A woman’s hair is a mark of her femininity. To most women good hair is a reflection of beauty and high self-esteem. When a woman starts noticing hair loss, the panic mode goes into over drive. 

However, experts say that losing hair should not cause panic because hair sometimes ‘falls off’ when blow dried, combed or washed. However, when bald patches appear, it is a sign of a more serious medical condition.

"As a child, it didn’t bother me that I had thin hair until I joined college. I started feeling low about myself. So I began wearing weaves. Later, I noticed bald patches and my hair stylist told me that I was losing hair rapidly. At my age, I’m not sure I understand why I’m losing hair,” says 30-year-old Sheila Komukama, a worker at a fast food restaurant in Kigali.

28-year-old Aidah Kayitesi suffered a terrible skin disease as a child. She developed coarse wounds on the head which later turned into three bald patches.

"I was around seven years old when a rare skin disease affected my scalp; it was so painful and I had to get extensive treatment for it to heal,” Kayitesi recalls.

The wounds healed but they left big bald patches on her head that not only made it impossible to maintain hair, and to this day, she makes it a point to wear wigs to maintain a feminine feel.

Partial or even thorough absence of hair, also known as alopecia, is an ordeal that is hard to grasp, especially for a woman. 

According to Medline Plus, female pattern baldness is the most common type of hair loss in women.

Each strand of hair sits in a tiny hole in the skin called a follicle; baldness in general occurs when the hair follicle shrinks over time eventually not growing new hair. The reason for female baldness is not well understood, but it is mostly related to changes in the levels of androgens (a male sex hormone such as testosterone), family history of male or female pattern baldness among other factors.

Dr Rachna Pande, a specialist in internal medicine at Ruhengeri Hospital, says that the causes for women’s baldness are similar to those of men.

She points out that a reduced estrogen level, which mostly comes with menopause, can cause the condition. 

"Increase in testosterone or androgen levels can cause baldness too, and this can occur due to stress, or hormonal disorders,” Dr Pande says.

Adverse effect of corticoid therapy, anti-cancer drugs, infections of the scalp like fungal infections, dandruff, lice infestation, can also cause excess hair fall and baldness.

"Hair colours, shampoos with harsh chemicals can also contribute to baldness. Chronic protein malnutrition can also contribute to it,” Dr Pande adds.

She, however, points out that baldness may happen without an apparent cause, for instance in cases of alopecia areata.

Alopecia areata is a type of hair loss that occurs when the immune system erroneously attacks hair follicles, this damage is usually not permanent.

Dr Pande says that baldness is depressing for a woman because good scalp hair is associated with femininity and beauty. 

"Such a condition may make a woman avoid socialising because it lowers her self-esteem or leads to severe depression,” Pande says.

It is important to remain stress free, take diets with adequate proteins and vitamin B complex. Keep hair clean and do oil massage of scalp regularly to prevent dryness, she advises.

Dr Pande advises women to avoid shampoos with strong chemicals and hair colour if one is suffering from any infection that should be treated. 

Most people normally shed 50 to 100 hairs a day; this usually doesn’t cause an obvious thinning of the hair because new hair is growing at the same time.

However, typical hair loss occurs when this cycle of hair growth and shedding is disrupted, or when the hair follicle is destroyed and replaced with scar tissue, according to research on the Mayo Clinic website.

Justine Tushabe, a beautician in Rwamagana, says that it is common for women’s hair to thin due to poor quality hair products and also being attended to by a less experienced hairdresser.

Annet Kasoma had gone for her usual treatment at the salon when a mortifying thing happened. "A full patch of hair fell off when I came out of the dryer and on facing the mirror I noticed a round bald spot. I remember holding back tears,” Kasoma says.

Kasoma says that her fate came about because of the hairdresser who used certain chemicals. She had to cut all her hair off for it to grow at once.

"I now keep my hair short because when it becomes long, the patch is visible; I also wear wigs on rare occasions,” Kasoma says.

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