Thinning hair, receding hairline

Generally, humans shed between 50 and 100 single hairs per day. Hair shedding is part of a natural balance — some hairs fall out while others grow in. When the balance is interrupted — when hair falls out and less hair grows in — hair loss happens. Hair loss is different from hair shedding. The medical term for hair loss is alopecia. [9] 

During menopause, you might see one of two things happen with your hair. You might start growing hair where you didn’t before. Or, you might notice that the hair you have is starting to thin. One cause may be changing levels of hormones during menopause. Estrogen and progesterone levels fall, meaning that the effects of the androgens, male hormones, are increased because there is less estrogen and progesterone to balance against them.

During and after menopause, hair might become finer (thinner) because hair follicles shrink. Hair grows more slowly and falls out more easily in these cases. [9]

Growth of facial hair

Changing hormones, and hormone balance, where the effects of the androgens, male hormones, are increased because there is less estrogen and progesterone, affect hair growth. You may see increases in unwanted hair around your upper lip and chin. While this can be annoying, it is also easily treated and managed with plucking or waxing as discussed in the self-care section, or you can Lean In to Movember!

Brittle and/or peeling nails, ridges on nails

Keratin is a protein in your body that builds your nails, your hair and the outside layer of your skin. The root cause of problems with your nails during the menopausal transition is the reduction in levels of estrogen because estrogen drives the production of keratin. As your estrogen levels drop and keratin production is affected, your nails can start to show distinct vertical ridges (called onychorrhexis). If your nails have become brittle and break easily or peel, this can also be a result of dehydration in combination with lowering levels and strength of keratin. 

Thinning hair, receding hairline

• See a board-certified dermatologist at the first sign of a problem. The early hair loss is treated, the better the results. As well, there are multiple causes of hair loss, and your dermatologist can determine which one is affecting you. 
• If hormones are the cause of your hair problems, your dermatologist may recommend minoxidil (the ingredient in Rogaine) as a treatment. This over the counter remedy is clinically proven to work, however, you will need to use it continuously. 
• You can work with your hairstylist to make the most of what you have. For example, coloring your hair increases the size of the hair strand and can make your hair appear fuller. Short cuts or the addition of layers can also increase the fullness of your hair. 
• Massaging your head (easy to do when you are showering) can stimulate blood flow to the scalp and hair follicles, reducing the speed or amount of hair loss. 
• Some hair products are designed to increase hair volume and fullness. Volumizing shampoos  (without using sulfate detergents) or volumizers that are added to wet or dry hair can also help. Remember to confirm any products with your dermatologist as they may not be the best choice for your individual needs and health. [9]

Growth of facial hair

• Plucking, waxing and threading are common, effective  treatments for most facial hair. 
• Note that your skin gets thinner as you age, so over time, you may find that waxing damages your skin, even making it tear and bleed. If this happens, talk to your dermatologist about other less invasive treatments (like lasers or topical treatments) that could work for you. 

Brittle and/or peeling nails, ridges on nails

• Keep your hands out of water as much as possible. Wear rubber gloves when washing dishes.  
• Drink adequate water so your body, and your nails, stay hydrated. Dry nails can become brittle and break and peel easily. 
• Be careful about the cosmetic products you use. Many nail products contain chemicals, such as acetone, that can damage or weaken nails. 
• Avoid having gel or acrylic nails. Yes they are lovely, especially if you have trouble getting your nails to grow, but regular manicures with gel or acrylic weakens your nails and can cause them to be thin and peel easily. 
• Let your nails breathe by taking a break from any polish. Alternate weeks with and without polish. 
• Keep your nails shorter rather than longer. Short nails are less likely to get damaged and banged around and this helps keep them strong and avoid chipping, cracking and splitting. 
• Avoid using your nails as tools if you can. Try to use the pads of your fingertips instead. 
• Moisturize your nails regularly. You can use regular hand moisturizer or use a cuticle cream 
• Hand sanitizer products are very drying. If you are unable to completely avoid using these, use extra cuticle cream and moisturizers to compensate. These will make your nails brittle and more prone to peeling or breaking. 
• File your nails in one direction only, not a back and forth sawing motion that can weaken the structure of the nail. 
• Always wear rubber gloves when using cleaning products. Most cleansers contain harsh chemicals that will weaken and damage nails. 
• Avoid using strong shampoos for oily hair as they are designed to strip the oils off of your hair but will also strip them off of your nails, which are in contact with the shampoo as well. [11] 

Hair loss/thinning

Treatment for hair loss and thinning hair depends on what is causing your hair loss.  Consult with your healthcare provider or your dermatologist to discuss treatment options. For hair loss associated with changing hormones, the following treatments can be used:

• Minoxidil (Rogaine®) is an approved and effective treatment, available in different strengths. Discuss which is best for you with your healthcare provider. You must be on contraception if you are using Rogaine as it is not safe for use during pregnancy or if you are breastfeeding. Using this product is a commitment – the directions must be followed exactly and the effects only last for as long as you are using it. Side effects include irritation, dryness, scaling, itching and redness on your scalp. Also be aware that you need to avoid touching the minoxidil to other areas of your face and body, as it can cause hair growth there as well. 
• Laser treatments such as the HairMax Lasercomb® (a low light laser) or Theradome LH80 PRO® helmet and low light laser helmets and caps have been approved by the US FDA. 
• Hair transplant surgery takes small pieces of scalp that have attached hair follicles from the back of the head and moves them to areas of hair loss. The possible side effects include infection, folliculitis (infected or inflamed hair follicles) and shock loss that causes the hair in the transplant area to fall out.
• Injections of protein-rich plasma (PRP) involves drawing blood from the patient, removing and concentrating the platelets in their blood and then reinjecting back into the patient. This accelerates the healing process and stimulates the growth of new hair. [15]
• Microneedling of the scalp with and without the application of minoxidil. [9]

Growth of facial hair

• If you have found that your skin is too sensitive for waxing or plucking, have a board-certified dermatologist perform laser hair removal, if that’s an option for you. In skilled hands, this treatment may seem easy. Your risk of side effects increases dramatically when the person performing your laser treatment lacks medical training and in-depth knowledge of the skin.

Hair

Hair comes out of the epidermis, but it is actually rooted deep in the dermis. There are two parts to the structure of hair. The hair shaft, made of a protein called keratin, can vary in length and width and it is what we see on the outside of our body. The hair follicle is a complex structure that contains the hair bulb, which is the place where the hair grows to make the shaft grow up vertically out of the skin. The grouping of the hair shaft, the hair follicle, the sebaceous gland, and the erector muscle is called the pilosebaceous unit. 

There are two types of hair – one that is affected by hormones, typically found under the arms, in the pubic region, on the scalp, and the chest. The second type is hair that isn’t affected by hormones, called vellus hair and it covers the rest of the body with the exception of the palms of the hands, soles of the feet, lips and parts of the genitals. 

Hair grows in phases – a growth phase (anagen phase), a transition phase (catagen phase) where the hair follicle detaches from the bulb but doesn’t yet fall out, and the resting phase (telogen phase) where the hair prepares to fall out of the follicle after dying from lack of blood supply. In the case of scalp hair, the shaft stays in the growth phase for two to six years on average – individual variation is determined by genetics. About 80 to 90% of the hair on your head is in the growth phase at any given time. Shorter hair like the hair on your arms, legs, and your eyelashes have a shorter growth phase, on average about one month. [7] [16] 

Download PDF

Hair loss

There are three reasons you lose hair. Anagen effluvium is a result of medications that poison the hair follicles during the growth phase, for example during chemotherapy. Telogen effluvium happens when increasing numbers of hair follicles reach the resting phase and fall out. This can happen as a result of physiologic stress. Causes of physiologic stress include nutrient deficiencies associated with crash diets or starvation, illness, emotional stress, or starting on new medications. 

The most common reason for hair loss is called androgenetic alopecia or male or female pattern hair loss or baldness. Hair thins over the top and on the sides of the head. Despite the fact that male pattern baldness is well known and commonly discussed, it has recently been estimated that more than 50 % of women will experience hair loss that is noticeable. [9]

Nails

Nails are made up of layers of keratin, a type of protein that also forms hair.  The root cause of problems with your nails during the menopausal transition is the reduction in levels of estrogen because estrogen drives the production of keratin. Much like a hair shaft growing out of the bulb of the hair follicle, your nail grows from the nail matrix and pushes the older cells out lengthwise. The nail bed keeps the nail nourished, and once the nail cells are pushed past the nail bed, the cells die and can break off or be cut off without any pain.

Download
 

Glands

Your skin contains four different types of glands – sweat glands, sebaceous glands, ceruminous glands and mammary glands. There are two types of sweat glands – eccrine glands and apocrine glands. Eccrine glands excrete a fluid directly to the surface of the epidermis, your skin, and as this sweat evaporates it cools your body and regulates your body temperature. This sweat doesn’t usually cause any smells. The second type of sweat gland, apocrine glands, excrete a sweat into your hair follicles, not directly to the surface of your skin. The sweat that these glands excrete doesn’t smell until it combines with bacteria on the surface of your skin. The bacteria break down this secreted fluid and it is this process that causes body odour. Apocrine glands do not become active until puberty, which is why children do not have body odour. Sebaceous glands are found in the pilosebaceous unit, so they are associated with a hair follicle and shaft. These glands secrete a substance called sebum that makes up the natural oils covering your skin in a thin film. This adds a protective layer on top of the epidermis and works to repel bacteria as well as keep your skin moisturized. [7] [8]