Thinning where you least want it

Is the hair on your head as thick as it once was? Mine isn't. Where I never saw my scalp, now I know it's there.

As many as two-thirds of women experience hair loss at some point, often more pronounced as the years pass. I'm not referring to hair texture (though the diameter of each individual shaft also diminishes as we get older), but to the amount of hair on your head.

Contributing factors include hormonal changes (typically at menopause), stress, illness (including treatment such as chemotherapy) and heredity. Look to your mother, aunts and grandmothers to see what you might expect. Hair care (especially styling with heat) can damage hair by breaking it off, but does not decrease the amount of hair on your head.


What are our choices?


Drug therapies: iffy to spurious

The role of estrogen in hair growth, at least in humans, is not clear. Both oral and topical estrogens are prescribed by physicians to treat hair loss in women, although there are no controlled studies to support this use of estrogen.

The only drug approved for promoting hair growth in women is the same one men use, Minoxodil. The internet is full of hair-growth products; be as leery of these as of fat-burning pills.

See your hairdresser first

Unlike guys, we can't shave it off and look studly. Ask for a style that makes the most of your hair's density. A talented hairdresser can assess the areas of loss, as well as your face, style and preferences.

There's no one magic style, but if you have wavy or curly hair, a cut short enough to make the hair stand up from the roots will camouflage loss.

Options depend on the pattern and extent of thinning. A bob is effective unless you're thinning on top, or have superfine hair that is also thin.

Asymmetrical styles 'stack' the hair to the thickest side, so that the thinner side looks like part of a deliberate style. Choppy, shorter layers can add volume and lift around thinning areas.

A technique you learned in your teens, teasing, could re-enter your life. Backcombing adds thickness and volume, and may only be needed on sections of hair.

Stylists recommend volumizing shampoos, conditioners, mousses and gels, to make the most of the hair you do have. Thickening shampoos and conditioners plump up each individual hair strand to add overall volume and lift. (If you are red by way of colour, check with the stylist, as some volumizing shampoos open the cuticle, which causes red colour to become even more fragile than it already is.)

Avoid waxes and muds, which weigh the hair down.

The site Hair Loss Expert explains how hair colour helps thinning hair by creating an impression of fullness:

"Hair dyes thicken hair by depositing colour in the strand, which plumps the shaft. This boost in strand size helps produce thicker- looking hair that offers more complete scalp coverage.

Hair colour can also be used to give the illusion of fuller, thicker hair. Darker colours produce an illusion of having more hair, and lighter colours that better match the skin colour of the scalp help blend thinning areas in with existing hair.

Well-placed highlights produce the illusion of fullness. Having the tips of your hair highlighted will make the root colour stand out more, thus tricking the eye into seeing more depth and volume."


A little help from friends

Many stylists suggest hairpieces, especially for up-dos. If the loss is significant, an integration hairpiece can help; its honeycomb base lets you pull your own hair through to blend with the hairpiece. The best are custom made and fitted. For more about what these look like, see this detailed explanation on Hair Direct's site.

Invisible hairline or lace-front wigs or hairpieces are an innovation in the industry, and are used for both full wigs and hairpieces. According to some vendors, this type of wig or hairpiece keeps celebs like Tyra Banks and Beyonce tossing those voluminous manes. But they're not perfect, as the glue that holds the lace to the face can crack or buckle. For some revealing shots of lace gone wrong, see Hair Conspiracy Extensions' site.

Companies like Head Covers by Joni sell an update on the "fall" I wore in university days, a "headband hairpiece" that adds fullness and length. They offer hairpieces in unusual shapes, like the Perfect Blend, a halo-type piece worn on the crown, the area most prone to thinning.

Here's a before-and-after from the site, showing the Perfect Blend worn.


Weaves

Initially considered the best thing for women since the underwire bra, weaves are a slippery slope. Not all look like Oscar night 'dos; this shot shows a conservative style augmented by with subtle extensions.

I've never had one, so rely on the opinion of my friend Cathy, who calls them "the crack of the salon". Her bonded weave, applied for about $450, took nearly a full day in the chair, and the results were dramatic– the extensions were far lusher and more lustrous than her own hair. For awhile, everyone at the office was saving for weaves.

But it had to be redone every several months, and the weight of the glued-in extensions pulled on Cathy's remaining hair. She eventually decided to forgo extensions and crop it short, because repeated weaves had damaged what hair she had. Her pixie cut looks marvelous, but it's a style she never considered before her hair loss.

What to do? Boomers try to retain all the glossy markers of youth while they age, and I doubt succeeding generations will be any different. A full head of hair symbolizes health and desirability.

I'm betting that treatments, products and fill-ins will only rise in popularity, and "Does she or doesn't she?" will mean more than just colour.