All men and women will be affected by patterned hair loss at some stage in their lives. While the majority of men have developed temporal recession by their mid 20s and noticeable balding by their mid 50s, for most women, hair loss is mild and only occurs later in life. However, when hair loss is premature or severe, it can cause distress. A range of treatments is available to slow or reduce hair loss, and stimulate partial regrowth
Hair grows everywhere on the human skin except on the palms of our hands and the soles of our feet, but many hairs are so fine they're virtually invisible. Hair is made up of a protein called keratin that is produced in hair follicles in the outer layer of skin. As follicles produce new hair cells, old cells are being pushed out through the surface of the skin at the rate of about six inches a year. The hair you can see is actually a string of dead keratin cells. The average adult head has about 100,000 to 150,000 hairs and loses up to 100 of them a day; finding a few stray hairs on your hairbrush is not necessarily cause for alarm.
Androgenetic alopecia. Among adults, the most common cause of hair loss is androgenetic (pronounced: an-druh-juh-NEH-tik) alopecia. This is sometimes called male- or female-pattern baldness. This condition is caused by a combination of things, including a person's and hormones called androgens. This kind of hair loss can sometimes start as early as the mid-teen years. It also can happen to people who take steroids like testosterone to build their bodies.
Treatment of pattern hair loss may simply involve accepting the condition.[3] Interventions that can be tried include the medications minoxidil (or finasteride) and hair transplant surgery.[4][5] Alopecia areata may be treated by steroid injections in the affected area, but these need to be frequently repeated to be effective.[3] Hair loss is a common problem.[3] Pattern hair loss by age 50 affects about half of males and a quarter of females.[3] About 2% of people develop alopecia areata at some point in time.[3]

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.


There are few scientifically proven and FDA-approved treatments for hair loss. There are thousands of unproven claims and products to help with hair regrowth. Many conditioners, shampoos, vitamins, and other products claim to help hair grow in some unspecified way. Nioxin has been a popular brand of shampoo for hair loss, but there is no compelling evidence showing it is any more effective than regular shampoos. These products are usually harmless but generally not scientifically proven and therefore potentially useless. To slow down hair loss, there are at least four potentially effective, basic options. These include medications like Minoxidil, and Propecia, which are for long-term use. Stopping these drugs does not seem to worsen or exacerbate the prior hair loss. The patient will simply revert to the state he would have been in had he never started treatment.
While pregnant, many women notice that their mane becomes thicker, fuller, and shinier, thanks to a surge of pregnancy hormones. However, once they deliver, this flood of hormones leaves their body at a rapid pace, often leaving them with little time to adjust. One side effect of this depletion of hormones is hair loss. Thankfully, for many women, their hair goes back to normal a few months postpartum. Check out these other surprising ways you look different when you’re pregnant.
Every part of the body requires thyroid hormone for proper functioning, and that includes the hair follicles. In 2008, the Journal of Clinical Endocrinology and Metabolism presented the first evidence that human hair follicles are direct targets of thyroid hormones. This research demonstrated that the thyroid hormones T4 and T3 modulate multiple hair biology parameters from cycling to pigmentation.
Gray hair will be one of the common hair problems that are mentioned in this article. It is normal for hair to turn gray when you get older. Dr. Anthony Oro at Stanford University stated that 50 % of the population has half of their hair getting gray in their 50s [1]. However, this hair problem sometimes happens earlier in people’s 20s and becomes a big worry. These premature graying is proved due to the vitamin D3 deficient in the body, according to a study of Father Muller Medical College and Hospital in Indian [2]. There are also plenty of factors that can trigger greying early such as malnutrition, using electric dryers, a hormonal imbalance, hypothyroidism and hyperthyroidism, pernicious anemia and concentrated hair dyes, chemotherapy, radiation, and genetic disorders. Some studies also point out that graying early can happen as the result of the lack of some copper, vitamin B, iodine, and iron in the daily diet as well as mental stress. Among these common hair problems, the early greying can be determined by genes, which means if your parents have premature graying, you should start to worry about it.
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.
2. Volumizing shampoos and treatments. Typically, these work by depositing ingredients, like wheat protein and keratin, that adhere to the hair shaft to a) thicken it and b) create spaces between hairs so you look like you have more of it. Try Kiehl’s Rice & Wheat Volumizing Shampoo ($18) with hydrolyzed wheat protein; Rogers likes Redken Cerafill Defy Shampoo and Conditioner ($20 each) with ceramides that bulk up hair.
*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.    

"Despite some of the claims, a shampoo or conditioner won’t be able to stop or slow hair loss, nor help with a receding hairline or thicken hair that’s becoming thinner," says trichologist Anabel Kingsley from The Philip Kingsley Trichology Clinic in London. "At best, a thickening shampoo will make hair temporarily thicker for a short period of time, but they certainly won’t help with hair loss or thinning."
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.

Hair concealers and hair fibers. These are one of the newest cosmetic answers to hair loss. As the name suggests, these products are applied on the scalp or hair to camouflage hair loss and give the appearance of fullness to thinning hair. Some of these are applied directly on the scalp, while others (hair fibers) are attached to the hair, much like hair extensions, to add volume.


“The sun damages the cuticle, allowing harmful rays and heat to penetrate deeper,” explains dermatologist Dendy Engelman, MD, of Medical Dermatology & Cosmetic Surgery Centers. “Additionally, exposure to free radicals without antioxidants to neutralize them can cause serious oxidative stress to the body and, in this case, the hair.” Try using a sun protection spray, such as Living Proof Restore Instant Protection, or Clarins Sun Care Oil Spray. You can also try these 11 natural remedies for treating hair loss.
There are many different types and forms of hair concealers. The two most popular types are hair sprays, and sprinkles and powder solids. Sprays are easy to apply compared to creams and powders. They contain chemicals and dye that can match the shade of your hair, making it fuller. However, it has a tendency to look less natural if applied haphazardly so it requires some care during application.
According to the idea of Ladies Home Journal, frizzy hair can be improved with silicone-based products, which can help fight off frizz while smoothing down the cuticle. Moreover, frizz-fighting products containing certain types of proteins, for example, soy or wheat protein can help with hydration. Lastly, there is something that should not be done in order not to worsen the condition, such as brushing dry hair or over- process hair [4].

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. 

Make improvements in your diet to reduce hair loss. If your diet lacks marine proteins, vitamins and minerals for hair growth, it can lead to damaged hair, thinning hair, and hair loss. Eat a variety of colorful, well-balanced foods, consult a dietitian or nutritionist, and if you think you are still not getting a good hair loss diet, try a vitamin supplement for hair loss such as Viviscal.
My hair began to thin when I was 28 years old. Now I am 44 and the top of my head is bald. Recently, I considered using medicine to treat my hair loss and see if any hair would regrow. After reading the literature and talking to my doctor, I decided not to take medicine because it is unlikely to make a huge difference in my hair—and I don't want to take medicine forever!
Regarding the ferritin levels, mine fell to 8. They did five infusions of iron and got it to around 270. It has dropped to 170. I don’t feel as good as I did, and my hair is falling out again. Please explain to me the formula you use on proper ferritin levels so I might talk about with the hematologist about optimum levels for my hair. They think I’m fine at 170. I weigh 212. What should my optimum ferritin level be for my Hashimoto’s? Thanks.

Acupuncture is a form of Chinese medicine that has been practiced for thousands of years. Its applications are many, and some researchers believe that it may help with hair loss from alopecia areata. How? The needles inserted into the scalp may help stimulate hair follicles and promote regrowth. More research needs to be done in this area, but consider asking your doctor for a referral to a licensed acupuncturist if this treatment sounds appealing to you. (Learn more about acupuncture for hair loss.)


If proper treatments are not carried out, the dry conditions can lead to other serious common hair problems such as frizzy hair, split ends, thinning hair, hair loss, and hair breakage at an early age. Therefore, it is important for you to moisturize and hydrate the hair strands. High- quality conditioner is strongly required for those common hair problems. Some types of essential oils can be perfect choices for you by making your dry hair shiny and soft again. Remember not to comb your hair if it is still wet to avoid breakage and split ends.

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.


While pregnant, many women notice that their mane becomes thicker, fuller, and shinier, thanks to a surge of pregnancy hormones. However, once they deliver, this flood of hormones leaves their body at a rapid pace, often leaving them with little time to adjust. One side effect of this depletion of hormones is hair loss. Thankfully, for many women, their hair goes back to normal a few months postpartum. Check out these other surprising ways you look different when you’re pregnant.
Traction alopecia - certain hairstyles such as when you pull on your hair tightly can cause scarring of the hair follicles. If pulling is stopped before scarring to the scalp then your hair will grow back normally. Nervous habits such as continual hair pulling or scalp rubbing can also cause scarring and ultimately permanent hair loss. Excessive shampooing and blow-drying can also cause hair loss. 

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.

This refers to the habitual pulling or twisting of one's own hair. The scalp and eyelashes are often affected. Unlike alopecia areata patches, which are perfectly smooth, hair patches in trichotillomania show broken-off hairs. Treatment is often entirely behavioral. One has to notice the behavior and then consciously stop. Severe or resistant cases may require stress counseling with a therapist or psychologist or medical treatment with a psychiatrist. Several antidepressant or anti-anxiety medications can help with this condition.
The pluck test is conducted by pulling hair out "by the roots". The root of the plucked hair is examined under a microscope to determine the phase of growth, and is used to diagnose a defect of telogen, anagen, or systemic disease. Telogen hairs have tiny bulbs without sheaths at their roots. Telogen effluvium shows an increased percentage of hairs upon examination. Anagen hairs have sheaths attached to their roots. Anagen effluvium shows a decrease in telogen-phase hairs and an increased number of broken hairs.
Medical conditions and medications. A common medical condition that also causes hair loss is hypothyroidism, which can happen in both men and women. Patients suffer from an underactive thyroid gland, which is responsible for producing the hormone, thyroxin, which performs important bodily functions, such as the regulation of body temperature, proper utilization of carbohydrates and fats, and production of protein. Since protein is an important nutrient for the production of keratin, inadequate protein supply in the body due to an underactive thyroid means that hair growth in the follicles is slow. In men especially, hair loss is one of the first signs of hypothyroidism.
A little farther up the follicle is the mysterious feature called the bulge. That's where follicle stem cells live. When they get the right set of chemical signals, these self-renewing cells divide. They don't divide like normal cells, in which both halves become new cells that keep splitting and developing. Only one half of the follicle stem cell does that. The other half becomes a new stem cell, and stays put for future regeneration.

Dietary supplements are not typically recommended.[30] There is only one small trial of saw palmetto which shows tentative benefit in those with mild to moderate androgenetic alopecia.[30] There is no evidence for biotin.[30] Evidence for most other produces is also insufficient.[37] There was no good evidence for gingko, aloe vera, ginseng, bergamot, hibiscus, or sorphora as of 2011.[37]


What to do: Like anemia, simple supplementation should help the problem. So can dietary changes. Find natural vitamin B in fish, meat, starchy vegetables, and non-citrus fruits. As always, eating a balanced diet plentiful in fruits and vegetables as well as lean protein and “good” fats such as avocado and nuts will be good for your hair and your overall health. 

What’s got less evidence supporting its efficacy are the hair-growth shampoos that claim to block DHT (like those sold by Hims in their Rx Hair Kit). Rieder is skeptical that you’re going to see any tangible benefits by rubbing DHT blockers into your scalp. “I find it very difficult to believe that something that’s applied to the scalp and rinsed off is going to have any appreciable effect.” All four doctors also shut down any suggestions that hair-growth supplements or vitamins, like biotin, could help promote hair growth or stop hair loss — though a couple hypothesized that vitamins or supplements could lead to hair regrowth if your hair loss was a result of a nutritional deficiency. But otherwise, if you’re dealing with regular old male-pattern baldness, “There is no such thing as a ‘hair vitamin,’” says McMichael.
Beware online stores selling Propecia without a prescription.Finasteride is FDA approved, but buying it online without a prescription can be illegal and dangerous. Prescription-free online stores have a reputation for selling placebos or dangerous replacements. We recommend speaking with a doctor about prescriptions or sticking to save over-the-counter treatments.
While natural hairpieces are available, many hair loss consumers have little idea what to look for when purchasing a hairpiece. Unfortunately, the hair loss industry includes some companies that may take advantage of hair loss sufferers. Research conducted by the American Hair Loss Association estimates that more than 70% of nonsurgical hair loss consumers are unhappy with the quality, service, and price provided by their hair replacement salons.

The psychology of hair thinning is a complex issue. Hair is considered an essential part of overall identity: especially for women, for whom it often represents femininity and attractiveness. Men typically associate a full head of hair with youth and vigor. Although they may be aware of pattern baldness in their family, many are uncomfortable talking about the issue. Hair thinning is therefore a sensitive issue for both sexes. For sufferers, it can represent a loss of control and feelings of isolation. People experiencing hair thinning often find themselves in a situation where their physical appearance is at odds with their own self-image and commonly worry that they appear older than they are or less attractive to others. Psychological problems due to baldness, if present, are typically most severe at the onset of symptoms.[11]
Beyond that, things get more controversial, with some doctors saying there's inadequate evidence for other treatments. Saxena thinks there is enough scientific evidence to support some of the alternatives and recommends them to patients. But they are not for women on tight budgets. There's Nutrafol, a "nutraceutical" that costs about $80 a month. Women can also get injections in the scalp of platelet-rich plasma made from their own blood. The first four treatments cost about $2,000 at Saxena's practice in Fort Washington or Lansdale. Maintenance injections, done every three to six months, cost $515 each. Women can also buy Theradome, a light-emitting helmet, for $895 online.  Saxena, who has hair loss herself, said she has had the injections and currently uses minoxidil, spironolactone, and Nutrafol.
Menopause is the time in a woman's life when menstrual periods permanently stop, also called the "change of life." Menopause symptoms include hot flashes, night sweats, irregular vaginal bleeding, vaginal dryness, painful intercourse, urinary incontinence, weight gain, and emotional symptoms such as mood swings. Treatment of menopausal symptoms varies, and should be discussed with your physician.

Pattern balding is most common among middle-aged men, but signs can actually begin as early as the mid-20s. Once the hair loss starts, it generally takes about 15-25 years for most men with this condition to lose most of their hair. In some cases though, the progression of the condition can be fast so that others are already completely bald in just five years.
One hair loss tablet that targets hormones is Propecia. This targets a specific androgenic hormone (male sex hormone) named dihydrotestosterone (DHT). DHT is present throughout the body, and prompts the growth of hair and spurs sexual development around puberty. However, in later years, it binds to hair follicles and causes them to shrink, occluding hair shafts and making healthy hair growth impossible.

"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.
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