Alopecia areata - bald patches develop on the scalp, beard, and possibly eyebrows. eyelashes may fall out as well. This is thought to be an autoimmune disease, where the immune system attacks the hair follicles and leads to hair loss on the scalp and other parts of the body. However, the hair follicles are alive so there is potential for hair to regrow when the underlying problem has resolved. Growth may occur even without treatment and even after many years. In most cases hair loss only happens in a few places, leaving a few bare patches. In some cases though, the disease can advance to total loss of hair from the head (alopecia areata totalis) or complete loss of hair on the head, face and body (alopecia areata universalis).

Other medical conditions — most commonly telogen effluvium and seborrheic dermatitis — can also cause hair loss, but most people can trace their follicular woes back to androgenetic alopecia, so we focused our search there. We started with more than 200 products, including all-natural solutions and high-tech gadgets, while skipping treatments that focus only on volumizing or thickening hair. We also limited our scope to the scalp, and left out specialty products designed only for eyebrows or beards.

Why? Unwanted hair growth (sideburns, for example) is a reported side effect of minoxidil. The belief is that a higher concentration of minoxidil would result in more unwanted hair, which is why women are instructed to use it less often. However, the study in Skin Therapy Letter reports that unwanted hair was more common in 2 percent minoxidil solutions than 5 percent, and women are instructed to use Rogaine’s 2 percent solution twice daily — so what gives?


It's no myth that excess stress can literally make your hair fall out. How does this happen? Well, it can raise androgen (male hormone) levels, which in turn can causes hair loss. "Stress may also trigger scalp problems, such as dandruff, disrupt eating habits and mess with the digestive system – all of which can have a negative impact on hair" says Anabel.
Jimenez, J. J., Wikramanayake, T. C., Bergfeld, W., Hordinsky, M., Hickman, J. G., Hamblin, M. R., & Schachner, L. A. (2014). Efficacy and Safety of a Low-level Laser Device in the Treatment of Male and Female Pattern Hair Loss: A Multicenter, Randomized, Sham Device-controlled, Double-blind Study. American Journal of Clinical Dermatology, 15(2), 115–127.
Scalp reduction is the process is the decreasing of the area of bald skin on the head. In time, the skin on the head becomes flexible and stretched enough that some of it can be surgically removed. After the hairless scalp is removed, the space is closed with hair-covered scalp. Scalp reduction is generally done in combination with hair transplantation to provide a natural-looking hairline, especially those with extensive hair loss.
Most hair loss is not associated with systemic or internal disease, nor is poor diet a frequent factor. Hair may simply thin as a result of predetermined genetic factors and the overall aging process. Many men and women may notice mild physiologic thinning of hair starting in their 30s and 40s. Life vicissitudes, including illness, emotional trauma, protein deprivation (during strict dieting), and hormonal changes like those in pregnancy, puberty, and menopause may cause hair loss.
*Photograph used with permission of the Journal of the American Academy of Dermatology. This photograph was published in the Journal of the American Academy of Dermatology, Vol. # 60, Gathers RC, Jankowski M, Eide M, et al. “Hair grooming practices and central centrifugal cicatricial alopecia,” 660-8. Copyright Elsevier (2009). Journal of the American Academy of Dermatology.   
Finally, if these tests come back normal, your dermatologist may suggest a scalp biopsy of a couple of two-millimeter sections taken from your scalp under local anesthesia ($400 and up). It can determine whether genetic hair loss, telogen effluvium (a condition in which hair falls out from stress or rapid weight gain), or a disease (such as lupus) is the cause of your shedding, and your dermatologist can treat you accordingly.

As I mentioned before, the causes of hair fall are innumerable, and so it becomes crucial to get to the root of the problem. The best way to go about dealing with the problem would be to get the correct diagnosis to begin with. This can be made simpler by finding the areas where thinning is most prominent and also monitoring how much hair you are losing whenever you comb or shampoo. Consult a physician to find out whether you have any underlying medical issues causing the hair fall.
Cyclosporine is used to suppress the immune system in psoriasis and other immune-mediated skin conditions. Although cyclosporine helps hair regrowth in alopecia areata, the risks of using it may outweigh the benefits, as oral cyclosporine can suppress the immune system and increase the risk of serious infection. Other common adverse effects are hypertension and renal impairment, but these are usually reversible. 

The hormonal process of testosterone converting to DHT, which then harms hair follicles, happens in both men and women. Under normal conditions, women have a minute fraction of the level of testosterone that men have, but even a lower level can cause DHT- triggered hair loss in women. And certainly when those levels rise, DHT is even more of a problem. Those levels can rise and still be within what doctors consider “normal” on a blood test, even though they are high enough to cause a problem. The levels may not rise at all and still be a problem if you have the kind of body chemistry that is overly sensitive to even its regular levels of chemicals, including hormones.
Jimenez, J. J., Wikramanayake, T. C., Bergfeld, W., Hordinsky, M., Hickman, J. G., Hamblin, M. R., & Schachner, L. A. (2014). Efficacy and Safety of a Low-level Laser Device in the Treatment of Male and Female Pattern Hair Loss: A Multicenter, Randomized, Sham Device-controlled, Double-blind Study. American Journal of Clinical Dermatology, 15(2), 115–127.
As long as the new hair that grows from that follicle is the same as the one it replaces, the hair density will remain constant. In patterned hair loss, hormones affect the follicle, making it smaller and the new hair becomes shorter and finer than the one it replaces. Eventually, the new hairs are so short and fine they become invisible and the scalp becomes bald.
A group of topical medications called prostaglandin analogs have recently began undergoing testing for potential hair regrowth. They may be used in men and women. These drugs are not currently FDA approved for scalp hair loss. Currently, these are primarily used for eyelash enhancement. One of the new medications is called bimatoprost (Latisse). Further testing and studies are required to assess the efficacy of these products in scalp hair loss. Bimatoprost solution is sometimes used off-label for help in selected cases of hair loss. It is currently FDA approved for cosmetic eyelash enhancement. Studies have shown it can treat hypotrichosis (short or sparse) of the eyelashes by increasing their growth, including length, thickness, and darkness. This medication is also commercially available as Lumigan, which is used to treat glaucoma. It is not known exactly how this medication works in hair regrowth, but it is thought to lengthen the anagen phase (active phase) of hair growth. Interestingly, during routine medical use of Lumigan eyedrops for glaucoma patients, it was serendipitously found that eyelashes got longer and thicker in many users. This led to clinical trials and the approval of cosmetic use of Latisse for eyelashes.
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