Lady Gaga and Ariana Grande have both spoken publicly about the state of their hair—repeated bleaching, daily styling, and the constant wearing of extensions or wigs. Their accounts have broken the silence on a long-taboo subject, but they describe damaged hair fibers, not hormonal hair loss. This distinction makes all the difference, because it determines what needs to be done.
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Damaged hair or androgenetic alopecia: two different things
Hair weakened by chemicals and heat breaks along its length: the fiber breaks, but the follicle remains intact and continues to produce normal hair. Androgenetic alopecia, on the other hand, affects the follicle itself, which miniaturizes and produces increasingly thin fibers.
- Mechanical or chemical breakage: clean break along its length, follicle intact
- Androgenetic alopecia: progressive thinning, balding area, miniaturized follicle
- The two can coexist, and often do.
What I take away from these accounts is the relief they bring to my patients. Speaking publicly about one's hair, as a woman, remains difficult. However, I would never make a diagnosis on someone I haven't examined—and that's exactly what I ask my patients not to do with themselves either.
What is androgenetic alopecia?
This type of hair loss is hormonal and genetic in origin, linked to the sensitivity of hair follicles to DHT, produced from testosterone by the 5-alpha-reductase enzyme. This hormone binds to receptors in the follicle, shortens the growth phase, and triggers miniaturization: the hair grows back thinner and shorter, then stops growing altogether. It is the leading cause of chronic hair loss in adults, and it affects women as much as men—in women, it widens the part rather than receding at the temples.
Signs that point to a hormonal drop
You may be affected if you observe several of these signs:
- A central line that gradually widens over several years
- Hair that is noticeably thinner than it was two or three years ago
- A decreasing density without any noticeable bald patches or broken hairs.
- A family history of the same type
- A fall that never completely stops, unlike a reactive fall
If, on the other hand, your hair breaks at the ends, and you regularly bleach or heat it, the issue is not hormonal: it is mechanical.
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Discover the solutionWhat to do about androgenetic alopecia?
It doesn't stop on its own, and that's what distinguishes it from all other types of hair loss. Acting early is therefore more important than anything: it's much easier to protect a miniaturized follicle than to revive one that has died.
Treatment relies on four mechanisms , and an approach that only addresses one of them quickly reaches its limit: decongesting the scalp, washing at pH 5 to avoid perpetuating inflammation, applying a topical active ingredient to the follicle, and acting from within on the conversion to DHT. All of this must be done for at least three months, the duration of a hair growth cycle.
Before starting anything, make a diagnosis: reactive hair loss, breakage and hormonal alopecia are not treated in the same way.
Hormonal Anti-Hair Loss Protocol
Specifically acts on hormonal hair loss
To remember
- Breakage affects the length, alopecia affects the follicle
- Androgenetic alopecia is the leading cause of chronic hair loss in women
- It never stops on its own: acting early changes the prognosis
- A diagnosis always precedes a protocol
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