Central centrifugal cicatricial (scarring) alopecia: This type of hair loss occurs most often in women of African descent. It begins in the center of the scalp. As it progresses, the hair loss radiates out from the center of the scalp. The affected scalp becomes smooth and shiny. The hair loss can be very slow or rapid. When hair loss occurs quickly, the person may have tingling, burning, pain, or itching on the scalp. Treatment may help the hair re-grow if scarring has not occurred.
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.

See a doctor. While it may be easy to treat hair loss that's caused by stress or other physical or emotional shock, other types, especially those caused by medical conditions, require expert attention. Do not self-medicate. A medical test is necessary to determine the real cause of your hair loss. A medical diagnosis is important in order to rule out other factors that might be the cause of your hair loss. On the surface, it's easy to attribute hair loss to stress or the lack of sleep, but it is highly possible that the hair loss may be caused by an unknown or undetected condition related to hormones or genetics. With the right diagnosis, you'll be able to get the right medication and course of treatment.


For those concerned that the existing treatments lack a certain sci-fi quality, behold the Laser Comb. The Laser Comb recently became only the third hair loss treatment to receive FDA approval. And it is the first that doesn’t use drugs or surgery. By stimulating follicles with a low-level laser, the hand-held device was shown in test trials to increase hair volume in a majority of patients.
Female-pattern hair loss, called androgenic or androgenetic alopecia, is basically the female version of male pattern baldness. “If you come from a family where women started to have hair loss at a certain age, then you might be more prone to it,” says Dr. Glashofer. Unlike men, women don't tend to have a receding hairline, instead their part may widen and they may have noticeable thinning of hair.
Take in natural supplements. If you aren't getting enough nutrients from the foods you eat, you can also try taking natural supplements to address your nutritional deficiencies. Multivitamins that especially contain vitamins A, C, and the B-complex vitamins can be taken once a day. Fish oil capsules that contain omega-3 fatty acids are also recommended.
When hair loss is related to a medication, stopping the drug usually prevents further hair loss, and the hair will eventually grow back. Hair also tends to grow back after most illnesses, radiation therapy, or chemotherapy. Wearing a wig or hat can hide the hair loss until the hair returns. Hair transplants are a more permanent hair-replacement solution.
Androgenic alopecia is a genetic condition that can affect both men and women. Men with this condition, called male pattern baldness, can begin suffering hair loss as early as their teens or early 20s. It's characterized by a receding hairline and gradual disappearance of hair from the crown and frontal scalp. Women with this condition, called female pattern baldness, don't experience noticeable thinning until their 40s or later. Women experience a general thinning over the entire scalp, with the most extensive hair loss at the crown.
Consider other factors besides color. Color is important - your wig or hair piece should match your natural hair to look natural. However, consider also texture. You wig should feel like real hair; it should have a smooth and silky feel. For those that need full coverage, choose a wig that bounces to give the illusion of volume. A wig that has a lacing that fits your natural hair also helps in making sure that you have a more natural looking hairline.

DR. WRIGHT: If stomach acid is low, protein isn’t efficiently digested – and hair and nails are made up of… protein! If we are deficient in protein, our bodies know that we can live without hair or nail proteins, but we can’t survive without heart muscle proteins or other important body proteins. So if we are short in supply of protein, the hair or nails are the first to go.
Polycystic ovary syndrome (PCOS) is another imbalance in male and female sex hormones. An excess of androgens can lead to ovarian cysts, weight gain, a higher risk of diabetes, changes in your menstrual period, infertility, as well as hair thinning. Because male hormones are overrepresented in PCOS, women may also experience more hair on the face and body.

Our other recommendation is the HairMax Ultima 12 LaserComb. The comb uses low-level lasers to stimulate hair follicles and modulate dihydrotestosterone (DHT) — a hormone that causes the most common type of hair loss. While it sounds like something from a sci-fi movie, the treatment works, and the dermatologists we consulted reported that their patients saw thicker and longer hair when combined with our top pick. The only catch: The comb isn’t as effective as minoxidil treatments, and at nearly $400, it’s a much bigger investment. Still, it’s the best option if you’re looking for a non-invasive, non-chemical treatment.

However, the high incidence of androgenic alopecia is caused by the male hormones. Testosterone in the scalp is converted into dihydrotestosterone (DHT) that causes the follicles to shrink in size, therefore inhibiting the growth of hair, which eventually leads to baldness. However, hair follicles on the sides and back of the head do not have as much DHT compared to the top, hence why hair loss is concentrated on the crown of the head. Interestingly, DHT is known to help in the growth of the beard and hair on the chest, a reason why most bald men have hairy chests and grow their beards much faster.
Consider other factors besides color. Color is important - your wig or hair piece should match your natural hair to look natural. However, consider also texture. You wig should feel like real hair; it should have a smooth and silky feel. For those that need full coverage, choose a wig that bounces to give the illusion of volume. A wig that has a lacing that fits your natural hair also helps in making sure that you have a more natural looking hairline. 

Localized or diffuse hair loss may also occur in cicatricial alopecia (lupus erythematosus, lichen plano pilaris, folliculitis decalvans, central centrifugal cicatricial alopecia, postmenopausal frontal fibrosing alopecia, etc.). Tumours and skin outgrowths also induce localized baldness (sebaceous nevus, basal cell carcinoma, squamous cell carcinoma).
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.)
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.
Hair loss is not a hopeless condition. While there are certainly cases of permanent hair loss in men, there are still cases when it's only temporary and therefore can be treated, controlled and prevented. There are treatments and cures available, and many of these, especially those for temporary cases, can be as simple as lifestyle changes -- eating the right foods, learning to manage stress properly, and doing away with unhealthy, nasty habits that can aggravate the condition.
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.
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?
Has your doctor told you that your blood sugar levels are too high? Low thyroid is one potential cause of diabetes, and it may be your red flag to have your thyroid re-evaluated. When my doctor once mentioned that my blood sugar was at the high pre-diabetic level and suggested starting diabetes medication, I asked for 6 months to try replacing my regular multivitamin with this one Designs for Health Metabolic Synergy (created by a nationally prominent doctor specializing in blood sugar) and by my follow-up appointment my blood sugar was completely normal and diabetes medication was not needed (what a relief).
The views expressed in this article intend to highlight alternative studies and induce conversation. They are the views of the author and do not necessarily represent the views of hims, and are for informational purposes only, even if and to the extent that this article features the advice of physicians and medical practitioners. This article is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment, and should never be relied upon for specific medical advice.
Some hair loss can also result from the psychological condition trichotillomania. “People with this condition compulsively pull out their hair when they are stressed or even when they are concentrating, e.g. studying hard,” says Burg. “Sometimes the individual doesn’t know they are pulling their hair out, doing the activity absent-mindedly, and only notice once the bald patches appear.” Over time the hair follicles can become so damaged that they die and leave permanent bald patches. Find out why you shouldn’t pull out gray hairs either.
Has your doctor told you that your blood sugar levels are too high? Low thyroid is one potential cause of diabetes, and it may be your red flag to have your thyroid re-evaluated. When my doctor once mentioned that my blood sugar was at the high pre-diabetic level and suggested starting diabetes medication, I asked for 6 months to try replacing my regular multivitamin with this one Designs for Health Metabolic Synergy (created by a nationally prominent doctor specializing in blood sugar) and by my follow-up appointment my blood sugar was completely normal and diabetes medication was not needed (what a relief). 

A good daily multivitamin containing zinc, vitamin B, folate, iron, and calcium is a reasonable choice, although there is no good evidence that vitamins have any meaningful benefit in alopecia. Newer studies suggest that vitamin D may be somewhat helpful and worth considering. Specific vitamin and mineral deficiencies like iron or vitamin B12 may be diagnosed by blood tests and treated.
Propecia (finasteride) is a 5 alpha-reductase inhibitor. It works by inhibiting the conversion of testosterone into 5 alpha-dihydrotestosterone (DHT), a hormone that plays an important role in hair loss. Propecia is a prescription medicine and is only approved for use in men. There are other 5 alpha-reductase inhibitors on the market but Propecia is the only one approved for androgenetic alopecia.
Two of the most common LLLT products in the market are the Hairmax Lasercomb and the Capillus 272. The Lasercomb is a hand-held device that is used to comb the hair for 10-15 minutes every treatment, and takes about eight weeks of use in order to see a noticeable improvement in the thickness and quality of the hair. The Capillus is a laser cap that must be worn, and is more convenient because this can be used at home or even out in public (it can be worn underneath a cap or a turban).
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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.
The trick about all of these hair-loss products and treatments is that they’ll stop working as soon as you stop using them. “They have to be ready for a lifetime commitment,” says Rieder. But, just like brushing your teeth, as long you keep on keeping on with the scientifically proven preventative treatments, those hairs on your head should be just fine.
When women have a hormonal disorder that causes high levels of testosterone, including polycystic ovary syndrome (PCOS), they may experience thinning of hair on the scalp. Often these conditions are also associated with acne, irregular periods, and hair growth in areas typically seen in men, says Joshua Zeichner, MD, director of cosmetic and clinical research in dermatology at Mount Sinai Hospital in New York City. “Over-the-counter supplements, such as Nutrafol, can help provide the follicles with the necessary building blocks for healthy hair production,” he says. These are other sneaky reasons your hair is thinning.
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.)
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 

Learn to get used to it. Men with balding hair would like to wear caps as a way to mask or cover-up their thinning hair. But while this is understandable, wearing a cap will not make the issue go away. Rather, by teaching oneself to get used to your new look, the easier it will be to accept and the less awkward you'd feel if you're out in public. Wear a hat only when necessary, that is, if you need scalp protection.
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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.
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.

"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."


A key aspect of hair loss with age is the aging of the hair follicle.[43] Ordinarily, hair follicle renewal is maintained by the stem cells associated with each follicle. Aging of the hair follicle appears to be primed by a sustained cellular response to the DNA damage that accumulates in renewing stem cells during aging.[44] This damage response involves the proteolysis of type XVII collagen by neutrophil elastase in response to the DNA damage in the hair follicle stem cells. Proteolysis of collagen leads to elimination of the damaged cells and then to terminal hair follicle miniaturization.
Do not lose sleep over it. The more one obsesses over the loss of hair, the more depressed one can get. This can lead to unhealthy habits that can only worsen or aggravate hair loss, such as consuming too much sugar or sleeping less, which can contribute to increased stress and physiological trauma to the body. Proper management of the depression that comes with hair loss is important. Having a strong support group that one connects with and shares feelings and advice is a big help. It's also a big boost if one can learn how to make the most of their appearance to divert attention from their head by playing up other features of their body, such as wearing make-up or putting on a statement jewelry or a striking piece of clothing.

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.


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.
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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