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.
You might be wondering why there are so many men walking around with significant hair loss, especially considering there are a number of remedies out there that can slow down or stop male pattern baldness completely. The biggest reason is a lack of education about which hair loss treatments actually work. There’s a lot of misinformation out there regarding hair loss remedies, and most of it’s from armchair experts who boldly claim that their all-natural, homeopathic methods are guaranteed to promote hair growth and stop baldness (spoiler alert: they don’t).
Trichotillomania, classified as an “impulse control disorder,” causes people to compulsively pull their hair out. “It’s sort of like a tic, the person is constantly playing and pulling their hair,” says Dr. Glashofer says. Unfortunately, this constant playing and pulling can actually strip your head of its natural protection: hair. Trichotillomania often begins before the age of 17 and is four times as common in women as in men.
Disruptions in the normal length of each phase, which can cause hair loss and hair thinning, may be the result of a number of internal and external stimuli. These are also what we call the triggers and causes of your hair loss. As a quick example, dieting can leave the body stressed and in need of important nutrients. Because of this stress, hair growth may be cut shorter than usual and there is an early onset of telogen or shedding of hair.
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.
Hair loss often follows childbirth in the postpartum period without causing baldness. In this situation, the hair is actually thicker during pregnancy owing to increased circulating oestrogens. Approximately three months after giving birth (typically between 2 and 5 months), oestrogen levels drop and hair loss occurs, often particularly noticeably around the hairline and temple area. Hair typically grows back normally and treatment is not indicated.A similar situation occurs in women taking the fertility-stimulating drug clomiphene.
Follicular Unit Extraction (FUE). In this method, instead of taking out a whole sample strip, small, individual follicle grafts are cut using a machine and then transplanted. The process is more tedious and more time-consuming, but has been known to have a higher recovery rate and there are no risks of scarring because no cuts and stitches are required.
Pay attention to the foods you eat and how much you’re eating. For example, eating a variety of whole foods that are rich in vitamins and minerals will help fuel your body and the areas responsible for hair regrowth. If you suspect you may be deficient in certain vitamins, visit your doctor to get a blood test and address other dietary issues, such as eating disorders or health conditions that might block nutrient absorption.
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.
Giovanni Mele, a stylist who owns Giovanni and Pileggi in Center City, said many women with thinning hair try to wear their hair long. He thinks they're much better off with short, pixie-like styles with light layering on top. He recommends that lighter-skinned women choose colors that are a little darker than blond or gray. He is a fan of a hair-thickening product made by Nioxin.
The truth is, the amount of propylene glycol in hair loss treatments is not likely to cause any real harm and the FDA has given the chemical approval for many uses. But even though it is safe, we wanted to ensure that our top picks would be as comfortable to use as possible. So when Dr. Khadavi told us that “a third of my patients get irritated from minoxidil products because of propylene glycol,” we decided to cut any treatments with it. In any case, it’s the minoxidil that helps curb hair loss and not the propylene glycol.
The cause of female-pattern hair loss is unknown, but doctors said there is a strong genetic component. The risk can come from male or female relatives. Though it looks as if the hair is falling out, that's not really what's happening. Cotsarelis said hair follicles are becoming smaller and producing hairs that may be so small that you can't see them. Women tend to retain more normal, thick hairs than balding men do.
Once male-pattern baldness starts, it’s not going to stop until every last hair on your head has shrunk or shed, though the rate at which this happens differs from person to person and depends on genetics. And since the grind of hair loss is unending, it’s important to start treatment as soon as your hairline starts bothering you. If you’re looking for a more quantitative metric, Dr. Paul McAndrews, clinical professor of dermatology at the USC School of Medicine and member of the International Society of Hair Restoration Surgery, assures me that “you have to lose half your hair before the human eye can tell.” (Of course, if you don’t care about losing your hair and are fine with going full Prince William and shaving your head, go for it. We’ve got some recommendations for razors and hair trimmers to help you out on that front.)
Always shampoo and condition your hair regularly. Let your hair breath by avoiding wigs that are made with cotton and nylon caps that absorb moisture and lead to drier and more damaged hair. Instead, choose those with netted caps. Make sure your wig isn't too tight. Secure it with hypoallergenic double-sided tapes. Do not put your wig on over wet hair to avoid the growth of mildew and bacteria.
Thinning hair in women is worth investigating for more than its impact on physical appearance. While many conditions that lead to temporary hair loss will go away without treatment or with simple lifestyle measures, others may be signs of potentially irreversible loss or health conditions. Others yet may respond well to treatments to promote regrowth, so starting sooner rather than later is key.
It is estimated that 90% of people with hypothyroidism have the thyroid autoimmune condition known as Hashimoto’s Thyroiditis. Hashimoto’s is an autoimmune condition in which the body attacks its own thyroid gland. Despite the prevalence of Hashimoto’s, thyroid antibodies are often NOT tested. You may have Hashimoto’s and not even know it. There are two thyroid antibodies to test for Hashimoto’s: Thyroid Peroxidase Antibodies (TPOAb) and Thyroglobulin Antibodies (TgAb).
Chemotherapy is also one of the primary causes of balding among cancer patients, men and women alike. While not all chemotherapy treatments result in hair loss, some that involves the use of drugs like Altretamine, Carboplatin, Docetaxel, and Idarubicin can cause hair thinning and hair fall. In such cases, the hair loss varies from person to person and the dosage of drugs administered. Hair fall doesn't occur at once, but rather after several weeks of treatment until hair fall rate increases after one or two months of exposure to chemotherapy. Radiation therapy as part of cancer treatment can also result into hair loss but typically only in areas where the radiation is targeted.
A few studies support the use of red ginseng, sometimes called panax ginseng (about $25), for hair regrowth. It can have an anti-apoptotic effect on the hair, Rogers says, meaning it slows cell death so hair follicles can grow for a longer period of time. But before taking any of these supplements, it’s important to consult your doctor; a lab test can confirm whether you need a particular supplement or if taking it will just be a waste of time and money.
Alopecia mucinosa - also known as follicular mucinosis is an autoimmune disorder. It causes inflammation of the hair follicles which can result in scarring or non-scarring hair loss. This condition can affect any part of the body and can affect both children and adults. If treated early, the hair will grow back. If the condition is too severe, the hair will not grow back.
Pregnancy may cause many changes in the scalp hair. As the hormones fluctuate during pregnancy, a large number of women feel their hair thickens and becomes fuller. This may be related to change in the number of hairs cycling in the growth phase of hair growth, but the exact reason is unknown. Quite often, there may be a loss of hair (telogen effluvium) after delivery or a few months later which will eventually normalize.
Finasteride (Propecia): This medication is FDA approved for use in only men with androgenic hair loss. Finasteride is in a class of medications called 5-alpha reductase inhibitors. It helps reduce hair loss by blocking the action of natural hormones in scalp hair follicles. Propecia is a lower-dose version of a commercially available drug called Proscar that helps shrink enlarged prostates in middle-aged and older men. Women of child-bearing potential should avoid finasteride. Propecia 1 mg tablets are available by prescription and taken once daily. Propecia may grow and thicken hair to some extent for some people, but its main use is to keep (maintain) hair that's still there. Studies have shown that this medication works well in some types of hair loss, and patients should use it for about six to 12 months before full effects are determined. This medication does not "work" in days to weeks, and its onset of visible improvement tends to be gradual. It may be best for men who still have enough hair to retain but also can help some regrow hair. Possible but very unlikely side effects include impotence or a decreased sex drive (libido). Studies show that these side effects were possibly slightly more common than seen in the general population and are reversible when patients stop taking the drug. The cost is about $70-$100/month, and most health insurers do not reimburse for the expense.
Cosmetic procedures, such as shampooing too often, perms, bleaching, and dyeing hair can contribute to overall hair thinning by making hair weak and brittle. Tight braiding, using rollers or hot curlers, and running hair picks through tight curls can also damage and break hair. However, these procedures don't cause baldness. In most instances hair grows back normally if the source of the problem is removed. Still, severe damage to the hair or scalp sometimes causes permanent bald patches.
Hair thinning and hair loss are often wrongly thought to only affect men, but in reality both sexes can suffer from the condition. It’s perfectly normal to lose 50-100 strands of hair per day, even 250 on a day when you wash your hair. For some people though, thinning hair can be a real problem. It can happen very gradually or suddenly and it can be a result of a range of conditions, such as stress, genetics, medical treatment or childbirth.
There can be several factors behind hair loss such as environmental effects, aging, too much stress, excessive smoking, nutritional deficiencies, hormonal imbalance, genetic factors, scalp infections, use of wrong or chemically enriched hair products, certain medicines and medical conditions like thyroid disorder, autoimmune diseases, polycystic ovary syndrome (PCOS), iron-deficiency anemia, and chronic illnesses.
"This is an oral, prescription-only medication with the brand name Propecia that’s also FDA approved to treat hair loss," says Spencer. Male pattern hair loss occurs when a hormone called dihydrotestosterone (DHT) prevents hair follicles from getting the nutrients they need. Finasteride works by blocking the production of DHT, which protects the follicles.
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.
There are numerous ways to categorize hair loss. One must first examine the scalp to determine if the hair loss is due to the physical destruction and loss of hair follicles (scarring or cicatricial alopecia). If the scalp appears perfectly normal with plenty of empty hair follicles, this is called non-scarring hair loss. On the other hand, cicatricial alopecia permanently destroys the follicles. Non-scarring hair loss also happens in situations where there is physical or chemical damage to the hair shaft, resulting in breakage. Occasionally, it may be necessary to do a biopsy of the scalp to distinguish these conditions. Sometimes, a physician may pull a hair to examine the appearance of the hair shaft as well as the percentage of growing hairs (anagen phase). This article will concentrate on the non-scarring types of hair loss.
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:
Alopecia areata. This condition, called patchy hair loss, is the opposite of pattern baldness. Whereas in the former, thinning hair follows a pattern, alopecia areata is marked by smooth and bald patches anywhere on the scalp. The bald patches are circular, and can be as small as a pencil eraser or as big as a quarter. It begins with one or two spots that multiply on other parts of the head. The condition is caused by an autoimmune disease where the antibodies mistake the hair as the "enemy" and start attacking it, resulting into hair loss.
A common skin condition, alopecia areata usually starts as a single quarter-sized circle of perfectly smooth bald skin. These patches usually regrow in three to six months without treatment. Sometimes, white hair temporarily regrows and then becomes dark. The most extensive form is alopecia totalis, in which the entire scalp goes bald. It's important to emphasize that patients who have localized hair loss generally don't go on to lose hair all over the scalp. Alopecia areata can affect hair on other parts of the body, too (for example, the beard or eyebrows).
Thyroid medication. Hair loss as a result of thyroid problems will only be solved by treating the root cause. This means that you need to take medications for hypothyroidism in order to address the hormonal imbalance in the body. The most common medication for thyroid problems is levothyroxine, a synthetic version of thyroxine (thyroid hormone). Since the medication is used to address the thyroid problem and hair loss indirectly, the medication has to be continued even when you've gotten better or your hormone level has gone back to normal in order to continue hair growth.
Massage your scalp with hot oil preferably coconut, castor or olive oil. Take the warm oil on hand and apply it to your scalp. Rub your fingers on the scalp in a circular motion, applying gentle pressure. Keep kneading occasionally. This will open up the blood vessels and increase blood flow to your head and strengthen your hair follicles as well, encouraging new hair growth.
Daily hair counts are normally done when the pull test is negative. It is done by counting the number of hairs lost. The hair from the first morning combing or during washing should be counted. The hair is collected in a clear plastic bag for 14 days. The strands are recorded. If the hair count is >100/day, it is considered abnormal except after shampooing, where hair counts will be up to 250 and be normal.
Not surprisingly, treatments with 5 percent minoxidil work better than treatments with 2 percent minoxidil. A randomized clinical trial published in the American Journal of Clinical Dermatology in 2002 found that, in men with androgenetic alopecia, “5 percent topical minoxidil was clearly superior to 2 percent topical minoxidil and placebo in increasing hair growth.” The difference was actually pretty astounding — after 48 weeks, the men who used 5 percent minoxidil experienced 45 percent more hair growth than the men who used the 2 percent treatment.