What’s causing woman’s hair to fall out? How to stop it?

Dear Dr. Roach: What is causing my hair to fall out? What can I do to stop it? I’m 72 years old and female. Could I be hypothyroid? — L.O.I.

Dear L.O.I.: By far, the most common cause of hair loss in women in their 70s is female pattern hair loss. This pattern of hair loss can be highly characteristic, typically affecting the scalp above the forehead and on the crown of the head.

Hair loss resulting from hypothyroid is most commonly seen as circular patches of complete hair loss, but being hypothyroid may also predispose to other types of hair loss.

Not everybody’s hair loss presents the way the textbooks say it should. A careful exam and laboratory evaluation can be invaluable in making the diagnosis, which is essential to deciding on the best therapy. A dermatologist is likely to have the most expertise, though many primary care doctors can make the diagnosis.

If it is female pattern hair loss, treatments include topical medications, such as minoxidil, or oral medication, such as spironolactone.

Dear Dr. Roach: Iama 77-year-old woman. I am allergic to mercury, and all products that have it as a preservative. My pharmacist made sure my flu shot was safe for me to get. Can you tell me if the COVID-19 vaccines contain mercury? I am also concerned about the shingles vaccine. — D.K.

Dear D.K.: Thiomersal is a mercury-containing preservative used in some vaccines, such as the multidose flu vaccines. However, there is no thiomersal in either the Pfizer or Moderna COVID-19 vaccines. There is also no thiomersal in the available shingles vaccines.