Low ferritin (the stored form of iron) is one of the most common causes of hair loss in women. Given low ferritin is also a common problem for hypothyroid people, it is important to have iron testing including ferritin especially if you are experiencing hair loss. It is not enough to be told by your doctor that your iron levels are ‘normal’. Ferritin levels are not always tested. Get a copy of your lab results and be sure ferritin has been specifically tested. Even if ferritin is within the ‘normal’ range that doesn’t make it ‘optimal’.
Finasteride and minoxidil (for men) and minoxidil (for women) have the best level of evidence for medicines used to treat inherited hair loss.footnote 1, footnote 2 How well finasteride or minoxidil works depends on your age and the location of the hair loss. These medicines don't work for everyone, and you should not expect to regrow a full head of hair.
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.
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.
Certain other classes of medication may also promote hair loss. More common among them are certain blood thinners and the blood-pressure drugs known as beta-blockers. Other drugs that might cause hair loss include methotrexate (used to treat rheumatic conditions and some skin conditions), lithium (for bipolar disorder), nonsteroidal anti-inflammatory drugs (NSAIDs) including ibuprofen, and possibly antidepressants.
Sex hormone testing, especially for women and men with hair loss, should include DHT (DiHydroxy Testosterone). DHT is a derivative of the male hormone testosterone. In women, perimenopause and menopause marks a drop in estrogen which leaves hair particularly vulnerable to DHT. Women with PCOS struggling with hirsutism (excessive body hair in women in areas where men typically grown hair including the fat, check, and back ) and male-pattern hair loss should be sure testosterone and DHT are part of their lab testing too. The American Hair Loss Association describes DHT as “the enemy of hair follicles on your head”:
I stumbled upon this recent study with the title Hair Follicle Characteristics As Early Marker of Type 2 Diabetes. Now that’s a warning bell, if I’ve ever heard one, to get focused on lowering daily sugar consumption and eliminating those blood sugar swings. You know those highs you get when you eat high carb, high sugar and then come crashing down? Yes, those.
Rub the gel-like sap/juice of the aloe vera leaf directly on your scalp. Leave it on for a few hours and then rinse with lukewarm water. Do this three to four times a week. You can also mix a tablespoon of aloe vera gel with wheat grass juice to boost hair growth. Wheatgrass is also rich in protein, vitamins C and E and other minerals. Drink the wheatgrass juice mixed with aloe vera extract for two weeks to stop hair breakage and minimize hair fall.
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.
Hair-fiber powders: Colored, powdery fiber sprinkles are commercially available and may work to camouflage balding areas. These colored sprinkles have special properties that help them attach to hair and give a fuller appearance. Toppik is one manufacturer of these products and can be found online. These cosmetic products are available without a prescription, are fairly inexpensive ($20-$40 range), and quite safe with minimal risk. Often these may be used in addition to medical treatments like Rogaine, Propecia, and hair transplants, and they are a great temporary measure to tide one over for special occasions.
As with transplants, the word toupee conjures an outdated and disagreeable image. The 70s-style rugs have mostly been traded in for spiffier "hair replacement systems." But the basic concept -- a foreign object atop your head -- can only evolve so far. Of course, the effectiveness of hairpieces is tough to evaluate. You may spot an awful one now and then, but the ones you do spot are just the awful ones. Who knows how many masterpieces slip undetected under the radar?