 90 per cent of follicles on the head are in the anagen growth phase and about 10 to 15 per cent in the telogen resting phase, after which the hair falls out. Because of that lack of synchronisation, losing fifty to a hundred hairs a day is normal and goes unnoticed.

During pregnancy

Raised oestrogen levels prolong the anagen phase. Follicles that would ordinarily move into rest stay in the growth phase. That is why many women in the second and third trimester notice that their hair looks thicker, fuller and barely sheds. It is not that new hair has grown: it is that the old hair has not left.

After childbirth

Oestrogen levels drop sharply in the days after birth. All those follicles that had been “held back” move into the telogen phase, and roughly at the same time. Since the telogen phase lasts two to three months, hair starts falling out en masse about three months after the birth.

Hence the impression of drama: strands on the pillow, in the drain, on the brush. In reality no more hair is lost than would have been lost throughout the whole pregnancy: what was postponed is lost in a short time.

The typical course

• 2 to 4 months after birth, shedding begins, often suddenly
• 4 to 6 months, usually the most pronounced period
• 6 to 9 months, the shedding gradually settles
• around 12 months, in most women the situation returns to normal

Short new hairs along the forehead hairline and at the temples that appear in that period are a sign of recovery, even though they are awkward in a hairstyle. They are proof that the follicles are back in the growth phase.

What helps and what does not

The main thing that helps is time. In typical postpartum effluvium the follicles are not damaged; they are resting and return to the cycle by themselves.

Practical measures in that period reduce additional strain on the hair:

• Avoid tight ponytails, buns and braids that pull on the root
• Comb carefully, from the ends towards the root, with a wide comb
• Reduce heat, a lower hairdryer temperature, less use of straighteners and curling irons
• Postpone chemical treatments until the situation settles
• Wash the hair regularly; washing does not cause shedding, it only removes hairs that have already come loose
• Pay attention to protein and iron intake and overall nutrition, particularly while breastfeeding
• A haircut that shortens the length reduces weight and mechanical strain

What does not help: aggressive treatments, frequently changing products and expecting a shampoo to change the course of a hormonally driven cycle. The role and reach of rinse-off products are described in the text on shampoos for hair loss.

Caution with preparations while breastfeeding

This is an important note. During pregnancy and breastfeeding every preparation applied to the skin or taken orally should be checked with a doctor first. That applies to medicines, to supplements and to cosmetic products, including scalp serums and ampoules and preparations with peptides. The decision is made by the doctor who knows your situation, not by the packaging and not by the internet.

When to see a doctor

Postpartum effluvium is common, but it does not explain everything. A conversation with a doctor is warranted if:

• The shedding lasts longer than a year or gets worse instead of settling
• Clearly defined bald patches appear: that is not the effluvium pattern, see the text on alopecias
• There is redness, scaling, pain or itching on the scalp
• The shedding is accompanied by marked fatigue, palpitations, weight or mood changes, possible signs of a thyroid disorder, which occurs more often in the postpartum period than otherwise
• There is a suspicion of low ferritin, particularly after a birth with greater blood loss

Postpartum thyroiditis and iron deficiency are two conditions easily missed in this period, because their symptoms are put down to tiredness from a newborn. Basic blood tests clarify the picture quickly.

In short

• Oestrogen during pregnancy prolongs the growth phase, so hair looks thicker.
• After birth oestrogen drops sharply and follicles move into the resting phase at the same time.
• Shedding starts around the third month and usually settles by the end of the first year.
• The follicles are not damaged: time is needed, not aggressive treatment.
• While breastfeeding, check every preparation with a doctor.
• If the shedding lasts longer than a year or bald patches appear, an examination is needed.

This text is informative in character and does not constitute medical advice. In pregnancy and while breastfeeding always consult a doctor.

Related: Peptides for hair with GHK-Cu, PP405 set