Exactly How These Common Health Conditions Affect Your Hair

Photo: Meg O'Donnell
Our bodies have their own unique ways of telling us when something isn’t right, and hair is one of their many methods of communication. While split ends are simply a way of telling you to be kinder to your strands, and a few rogue chin hairs are no cause for concern, other signs might indicate that something more serious is happening with your health.
There are myriad conditions that can impact your hair, resulting in too much or too little. Alopecia, hormone imbalances, side-effects from medications, and even poor nutrition or mental health, can all either inhibit or stimulate hair growth. “As hair is non-essential tissue, it is incredibly sensitive to general health and is often the first part of us to display symptoms from metabolic, dietary or hormonal upsets,” says Anabel Kingsley, trichologist at Philip Kingsley.
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Hormones are a major ruling factor for hair growth and even the slightest imbalance in your endocrine system can lead to hirsutism, the growth of excessive male-pattern hair in women. “Excess hair growth affects around 10-15% of women in most populations,” says consultant dermatologist Dr. Kapil Bhargava, and although the most common forms of excess body hair are due to genetics, “polycystic ovary syndrome (PCOS) is the most common cause of hirsutism.”

My husband actually showed me how to safely shave my chin and it's hilarious because we sometimes stand in the tub shaving together.

As a hormone disorder that affects how your ovaries function, PCOS manifests as a series of ovarian cysts, irregular periods, weight gain, and higher levels of male hormones called androgens (these include testosterone), which cause excessive, often coarse and dark hair growth, typically on the face, chest, and back.
Jess was officially diagnosed with PCOS at 29 but had to start shaving as young as nine years old; she tells Refinery29 that one of her biggest fears was that she’d never get married. “My thought was, 'I'm hairy and therefore ugly.' I'd wax or shave or do whatever I could to hide that I was hairy, but my husband and I lived together very early on so it became more difficult to hide what I was doing. It was mainly my facial hair that made my life miserable — the rest I could deal with — but having hairs on my chin and cheeks was too much!”
After years of waxing, shaving, and laser hair removal, Jess says she stopped allowing PCOS to affect her body image as well as her relationship. “My husband actually showed me how to safely shave my chin, and it's hilarious because we sometimes stand in the tub shaving, and then I realize how awfully lucky I am to have found him.”
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Although it’s the most common, PCOS isn’t the only condition that can lead to excess body and facial hair. Hormonal changes are a massive trigger of facial hair, which means pregnant or menopausal women are more likely to experience growth, but Dr. Bhargava tells Refinery29 that hirsutism is also often a side-effect of medications such as danazol, used for endometriosis, or fluoxetine, the antidepressant sold as Prozac. “Obesity can also result in increased androgen production, [and] anorexia, or other disorders resulting in malnutrition, can cause generalized excess hair growth over the whole body.”
Dr. Bhargava explains that there are a number of rare endocrine disorders resulting in hormone excesses that contribute to hirsutism, including Cushing's syndrome, a condition caused by high levels of the hormone cortisol. Although it’s very rare, affecting only 1 in 50,000 people, according to NHS figures women are three times more likely to develop the syndrome than men.
At the opposite end of the spectrum from disorders like PCOS or Cushing’s are conditions that cause hair to fall out, rather than grow. “Female hair loss and reduced hair volume are much more common than people assume,” says Kingsley. “In fact, research shows that 1 in 3 women will experience some type of hair loss.” Any woman with long hair will find herself regularly unclogging the shower drain or vacuuming up Cousin It lookalikes from behind the sofa, but while a little bit of shedding is a normal part of your hair’s growth cycle, too much hair loss is when things start to get a bit, well, hairy.
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The fact that I’m running away from it means I’m running away from myself. If I want to have a solid relationship with myself I have to also build a relationship with the parts of myself that I don’t necessarily like.

There are so many potential triggers for hair loss that pinpointing the exact reason why yours is falling out becomes tricky, but Kingsley explains that most hair loss is reactive, triggered by an internal imbalance. “The most common causes are vitamin and mineral deficiencies. Crash dieting, lack of dietary protein, a period of being unwell, stress, pregnancy and thyroid imbalances can also be triggers,” she says.
“The oral contraceptive pill can both help or hinder hair loss,” says Dr. Bhargava, and it’s often prescribed as treatment for PCOS. However, he’s cautious in pointing out that although “hair-friendly” oral contraceptives are a recognized treatment for both female-pattern hair loss and hirsutism, “contraceptive pills where progesterone mimics male androgens can worsen female-pattern hair loss and will be ineffective for treating hirsutism.”
“It’s as if their bodies have a mind of their own,” explains Dr. Vivian Diller, a psychologist specializing in body image. “Alopecia and hirsutism are very upsetting experiences to most women, but if they understand why they feel that way, that alone can help them manage their reaction. It's a fear of being out of control.” Two-thirds of the 1,000 women surveyed for We Can Face It, a 2010 campaign to support women with unwanted facial hair, felt “unfeminine” and 30% suffered from clinical depression. Research also shows how hair loss can have a real, damaging psychological impact, and although we tend to think of baldness as something that only affects men with age, women are significantly more likely to suffer emotionally as a result.
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“I have a massive patch on the front of my head that is completely bald,” says award-winning blogger the Slumflower, who has traction alopecia caused by chemical relaxers and hair extensions. “In the Black community, there’s a lot of shame attached to baldness. We have phrases like ‘edges on fleek’, ‘baby hairs poppin’ but because of my traction alopecia, baby hairs don’t even exist on the side of my head, so it’s quite excluding and contributes to stigma attached to baldness,” she tells Refinery29.
“I decided that I was just tired of trying to hide something that isn’t going to go away. The fact that I’m running away from it means I’m running away from myself. If I want to have a solid relationship with myself, I have to also build a relationship with the parts of myself that I don’t necessarily like.”
Considering how many health conditions affect not only the appearance but sheer existence of hair, surely it's time to shake off the taboos surrounding baldness and hirsutism. “The emphasis on our physical appearances exists because we’ve been taught to attach our value to our appearance, so we hyper-critizise our bodies,” says the Slumflower, “but we also have a soul and energy, as well.” Dr. Diller agrees, saying that self-esteem shouldn’t rely exclusively on our appearance: “Feeling confident in who you are goes a long way in portraying real beauty.”
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