Postpartum Hair Loss: Why It Happens and When It Stops

Baby is three months old. The brush is full every morning, so is the shower drain, and your hair seems to have thinned at the temples. This postpartum hair loss worries many new mothers, even though it is common, temporary and harmless. It even has a medical name: telogen effluvium.

Understanding where it comes from makes it easier to wait it out. Here is how long it lasts, the things that really help, what henna and oils are worth, and the rare cases where it hides something else.

Why do you lose hair after giving birth?

Because pregnancy had been holding it in place. Each hair grows, rests, then falls out to make room for a new one. Normally we lose 50 to 100 a day, according to the American Academy of Dermatology (AAD). During pregnancy, hormones slow this shedding, explains Naître et grandir: hairs that should have fallen stay on the head.

After birth, oestrogen levels drop. Many hairs then enter their resting phase at the same time, and fall a few months later. The AAD speaks of excess shedding rather than true loss: every hair that falls is replaced by a new one. DermNet, the New Zealand dermatology site, lists childbirth among the triggers of telogen effluvium, along with fever, surgery, intense stress or major weight loss.

When does shedding start, and when does it stop?

Landmarks vary a little from one source to another, but they draw the same timeline:

Meanwhile, new hairs keep growing, DermNet points out. And the AAD sees nothing to treat: the shedding stops by itself.

Breastfeeding, stress, dieting: what can make it worse?

Breastfeeding is not among the causes listed by our sources: nothing justifies stopping to save your hair. Other factors, on the other hand, are known triggers of telogen effluvium and can add to the birth, according to the AAD and DermNet:

• major or rapid weight loss, or a nutritional deficiency;
• a high fever, for instance with mastitis;
• an operation, such as a caesarean;
• intense stress, and the AAD notes that shedding can last much longer if the stress persists.

All good reasons not to start a strict diet in the first months, as our article on your belly and weight after birth explains, and to eat a varied diet: our guidelines on eating well while breastfeeding apply to your hair too. And if tiredness and pressure become too heavy, our article on the mental load of new mothers suggests ways to catch your breath.

What actually helps

No treatment is essential: the AAD reminds us you need do nothing for the shedding to stop. Dermatologists mostly offer tricks to make hair look fuller while you wait:

1. A volumising shampoo, often enriched with protein, rather than a treatment shampoo or a 2-in-1, which weigh hair down.
2. A conditioner for fine hair, applied mostly to the ends, avoiding "intensive" treatments.
3. A new cut: some give more volume, and many new mothers go for short hair, which looks thicker and saves time in the morning.
4. No chemical treatments or heavy styling during this period: relaxing, perms or bleaching can make shedding worse, warns the AAD.

Henna, oils, supplements: what is proven, and what is not

Oils. Argan, castor, olive, nigella: every family has its recipe. None of the medical sources we read credits them with any effect on postpartum shedding, which stops by itself anyway. If a scalp massage does you good, keep it as a moment of relaxation, without expecting miracles.

Natural henna. It colours hair and has been part of our beauty rituals for generations. None of our sources shows that it slows this shedding. The real issue is what gets added to it:

• so-called "black" henna often contains paraphenylenediamine (PPD), the takaout roumia, mixed in to darken the colour or make it last. The Moroccan site pharmacie.ma reminded readers in 2017 that it can provoke sharp skin reactions, that sensitisation can extend to hair dyes, and that the Anti-Poison Centre regularly receives such cases;
• swallowed, PPD is a poison. Between 1980 and 2010, Morocco's Anti-Poison Centre recorded 1,074 poisonings by cosmetic products, with PPD the leading culprit, reported Aujourd'hui le Maroc. Keep it out of children's reach, or better, do not buy it.

Supplements. None of our sources recommends a vitamin to stop this shedding. An iron deficiency can be treated, but only after a blood test: that is the subject of the next section.

Thyroid, low iron: when shedding hides something else

Most of the time, postpartum shedding is the only thing going on. Two situations that are common after a birth are still worth knowing about.

Iron deficiency. Pregnancy is one of the very common causes of iron-deficiency anaemia, notes the UK's NHS. Its main signs are tiredness, shortness of breath, palpitations, paler skin and headaches; hair loss is among the less common signs. Diagnosis relies on a blood test, and treatment follows your doctor's instructions.

Postpartum thyroiditis. This inflammation of the thyroid affects about 5 to 10% of women in the United States, according to the American Thyroid Association (ATA). It often unfolds in two phases:

• between 1 and 4 months after birth, a phase when the thyroid releases too many hormones: anxiety, insomnia, a racing heart, tiredness, weight loss, irritability, all signs easily blamed on the newborn;
• between 4 and 8 months, a phase when it no longer makes enough: tiredness, weight gain, constipation, dry skin, low mood.

Most women regain a normal thyroid 12 to 18 months after symptoms begin, but about 20% of those who go through the second phase keep an underactive thyroid, the ATA specifies. Your doctor will tell you which tests to have. And if it is mostly your mood that is sinking, read our article on baby blues and depression after birth: lasting tiredness and sadness can be treated too. The rest of physical recovery is described in our article on the first six weeks after baby.