Hair loss during pregnancy or after delivery

Why hair loss happens in pregnancy and after birth

• Most women who notice shedding in late pregnancy or after delivery have telogen effluvium – a temporary shift of many hairs into the shedding phase, usually triggered by hormonal change, childbirth, surgery, major illness, or psychological stress.​

• Other contributors include iron deficiency from pregnancy or blood loss at delivery, poor sleep and nutrition, thyroid dysfunction, and certain medications.​

Non‑pharmaceutical measures to suggest

• Reassurance and time: Telogen effluvium is usually self‑limited; shedding often peaks around 3–4 months postpartum and improves by 9–12 months as follicles recover.​

• Gentle hair care: Advise avoiding tight hairstyles, harsh chemical treatments, and frequent heat styling; use wide‑tooth combs and pat hair dry instead of vigorous rubbing.​

• Stress, sleep, and nutrition: Encourage regular meals with protein, vegetables, whole grains, and stress‑reduction strategies (short walks, breathing exercises); chronic stress can worsen shedding.​

Supplements with some evidence (and how to frame them)

1. Iron or zinc deficiency

   • Low ferritin is associated with diffuse hair shedding and female pattern hair loss; several studies suggest aiming for serum ferritin at least 40–60 ng/mL for optimal hair growth, higher than the threshold used just to rule out anaemia.​

   • Suggest: check blood for full blood count, ferritin and zinc levels. If serum ferritin is below 40–60 ng/mL, an oral iron supplement or intravenous iron infusion can be considered, and re‑check ferritin levels after a few months. If serum zinc ​is less than 70 mcg/dL, consider oral zinc replacement.

2. General multivitamin / postnatal supplement

   • Many women with hair shedding have borderline or low levels of micronutrients such as vitamin D, magnesium, selenium and copper; a balanced multivitamin can correct mild insufficiencies, although direct RCT evidence for hair growth in otherwise well adults is limited.​

   • Use a standard prenatal/postnatal multivitamin, rather than high‑dose single nutrients, unless a deficiency is proven.

3. Biotin: use with caution

   • Biotin is heavily marketed for hair, but evidence in healthy individuals is weak; a systematic review of case reports found improvement mainly in patients with clear, documented biotin deficiency or enzyme disorders, not in the general population.​

   • For most postpartum women, routine high‑dose biotin is not recommended.

Shampoo options to discuss

• There is no shampoo proven to stop telogen effluvium, but gentle formulations can reduce breakage and scalp irritation.​

• Look for products that are sulfate‑free, paraben‑free, and silicone‑light, with added moisturising or volumising ingredients (e.g. botanical oils, mild surfactants such as coco‑glucoside).​

• You can suggest patients choose a gentle “postpartum” or “sensitive scalp” shampoo, and reassure them that the key driver of recovery is follicle cycling and correcting iron or other deficiencies, not the brand of shampoo.​

• Minoxidil foam is quite effective and can be used in breastfeeding mothers as long as the baby is not premature. Small amount can be absorbed through the scalp but is unlikely to cause issues in the full term baby even if the baby is being breastfed. Let us know if you are keen for this treatment.