Poor nutrition. Not eating enough healthy food can contribute to hair loss. This is why some people with eating disorders like anorexia and bulimia lose their hair: The body isn't getting enough protein, vitamins, and minerals to support hair growth. Some teens who are vegetarians also lose their hair if they don't get enough protein from non-meat sources. And some athletes are at higher risk for hair loss because they may be more likely to develop iron-deficiency anemia.
The third and fourth stages are known as telogen and exogen, respectively. In telogen, the hair is supposed to be at "rest" until it finally detaches itself from the follicle and enters the exogen or shedding stage. Once the hair is detached from the follicle, the follicle remains inactive for about three months, after which a new cycle begins again.
"I recommend that everyone [with any hair loss] take finasteride," says Robert M. Bernstein, MD. Bernstein is associate clinical professor of dermatology at Columbia University and founder of the Bernstein Medical Center for Hair Restoration. "To patients who are younger,” he says, “I also recommend minoxidil. But the mainstay is finasteride. The data show that, over five years, it significantly retards hair loss in 85% of users."
Any kind of physical trauma—surgery, a car accident, or a severe illness, even the flu—can cause temporary hair loss. This can trigger a type of hair loss called telogen effluvium. Hair has a programmed life cycle: a growth phase, rest phase and shedding phase. “When you have a really stressful event, it can shock the hair cycle, (pushing) more hair into the shedding phase,” explains Marc Glashofer, MD, a dermatologist in New York City. Hair loss often becomes noticeable three-to-six months after the trauma.
Ms. Imhof, who lives in Land O’Lakes, Fla., was skeptical. The company’s before and after photos seemed too good to be true. But she went for a consultation and made the cut. (Harklinikken’s products are not available to anyone with autoimmune illnesses like alopecia or baldness from scarring, or anyone who is unlikely to see at least a 30 percent increase in growth.)
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.
It may seem a peculiar American vanity that men have in-boxes full of hair loss treatment offers and spend billions of dollars on hair loss treatments each year. Not so. As Gersh Kuntzman illustrates in his book Hair! Mankind's Historic Quest to End Baldness, chrome-dome anxiety has tormented us for ages. Caesar's laurel wreaths? Classic red herring, Kuntzman says.
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.
Despite advances in our understanding of hair loss, there are limits to current treatment. In particular, age-related hair loss and inherited forms of hair loss are difficult to reverse, although treatment may prevent further loss and produce partial regrowth. Non-surgical treatments include lotions and tablets. These generally need to be used continuously for the benefits to be maintained. If you stop treatment, regrowth will cease and hair loss will resume.
Ms. Imhof, who lives in Land O’Lakes, Fla., was skeptical. The company’s before and after photos seemed too good to be true. But she went for a consultation and made the cut. (Harklinikken’s products are not available to anyone with autoimmune illnesses like alopecia or baldness from scarring, or anyone who is unlikely to see at least a 30 percent increase in growth.)
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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