Pink Prescriptions - March 2026

March 2026 Issue — Pink Prescriptions
Not Just a Bad Hair Day: Understanding Hair Loss in Women

A woman’s hair is often closely tied to her identity, femininity, culture, and self-expression, which can make hair loss a distressing experience. Unlike male balding, which is widely visible and socially normalized, thinning hair in women is frequently hidden, minimized, or endured in silence. Women experiencing hair loss may notice subtle changes at first—widening parts, increased shedding in the shower, or a thinner ponytail—before confronting the emotional weight of what these changes represent. The most common cause, female pattern hair loss, typically develops gradually, often eroding confidence over time rather than presenting as a sudden dramatic event. For some, hair thinning accompanies hormonal transitions such as menopause or conditions like polycystic ovary syndrome, adding another layer of emotional and physical complexity.

With growing hair loss diagnoses, women frequently report anxiety, social withdrawal, altered self-image, and even strain on intimate relationships. Many spend years experimenting with hairstyles, supplements, or cosmetic camouflage before seeking medical advice. Because understanding hair loss requires not only clinical knowledge, but also sensitivity to the profound personal impact it can have, it is important to address this issue head-on. This is why we went straight to the medical professionals who can help us understand and take action.

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By Dr. Eve Ashby
Beaufort Memorial Lowcountry Medical Group

How do I know if my hair is just shedding or truly thinning? How can I tell the difference?

Hair loss is very common in women, with nearly as many women as men experiencing hair thinning or hair loss during their lifetime, most often after turning 40. Daily hair shedding is normal; most women lose about 60 to 100 hairs per day. However, consistently losing more hair throughout the day can signal hair thinning rather than normal shedding. You may also notice visible changes to your hair or scalp, such as a widening part, thinning around the temples or crown, bald spots or more scalp showing than usual when you pull your hair back. Hair thinning beyond normal shedding may sometimes be accompanied by scalp tenderness, itching or burning. If you’re concerned, talk with your women’s healthcare provider to help identify the cause and next steps.

What are some options for me if my
hormones are causing hair loss?

If hair loss is related to a hormonal imbalance, addressing the underlying issue may help slow or improve hair thinning. For some women, particularly those experiencing menopause-related symptoms, hormone therapy may be considered as part of their overall treatment plan. There are also over-the-counter topical options such as minoxidil and oral prescription options to help hair loss, as well as increase hair growth, if indicated. 

Strategies to help with hair thinning/loss include a healthy diet, including protein sources, supplements specifically made to strengthen hair, and using hair products without harsh chemicals. This all takes time. You may see new growth in one to three months and thickening within one year if the underlying problem is corrected.

The bottom line: If you’re concerned about thinning hair or hair loss, speak with your women’s healthcare provider, primary care provider or dermatologist to discuss possible causes and appropriate treatment options.

Eve A. Ashby, DO, FACOOG, is a board-certified gynecologist with Beaufort Memorial Lowcountry Medical Group in Beaufort and Okatie. Dr. Ashby is also an Assistant Professor and Regional Director of Medical Education for A.T. Still University School of Osteopathic Medicine.

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By Alexis Riccione, FNP
Novant Health Okatie Primary Care

Why is my hair falling out?

Here are the most common reasons hair
will start to shed or thin:
Genetics/Hereditary: This tends to be the most common cause particularly in men (known as male pattern baldness), though there are conditions of female pattern baldness (androgenic alopecia) which causes hair to thin and break over time.

Hormonal Changes: Hormonal shifts that occur during pregnancy, childbirth, menopause, or thyroid changes can cause temporary or even permanent thinning of hair, particularly along the crown.

Aging: As we age, hair growth typically slows and hair
becomes thinner.

Stress: High levels of physical and/or emotional stress can cause hair follicles to go into a more dormant phase, which can cause an increase in hair shedding.

Weight Loss/Nutritional Deficiencies: People who experience rapid weight loss and those who have very restrictive diets can lack vital nutrients, such as iron, protein, zinc, vitamin D, and an array of B vitamins, which can impair hair growth.

Styling and Hair Care: Excessive heat, chemical processing, or even tight hair styles can cause damage to the hair due to traction of the hair follicle—these factors can lead to alopecia.

Medical conditions, such as fungal infections, diabetes, and autoimmune diseases, and medications to treat cancer, heart problems, or arthritis may sometimes lead to hair thinning.

Prevention
If hair loss is related to genetics, there is not much that can be done in the way of prevention, however there are several things that can be done to prevent hair loss related to other factors.

Being gentle with your hair, avoiding significant tugging or pulling, using a wide tooth comb, using a detangler, reducing the use of hot rollers, curling irons, hot oil treatments or chemicals on the hair can help reduce hair thinning.
Ensuring you are taking appropriate supplements, such as biotin, B vitamins, zinc, iron, increasing protein intake, and protecting hair from UV rays can all be beneficial in helping improve the health of your scalp and hair.

Treatment Options
There are several types of topical and oral medications, such as minoxidil, that can help boost blood flow to the follicles which in turn can improve hair growth. Finasteride is an oral prescription for men that blocks hormones like testosterone, which are related to hair loss. Spironolactone is a medication often used for female pattern hair loss to reduce testosterone effects on the hair follicles. If you are believed to have a fungal infection on the scalp, ketoconazole shampoo would be recommended.

There are several clinical procedures that can help with hair restoration as well. PRP injections utilize your own blood platelets that are injected into the scalp to help stimulate hair growth. Low-level laser therapy utilizes red light therapy to increase hair density and stimulate hair growth. Microneedling can help improve blood flow and stimulate collagen to support the hair follicles. Hair transplants are also an option.

Alexis Riccione is a Nurse Practitioner specializing in family medicine with Novant Health Okatie Primary Care. Alexis believes in a collaborative approach to healthcare and works individually with each patient to understand their unique needs. Alexis Riccione is accepting new patients­—call (843) 705-9145 to schedule an appointment.

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By Dr. Tracy Blusewicz
 | Advanced Women’s Care
of the Lowcountry & Aspire Medical Spa

There are so many people touting supplements.
What treatments actually work?
And how do medications affect hair thinning/loss?

Hair loss is one of the most common complaints women have throughout their lives. This frustrating loss can have one instigating factor or may be due to a whole multitude of reasons that add up to one “root” cause. Hair loss often occurs during specific phases of life that women experience. Menopause, peri menopause, and post pregnancy are common times for hair loss or thinning due to significant hormonal changes. New medicines, changes in diet, changes in weight, and medical treatments can also cause the unwelcome clumps of hair noticed in the shower. Life stressors like divorce, deaths in the family, and job challenges can cause hair loss. Even happy stressors like planning a wedding, graduation, or moving to a new house can result in hair loss.

Hair loss often happens in two common patterns:

Increased shedding (telogen effluvium): a “shock” to the hair cycle that causes more hairs to shed at once. This is usually limited to a 90-day cycle of shedding that will resolve spontaneously with the proper support.

Gradual thinning: medications (or the condition they’re treating) may unmask or worsen hormonally influenced, genetic thinning over time.

The factors that contribute to hair thinning or increased shedding is often temporary and reversible once the trigger is addressed. Many people notice changes and improvements in six to 12 weeks, but often women do not want to wait the loss out. Unfortunately, hair loss is rarely solved with one quick magic fix, which no one wants to hear because we all want the loss to stop immediately once it is noticed. The best results for stopping hair loss and helping healthy hair growth usually come from a multifunctional, multi-modality approach involving a three-tiered treatment plan.

Treat from within: Nutrition matters. Believe it not, your gut’s microbiome directly affects your hair! Hair follicles are highly active and sensitive to poor nutrition, low iron, low vitamin D, inadequate protein, physiological stress, and inflammation. Foundational, well-studied supports include adequate protein, iron (only if low), vitamin D, zinc, collagen, magnesium, and omega-3s. DHT blocking agents like Nutrafol™ DHT inhibitor or the prescription medicine spironolactone can be used to decrease hair loss on the head, while also decreasing hair growth on places where it is unwanted like the chin, face, and body.

Treat the scalp: A healthy scalp is the “soil” for hair growth with a goal of a clean, calm, and pH balanced “fertilized” scalp. Supporting a good scalp microbiome and reducing irritation or buildup helps follicles function optimally. Scalp treatments include serums composed of plant-based or human exosomes, tretinoin, dutasteride, minoxidil or a combination of them all. For more severe cases of hair loss, red light therapy, laser caps, PRP/PRF/exosome injections, or microneedling with or without RF can be of use.

Treat the hair shaft: Remaining hair may be damaged by the same “root” causes of hair loss, resulting in flat, dull, and thin hair. Even when hair growth improves, fragile strands can still look thin and break easily. Gentle care when styling, using hair moisturizers and volume-improving shampoos and conditioners, and minimizing heat/chemical stress will help achieve shinier, fuller, and healthier appearing hair.

Nutrafol™ is a brand, backed by years of studies, which includes oral supplements that can be a helpful “inside-out” option for many women because it combines multiple ingredients aimed at some of the common drivers of thinning and loss (like stress signaling, inflammation, and nutritional support) in one routine. The Nutrafol line also includes supplements, serums, shampoos, and conditioners for support.

There are autoimmune disorders like Alopecia Areata and genetic predispositions to hair loss that are more difficult to manage and may result in permanent hair loss, which require a more clinically organized response. So, if shedding lasts more than three months, and involves large patches of hair loss with a widening part or receding hair line, then it’s time to check in with a hair loss specialist clinician.

But for most typical hair shedding reasons, including recently changed medications, illness/surgery, long COVID, postpartum shifts, menopause, or rapid weight loss, work with the above suggestions and create a personalized plan with your provider.

Tracy Blusewicz, MD, FACOG, DABOM (Diplomate American Board of Obesity Medicine) is double Board Certified and a Fellow of The American Congress of Obstetricians and Gynecologists. A GYN specialist, Dr. Blusewicz also specializes in Obesity medicine, is a global speaker and actively trains fellow doctors and practitioners both nationally and internationally. In addition, she is an official trainer of both the P-Shot (for men) and O-Shot® (for women) at her Bluffton office. She can be contacted at Advanced Women’s Care of the Lowcountry, 843-341-9700; www.awclc.com