Cicatricial or Scarring alopecia - hair loss occurs when inflammation damages and scars the hair follicle and replaces it with scar tissue. The inflammation that destroys the follicle is under the skin surface so affected areas of the scalp may show little signs of inflammation. It is not known what triggers or causes this inflammation. If the inflammation destroys the stem cells and sebaceous glands, then hair loss is permanent.

"Firstly, even the very good ones won’t get to the root of the issue - pardon the pun - and prevent or treat male or female pattern baldness which is caused by genetics, nor deal with hormonal issues at the heart of female hair loss. But they can help make the hair you do have stronger and healthier. And they can be useful in putting a hair loss regime in place, along with medication like Minoxidil or Finasteride and/ or a hair transplant.
“Many prescription drugs, often those that affect hormones, can lead to changes in the hair. One frequent culprit is anti-acne medications, specifically those that involve types of retinol (vitamin A),” explains Burg. “There are also reports of some anti-aging creams containing retinols causing hair loss.” It is unclear how these medications interfere with hair growth, but disruption of the hair cycle is a common issue, he adds. Learn about skin-care ingredients you should never mix.

Hair changes about as fast as grass grows, which is to say it’s extraordinarily slow and not visible to anyone checking impatiently in the mirror every day. But during regular follow-up appointments, Harklinikken uses high-tech equipment to photograph and magnify the scalp and count new hairs and active follicles, which motivates users to adhere to the regimen. Too many people give up on treatments like Rogaine and low-level-light devices before they’ve had a chance to work, Dr. Senna said.
One is how much emphasis the company places on compliance, the major stumbling block in the efficacy of any treatment, said Dr. Senna, an author of studies on the subject. Prospective users are questioned about their ability to stick to a regimen because the extract must be applied every day, and they are told that the more conscientious they are, the better. Users are also reminded and encouraged with regular check-ins.
A diet that is poor or lacking in certain nutrients, particularly iron, protein, and vitamin B, which are essential in the production of keratin, can cause a long telogen phase and a very short anagen stage. On the other hand, excess supply of vitamin A in the body, especially those taken through supplements, can prove to be toxic and can cause a range of adverse body effects including loss of appetite, fatigue and consequently, hair loss.
There’s no cure for baldness, but there are ways to hold on to what you've got. The six dermatologists and the clinical studies point to three methods: minoxidil, laser treatments, and prescription finasteride. The key is finding the combination and hair loss regimen that works for you. A doctor is your best bet for that kind of guidance — but we found a few trustworthy products that will work for most people.
Scarring alopecias result in permanent loss of hair. Inflammatory skin conditions  (cellulitis, folliculitis, acne), and other skin disorders (such as some forms of lupus and lichen planus) often result in scars that destroy the ability of the hair to regenerate. Hot combs and hair too tightly woven and pulled can also result in permanent hair loss.

Just as pregnancy hormone changes can cause hair loss, so can switching or going off birth-control pills. This can also cause telogen effluvium, and it may be more likely if you have a family history of hair loss. The change in the hormonal balance that occurs at menopause may also have the same result. “The androgen (male hormone) receptors on the scalp becoming activated,” explains Mark Hammonds, MD, a dermatologist with Scott & White Clinic in Round Rock, Texas. “The hair follicles will miniaturize and then you start to lose more hair.”
To us, that meant any product with zero proven ingredients, case studies, or FDA clearance — which shrunk our list by a whopping 180 contenders. That’s right, there are only three treatments that have actually been cleared by the FDA and supported with clinical studies: finasteride (commonly marketed as Propecia), minoxidil, and laser treatments. And, since finasteride is prescription-only, it left us with two.
However, researchers are still working to determine the best dose needed, whether the results are lasting, and whether they can develop a topical form of the drug, Day said. She added that patients should be aware that Tofacitinib has side effects. It's already associated with an increased risk of serious infections, as well as stomach and intestinal tears, according to Pfizer, the manufacturer.
The other main hair-loss treatment that was recommended by all four dermatologists I interviewed is finasteride, often called by its brand name Propecia. This FDA-approved medication is only available with a prescription, but these days, it’s found as a generic and ordered online after a virtual consultation, through start-ups like Hims, Keeps, and Lemonaid.
Few nutrients are as involved in keeping hair roots and fibers healthy as zinc. Zinc keeps an eye on your oil glands, making sure they’re coating new hair correctly. It also repairs and rejuvenates the protein components in dry and damaged hair and increases hair follicle regrowth. If you want shiny, bouncy hair that’s full of life, don’t skip the zinc.
Some medications can trigger hair loss. Hair loss is a well-known side effect of chemotherapy treatment for cancer. But some common medications may also lead to hair loss, including anticoagulants that thin the blood, high blood pressure medication, gout medication, antidepressants, and birth control pills. By switching to a different medication under your doctor’s guidance, you can usually stop this kind of hair loss. Your lifestyle, especially one characterized by high-stress levels, not getting proper nutrition, and significant weight loss can play a major role in your health and the health of your hair. Although experts don’t know the exact process, there is a clear relationship between high levels of stress and hair loss.
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Although many medications list "hair loss" among their potential side effects, most drugs are not likely to induce hair loss. On the other hand, cancer treatment (for example, chemotherapy or radiation therapy) and immunosuppressive medications commonly produce hair loss. Complete hair loss after chemotherapy usually regrows after six to 12 months.
When you're investing considerable time and money on a mix of hair treatments and cures, the last things you should be doing are those that will only aggravate your condition. Likewise, when your hair has finally grown back, the last thing you would want is for you to go through another horrific episode of hair loss. Preventing further - or another case of hair loss, and stopping it before it actually happens should be your goal.
^ Jump up to: a b Blumeyer, A; Tosti, A; Messenger, A; Reygagne, P; Del Marmol, V; Spuls, PI; Trakatelli, M; Finner, A; Kiesewetter, F; Trüeb, R; Rzany, B; Blume-Peytavi, U; European Dermatology Forum, (EDF) (October 2011). "Evidence-based (S3) guideline for the treatment of androgenetic alopecia in women and in men". Journal of the German Society of Dermatology. 9 Suppl 6: S1–57. doi:10.1111/j.1610-0379.2011.07802.x. PMID 21980982.
One is how much emphasis the company places on compliance, the major stumbling block in the efficacy of any treatment, said Dr. Senna, an author of studies on the subject. Prospective users are questioned about their ability to stick to a regimen because the extract must be applied every day, and they are told that the more conscientious they are, the better. Users are also reminded and encouraged with regular check-ins.
Post surgery care is important if you've undergone a hair transplant or surgery. Expect some swelling of the face and on the scalp a couple of days after the procedure. To fast track hair growth, you may be asked to use Minoxidil or Finasteride. Saline is applied on the grafts for a few days, while you will be prescribed to use a diluted shampoo that is softer and less harsh on the scalp. Hair growth in the transplanted areas becomes visible in three - six months.
But you must start these medical therapies before you lose all your hair. McAndrews likens it to brushing your teeth, in that both are preventative measures. “The sooner you start doing it, the better at slowing down this aging process,” he explains, adding, “Is toothpaste perfect? No, you’re still getting tooth decay with toothpaste, but you’re slowing down tooth decay.”
You can also get a hair-loss kit from Hims, which comes with both minoxidil and finasteride. Keeps has one, as well. And though it might seem like overkill to take two different hair-loss treatments at once, this is one of those rare instances where more is actually better. McAndrews calls the combination of orally administered finasteride and topically applied minoxidil a “full-court press” against hair loss. “That’s doing the most you can for preventative medicine.” Rieder notes that taking both drugs together is more effective than taking either one alone.
Correct ferritin levels maximize your hair’s “anagen” or “growing” phase and encourage your hairs to grow to their full length. When you aren’t getting enough iron through your diet, your body takes ferritin stored in non-essential tissue, like your hair bulb, and gives it to essential tissue, such as your heart. Because your hair bulb is where all your hair cells are produced, this leeching of ferritin can cause your hair to shed before it reaches its maximum length.
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Hair grooming, but more importantly, having a head-full of hair is as important to men as it is to women. To women, it may be an important accessory of beauty, and for men, it adds to a sense of manliness, enhances their looks and makes them more appealing and attractive to women. Balding to men is associated with aging (only old men are expected to lose hair) and therefore, having hair on one's head is a sign of virility and masculinity.


SOURCES: George Cotsarelis, MD, director, Hair and Scalp Clinic, University of Pennsylvania School of Medicine, Philadelphia. Andrew Kaufman, MD, assistant professor, department of dermatology, University of California, Los Angeles; medical director, Center for Dermatology Care, Thousand Oaks, Calif. Tom Barrows, PhD, director of product development, Aderans Research Institute Inc., Atlanta. Cotsarelis, G. and Millar, S.E. Trends in Molecular Medicine, July 2001; vol 7: pp 293-301. American Society for Dermatologic Surgery web site. American Academy of Facial and Reconstructive Plastic Surgery web site. American Hair Loss Council web site. Springer, K. American Family Physician, July 1, 2003; vol 68: pp 93-102. Hair Loss Help web site, "Interview with Dr. Ken Washenik from Bosley." Fuchs, E. Developmental Cell, July 2001: vol 1: pp 13-25.

Male pattern baldness is the most common type of hair loss, affecting 6.5 million men in the UK, according to the NHS Choices website. For some men the process can start as early as their 20s and by the age of 60 most men have some degree of hair loss, although in some cases this can just be a part of the ageing process as opposed to a hereditary condition. Male pattern baldness is not a disease or illness and it doesn't affect your health. However, if you have hair loss that doesn't follow this pattern, for example your hair is falling out in clumps and leaving patches, then you should talk to your GP.
Alopecia areata - starts suddenly and causes hair loss in patches anywhere in the body in children and young adults. This condition is also known as ‘spot baldness’. This condition is observed to run in families and experts believe this condition could be the result of autoimmune disease, where the immune system of the body mistakenly attacks the hair follicles.
Instead, you may want to add vitamin D (about $15) to your shopping cart. A vitamin D deficiency can exacerbate hair thinning and make it almost impossible for any over-the-counter product to reverse hair loss, says Dhaval Bhanusali, a dermatologist in New York City, who recommends taking 5,000 international units of D3 a day (and it’s generally beneficial for bone health in women over 40). “There’s also a link between low iron and zinc levels and temporary hair shedding, called [telogen] effluvium,” says Rogers.
See a doctor. While it may be easy to treat hair loss that's caused by stress or other physical or emotional shock, other types, especially those caused by medical conditions, require expert attention. Do not self-medicate. A medical test is necessary to determine the real cause of your hair loss. A medical diagnosis is important in order to rule out other factors that might be the cause of your hair loss. On the surface, it's easy to attribute hair loss to stress or the lack of sleep, but it is highly possible that the hair loss may be caused by an unknown or undetected condition related to hormones or genetics. With the right diagnosis, you'll be able to get the right medication and course of treatment.
Content on this website is provided for information purposes only. Information about a therapy, service, product or treatment does not in any way endorse or support such therapy, service, product or treatment and is not intended to replace advice from your doctor or other registered health professional. The information and materials contained on this website are not intended to constitute a comprehensive guide concerning all aspects of the therapy, product or treatment described on the website. All users are urged to always seek advice from a registered health care professional for diagnosis and answers to their medical questions and to ascertain whether the particular therapy, service, product or treatment described on the website is suitable in their circumstances. The State of Victoria and the Department of Health & Human Services shall not bear any liability for reliance by any user on the materials contained on this website.
Initially used to treat high blood pressure, minoxidil was the first medication approved by the FDA to treat male pattern baldness. By applying Rogaine (or a generic version) directly to the scalp twice a day, a man in the early stages of hair loss can often stimulate growth. The American Hair Loss Association points out that results of treatment with minoxidil are limited, but it still endorses using it in combination with other treatments or as an alternative if finasteride doesn't work.
Patel said the problem with those treatments is that they have not been subjected to large or head-to-head research. There's great variation in how doctors give the plasma treatments and in laser-based devices, so it's hard for patients to know whether they're getting a proven regimen. Nutrafol seems promising, he said, but he does not think that company-funded research showing its effectiveness has been replicated. He has not recommended it yet.
Minoxidil: This medicine is applied to the scalp. It can stop hairs from getting thinner and stimulate hair growth on the top of the scalp. The U.S. Food and Drug Administration (FDA) has approved minoxidil to treat hair loss. It is the only hair re-growth product approved for men and women. A dermatologist may combine minoxidil with another treatment.

Taking hair supplements can be helpful for anyone who is experiencing hair loss or hair thinning. Dendy Engelman, MD, a board-certified dermatologic surgeon at Medical Dermatology & Cosmetic Surgery in New York City, previously recommended Nutrafol, a research-backed hair supplement, to Prevention. "This uses highly concentrated botanicals to address every stage of the growth cycle," she says. Nutrafol's hair supplements include vitamin E and ashwagandha (an adaptogen that helps balance cortisol levels in the body), among others.

Please note that in January 2016 the Endocrine News published this article January 2016: Thyroid Month: Beware of Biotin which stated that taking biotin supplements could cause falsely high and falsely low results in a variety of laboratory tests, including thyroid lab tests because biotin interferes with the test platform used for particular laboratory tests. If you are taking biotin and your thyroid lab results begin to change and not make sense in terms of your clinical symptoms speak with your doctor about doing a retest of your thyroid labs after several days of discontinuing your biotin supplement to be sure there is no interference.
Sex hormone testing revealed that my estrogen levels were declining and that was making a mess of my hair. Another common sex hormone imbalance is estrogen dominance, too much estrogen relative to progesterone. Don’t forget testosterone testing too…yes high testosterone can cause hair loss but so can low testosterone. Harvard-trained MD Dr. Sara Gottfried had this to say about testosterone in her article The Horrors of Hair Loss for The Huffington Post:
Minoxidil: This medicine is applied to the scalp. It can stop hairs from getting thinner and stimulate hair growth on the top of the scalp. The U.S. Food and Drug Administration (FDA) has approved minoxidil to treat hair loss. It is the only hair re-growth product approved for men and women. A dermatologist may combine minoxidil with another treatment.
decrease in your blood Prostate Specific Antigen (PSA) levels. Finasteride can affect a blood test called PSA (Prostate-Specific Antigen) for the screening of prostate cancer. If you have a PSA test done you should tell your healthcare provider that you are taking Finasteride because Finasteride decreases PSA levels. Changes in PSA levels will need to be evaluated by your healthcare provider. Any increase in follow-up PSA levels from their lowest point may signal the presence of prostate cancer and should be evaluated, even if the test results are still within the normal range for men not taking Finasteride. You should also tell your healthcare provider if you have not been taking Finasteride as prescribed because this may affect the PSA test results. For more information, talk to your healthcare provider.
Other causes for hair loss or hair thinning can be stress, illness, poor diet, hormone imbalance or your body going into shock. Certain diseases and intensive medical treatment such as chemotherapy are also likely to result in hair loss, but it is best to consult your GP if you go bald at an alarmingly fast rate, especially if you have no family history of male pattern baldness.
It’s become “trendy” to not wash your hair for several days; in fact, some believe it’s beneficial for the hair. While you shouldn’t over-wash your hair, under-washing—washing your hair once or twice a week—and camouflaging dirt and grime with dry shampoos isn’t good for your hair either. “Overuse of dry shampoos leads to clogged follicles, which, over time, can cause permanent damage leading to hair loss,” warns Halasz. “To prevent this from happening, try to wash your hair a minimum of every three to four days.” Learn all the tricks you need to know when using dry shampoo.
Some hair loss treatments can cause side effects. Regaine for women can cause headache, skin irritation and changes in the colour or texture of your hair. It is normal to notice increased shedding during the first two weeks of treatment with Regaine. This indicates that the treatment is working. If you find that you are shedding an unusual amount of hair after the first 14 days of treatment, stop using Regaine and ask your doctor for advice.
However, researchers are still working to determine the best dose needed, whether the results are lasting, and whether they can develop a topical form of the drug, Day said. She added that patients should be aware that Tofacitinib has side effects. It's already associated with an increased risk of serious infections, as well as stomach and intestinal tears, according to Pfizer, the manufacturer.
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