Hair Loss During Pregnancy

Originally published 03/24/2022. Updated for accuracy and relevancy on 11/17/2023

Expecting mothers are likely to learn about postpartum hair loss, but do they ever experience hair loss while they are pregnant?

By OBGYN and fertility specialist Dr. Mare Mbaye

Everyone hears about the beautiful, thick, lustrous hair that is supposed to come with being pregnant. While this can be true for some parents to be, for others, pregnancy may actually lead to hair thinning or hair loss during pregnancy—rather than in the months immediately after delivery.

Pregnancy related hair loss is most common in the postpartum period—about two to four months after delivery—and affects anywhere from 40-50% of parents.¹ Up to 60% of a person’s hair that was in the growth state during pregnancy may enter into the telogen resting state.¹ Essentially, the normal hair loss that was delayed during pregnancy happens at once.

Obviously, seeing large clumps of hair in your hairbrush and excessive hair loss all of a sudden can be alarming. However, this hair loss is temporary and generally returns to normal within six to 12 months.

Now, what about hair loss during pregnancy? This is much less common due to the natural hormone shifts we see in the first trimester. During pregnancy, the rising estrogen levels slow down the natural cycle of hair follicle shedding and allow more hair to stay in the growing stage, known as the anagen phase. As a result, most pregnant patients see much less hair loss in pregnancy.

For those who do notice hair loss during pregnancy, it typically does not happen until later in a pregnancy. This is usually due to hormones and stress and should not be used as an indication of early pregnancy. There are other causes for hair changes in addition to this, like vitamin or mineral deficiencies or medical conditions that are associated with pregnancy.

Stress and Hormones

Some pregnant people experience hair thinning and excessive shedding due to stress or shock. The first trimester may stress the body as hormones shift dramatically to support the growing baby. This can force more of your hair into the telogen or “resting” phase of the hair life cycle–meaning you can lose a significantly higher number of hairs per day.¹ This affects a small number of women during pregnancy and is generally not serious enough to cause bald spots or permanent hair loss.

Vitamin or Mineral Deficiencies

Making sure you’re getting adequate daily nutrition is important—both during pregnancy and after. Iron deficiency is one of the most common mineral deficiencies seen in pregnancy and can affect hair growth and loss. Iron deficiency anemia (IDA) occurs when you have a lower than normal amount of red blood cells, the cells that deliver oxygen to different tissues in the body, due to lack of iron. It can cause thinning hair along with other symptoms such as headache, general fatigue, weakness, irregular heartbeat, and shortness of breath with activity.

Pregnant patients have a higher risk of developing IDA.² This is especially true if they’re pregnant with multiples, their pregnancies have been close together (short interval pregnancy), or they are dealing with severe morning sickness. IDA is diagnosed with bloodwork and is typically monitored throughout pregnancy as part of routine prenatal testing. Hair loss in these situations is also not permanent, but hair thickness may not return to its baseline until the mineral deficiency has been returned to normal ranges.

Other vitamins and minerals that can affect hair loss include biotin and zinc.³ There are many biotin supplement benefits beyond preventing hair loss. Switching to a prenatal vitamin that contains these can sometimes help to manage hair loss symptoms. Biotin supplements are a great option for those experiencing postpartum hair loss, but are not recommended for use during pregnancy without guidance from your medical provider.

Thyroid Disease

Thyroid disorders like hyperthyroidism (too much thyroid hormone) or hypothyroidism (too little thyroid hormone) are not uncommon during pregnancy. Hypothyroidism is more common and affects up to 3% of pregnant patients.⁴ Symptoms can include hair loss as well as fatigue, muscle cramps, intolerance to heat or cold, and constipation.

If you are concerned you may have a thyroid disorder or if you have a strong family history, bring it up to your provider. Thyroid issues are typically diagnosed with a blood test and can oftentimes be managed with daily medications.

Other Causes

It’s important to note that hair loss during and after pregnancy should appear as uniform thinning. If you are noticing specific patches of thinning hair or more dramatic balding, there may be something else going on.

If you’ve recently been wearing your hair in tight hairstyles or had certain beauty treatments, you may have traction alopecia, or hair loss due to inflammation of the follicles. This occurs due to the physical stress of certain hair products, treatments, and styles and can lead to hair shedding and loss. This can become permanent if the follicles scar, so it’s important to stop these practices as soon as you have any concern for this.

Genetic or autoimmune conditions like androgenetic alopecia (male pattern baldness) or alopecia areata can also affect pregnant patients.^5,6 Androgenetic alopecia is mediated by DHT (the more potent form of testosterone) and is caused by a shorter growth phase and a longer time between shedding hair and new growth. Alopecia areata is an autoimmune disorder in which the body attacks its own hair follicles. It usually presents as bald spots, which can appear anywhere on the body. There is no cure for alopecia areata, but certain treatments can help stop hair loss and increase healthy hair growth.

Tips for Managing Hair Loss During Pregnancy

For the most part, hair loss during and after pregnancy will resolve on its own, usually in about six to 12 months.¹ Most of the time, conservative management is all that’s needed, especially since many of the options available to those experiencing postpartum hair loss (like Minoxidil, or Rogaine) are not considered safe in pregnancy.

In the case of medical conditions like hypothyroidism or iron deficiency anemia, working with your doctor to find a medication or supplements that will help normalize your levels should help kickstart the hair growth cycle. For other conditions like androgenic alopecia, treatments are not recommended during pregnancy.

Here are specific tips for those dealing with hair loss during pregnancy:

• Address any vitamin, mineral, or hormone imbalances with the help of your provider.
• Supplements such as vitamin B complex, vitamin C, vitamin E, biotin, and zinc can be helpful. In addition, supplements specifically made for pregnancy and postpartum hair loss may be worth considering.
• Avoid hair styles that can pull and stress the hair, like tight buns or ponytails, cornrows, hair weaves, braids and tight hair rollers.
• Eat the recommended daily intake of fruits and vegetables, which contain flavonoids and antioxidants that can provide protection for the hair follicles and encourage hair growth.
• Incorporate shampoos and conditioners that contain biotin and silica.
• Hair is at its most fragile when it’s wet, so be gentle and avoid fine tooth combs when detangling.
• If you need to use blow dryers or other heated hair tools, use the cool setting.
• After giving birth, try a biotin supplement to support hair growth.
• Don't forget to include prenatal gummies with iron in your supplement regimen. These gummies can provide the necessary iron intake during pregnancy.

The Takeaway

Hair loss is a normal part of pregnancy for many pregnant people, especially during the postpartum period. It will usually resolve with time and patience, usually between six to 12 months after delivery, and is rarely permanent. In cases where there is an underlying condition, a doctor can help you find and treat the cause. If you feel your hair loss is excessive or you’ve noticed it has been accompanied by other persistent or worrisome symptoms, talk to your provider to get it figured out.

Sources:

1. Pregnancy and Hair Loss. American Pregnancy Association. Published April 27, 2018. https://americanpregnancy.org/healthy-pregnancy/pregnancy-health-wellness/hair-loss-during-pregnancy/
2. Mayo Clinic. Prevent iron deficiency anemia during pregnancy. mayoclinic.org. Published 2017. https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/anemia-during-pregnancy/art-20114455
3. Hair loss: Diagnosis and treatment. www.aad.org. Published December 13, 2022. https://www.aad.org/public/diseases/hair-loss/treatment/diagnosis-treat
4. Barbour L. Thyroid Disease & Pregnancy | NIDDK. National Institute of Diabetes and Digestive and Kidney Diseases. Published April 29, 2019. https://www.niddk.nih.gov/health-information/endocrine-diseases/pregnancy-thyroid-disease
5. Adil A, Godwin M. The effectiveness of treatments for androgenetic alopecia: A systematic review and meta-analysis. Journal of the American Academy of Dermatology. 2017;77(1):136-141.e5. doi:https://doi.org/10.1016/j.jaad.2017.02.054
6. Ludmann, MS P. Alopecia areata: Overview. www.aad.org. Published August 30, 2023. https://www.aad.org/public/diseases/hair-loss/types/alopecia