The pull test helps to evaluate diffuse scalp hair loss. Gentle traction is exerted on a group of hairs (about 40–60) on three different areas of the scalp. The number of extracted hairs is counted and examined under a microscope. Normally, fewer than three hairs per area should come out with each pull. If more than ten hairs are obtained, the pull test is considered positive.[27]
If you do decide to start treatment to save your hair, a good place to start is with minoxidil, more commonly known as Rogaine. Don’t expect this hair-loss treatment to create luscious locks; minoxidil is better at slowing down or preventing more loss rather than promoting hair growth. But, according to Dr. Amy McMichael, professor and chair of Wake Forest Baptist Medical Center’s Department of Dermatology, it is effective “if used as recommended, with evidence of improvement seen around six to nine months.” Simply massage the foam or solution into your scalp once or twice daily, and for best results, use a formula with 5 percent concentration.
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.
The HairMax Ultima 12 LaserComb ($395) makes for a great addition to any hair loss regimen — provided you can afford it. Dr. Wolfeld notes that it’s a popular option in his practice. “Some people like the action of combing something through their hair,” he says. “They find that to be a little bit easier to do as part of their routine in the morning.” Dr. Khadavi also recommends using a laser treatment of some kind in conjunction with other treatments. “Lasers do help in stimulating the hair into the growth phase. We don’t know the exact mechanism of how it works, but it definitely helps.”
Finasteride is the active ingredient in the men’s hair-loss treatment Propecia, which has been available in Australia since the late 1990s. One tablet a day will arrest further hair loss in over 95 per cent of men and stimulate partial hair regrowth in two thirds of men. Regrowth may be apparent at six months, but can take up to two years to be visible. 

Hair practices. Our hair is one of the strongest and most elastic parts of our body. One strand of a healthy hair can be twice as strong as a copper wire of similar thickness. However, not all hair types are equal. Unfortunately, hair care practices and styling can lead to scalp damage and unnecessary pressure on the hair follicles, resulting in hair breakage and loss.
Harsh hairstyles or treatments: Hairstyles that consistently use rubber bands, rollers or barrettes, or pull hair into tight styles such as cornrows, can inflame and scar hair follicles. So can incorrectly used chemical products such as dyes, bleaches, straighteners or permanent wave solutions. Depending on the degree of damage, resulting hair loss can be permanent.
Vigorous styling and hair treatments over the years can cause your hair to fall out. Examples of extreme styling include tight braids, hair weaves or corn rows as well as chemical relaxers to straighten your hair, hot-oil treatments or any kind of harsh chemical or high heat. Because these practices can actually affect the hair root, your hair might not grow back.

Get the right style. For men who are suffering from pattern baldness, the easiest way to manage hair loss is to ask your barber for a style that will draw less attention to the thinning hair. Shorter hairstyles can reduce the impression of thinning hair, while a longer one can emphasize it. Others often make the mistake of growing their hair on the sides of their head as a way to cover up the thinning at the crown. This is wrong - it only calls attention to the bald spot. Instead, a clean cut on both sides will be better. Avoid also combing over some strands of hair the bald patch as an attempt to cover-up - it only draws attention to it.


There are now clinical trials taking place around the country to test the safety and efficacy of the drug for hair loss conditions. One such study lasting 3 months gave Tofacitinib to 66 people with alopecia areata (an immune-system condition that causes hair to fall out in patches). Half of the people regrew some hair, and one-third had more than 50 percent of the hair on their scalp grow back, according to the 2016 study, published in the journal JCI Insight.
3. Hair fibers. The best (and easiest) way to hide a widening part or sparse patch is with hair fibers. They’re tiny, charged fibers that adhere to your scalp (until your next shampoo). Toppik Hair Building Fibers ($25) come in a range of colors so you can easily find one that matches your own hair. (In a pinch, you can also brush a powdered eye shadow that matches your hair color along your part.)
Enriched with the goodness of natural ingredients such as henna, brahmi, baheda, fenugreek, jojoba oil, amla, bhringaraj, olive oil, wheat germ oil, sesame oil, this nourishing hair oil helps fight and prevent hair fall. It encourages new hair growth by stimulating the follicles, while also strengthening the hair, and reducing thinning with regular use. While on the pricier side, this oil is worth the money because of how effective it is.
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.
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.
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.
While there are a number of treatments available for male pattern baldness, there is no cure. Treatments include minoxidil, and finasteride. Minoxidil lotion is available over the counter from pharmacies, but finasteride tablets are only available on prescription from your doctor. Cosmetic options include camouflage sprays, wigs and hair transplant surgery.
Women with androgenic alopecia may consider trying prescription ketoconazole at a strength of 2 percent. This drug comes in the form of a shampoo and also goes by the name Nizoral. It’s an antifungal agent and may help reduce the body’s production of testosterone and other androgens that lead to hair loss. You can also find 1 percent strength at your local pharmacy, but it may not be as effective.
“While nutritious eating isn’t going to bring your hair back by any means, eating plenty of protein-rich foods and healthy fats can make the hair that you still have look thicker and shinier.” Skimping on the B vitamins in particular can interfere with the formation of hair cells and, therefore, hair growth. The best sources of Bs are protein-packed foods like chicken, fish, eggs, and pork, as well as leafy greens such as spinach. (These foods are also good for melting belly fat, so it’s a win win).
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.
There’s also a women’s version (Women’s Rogaine Foam) — but a three-month supply costs $22 more online. The only difference between the two products are the instructions; women are instructed to apply once a day instead of twice. If you’re a woman who doesn’t feel like paying extra for marketing, the men’s product will suffice. A cheaper generic version is Kirkland Signature Minoxidil Foam, but with a longer history on the market and more customer testimonials, Rogaine is our first choice.
Jenn Sinrich is an experienced digital and social editor in New York City. She's written for several publications including SELF, Women's Health, Fitness, Parents, American Baby, Ladies' Home Journal and more.She covers various topics from health, fitness and food to pregnancy and parenting. In addition to writing, Jenn also volunteers with Ed2010, serving as the deputy director to Ed's Buddy System, a program that pairs recent graduates with young editors to give them a guide to the publishing industry and to navigating New York.When she's not busy writing, editing or reading, she's enjoying and discovering the city she's always dreamed of living in with her loving fiancé, Dan, and two feline friends, Janis and Jimi.
Proper levels of this promote optimal hair growth and longevity, leading to hair that is healthy, lustrous and more abundant. According to a paper produced by the Ohio State University, found that it is “critically important in the development and maintenance of multiple epithelial tissues, including skin, hair, and sebaceous glands.”  Getting the proper amount of Vitamin A can directly stimulate hair growth in both men and women.
Very little of the active ingredient, minoxidil, is absorbed into the circulation and therefore general side effects are not expected. You should stop using Regaine and see a doctor if hypotension (low blood pressure) is detected or if you experience chest pain, rapid heartbeat, faintness or dizziness, sudden unexplained weight gain, swollen hands or feet or persistent redness.
Contact immunotherapy. Another drug that can be administered for cases of alopecia areata is contact immunotherapy and is recommended for severe cases. Diphenylcyclopropenon (DPCP) is applied on the scalp every week, and the dosage of the drug is increased over time until a mild allergic reaction is observed, which signals that the drug is taking effect. Regrowth may be observed within three months from the beginning of treatment.
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. 

The most common form of hair loss is androgenetic alopecia, or, in other words, male or female pattern baldness or hair loss. Androgenetic alopecia is genetic and affects an estimated 50 million men and 30 million women in the United States. Among white women in the U.S., an average of 19% are affected by female pattern hair loss, but that percentage increases with age. The prevalence is nearly doubled in Australia at 32% and much lower in Korea and China at < 6%. As of 2015, no studies had been done on the prevalence of female pattern hair loss in Brazil or Africa.

In-office laser light treatments or at-home handheld devices, such as the HairMax LaserComb, supposedly grow new hair by stimulating blood flow to the area (think: an amped-up version of a scalp-stimulating shampoo). Just don’t expect the device to make your noggin go from looking like George Costanza’s to Jerry Seinfeld’s. “These lasers won’t grow any new hair. If anything, they may just help you hang on to some of the hair that you already have a bit longer,” says Dr. Joyce.
“For hair loss, I routinely recommend multiple vitamins, and especially evening primrose oil. If there’s any sex pattern to it — if a woman is losing hair in partly a male pattern – -then, the problem is there is excessive conversion of testosterone to dihydrotestosterone (DHT) at the level of the hair follicle. Evening primrose oil is an inhibitor of that conversion. So almost anybody with hair loss probably will benefit from evening primrose oil.”
You might think, "It's just hair", but think about this: What would you do if you wake up one day without a single strand of hair on your head? However, as we've mentioned, hair loss is a natural physiological process. In the hair growth cycle, old hair has to be shed in order for new hair to grow. As we age, our body's capacity to produce hair also slows down, similar to when our bones stop growing at a certain point in our lives.
The HairMax Ultima 12 LaserComb ($395) makes for a great addition to any hair loss regimen — provided you can afford it. Dr. Wolfeld notes that it’s a popular option in his practice. “Some people like the action of combing something through their hair,” he says. “They find that to be a little bit easier to do as part of their routine in the morning.” Dr. Khadavi also recommends using a laser treatment of some kind in conjunction with other treatments. “Lasers do help in stimulating the hair into the growth phase. We don’t know the exact mechanism of how it works, but it definitely helps.”
It is likely that several genes determine susceptibility to baldness. Some of these genes come from your mother’s side and some from your father’s side of the family. Identical twins lose hair at the same age, at the same rate and in the same pattern. This indicates that genetic factors are more important than environmental factors in causing hair loss.
There are many hair growth supplements in the market that help thicken hair and curb hair fall. Even certain vitamin supplements go a long way in improving the health and volume of your hair. However, do not start taking any supplements without consulting a healthcare professional first. Minoxidil (Rogaine) is one of the most effective, FDA-approved and commonly prescribed medications from doctors worldwide for arresting hair fall and treating alopecia-related problems.
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]
The general medical consensus around laser treatments — caps and combs alike — is that low-level laser light therapy stimulates the cells within the hair follicle. These devices may also increase cell metabolism to promote thicker and more durable hair shafts, something that neither minoxidil or finasteride can do. To use the HairMax Ultima, all you have to do is glide the device over your scalp slowly. Treatments should take about eight minutes, and you should do it three days per week for the best results.
According to practitioners of traditional Chinese medicine, hair health is tied to two things: kidney energy and the blood, which nourish the hair. The solution: acupuncture and Chinese herbs. While there isn't a lot of hard science to back this up, Maureen Conant, a TCM practitioner at Full Bloom Acupuncture in Seattle, says that she's seen women's hair stop falling out and then gradually regenerate after a few months of weekly treatments.
Avacor Physicians Formulation® for Men, Bosley Professional Strength Hair Regrowth Treatment for Men, Follinox-5 Hair Loss Treatment, Kirkland Minoxidil Extra Strength for Men 5% Topical Solution, Leminox for Men, Lipogaine for Men, Lipogaine for Men Sensitive, Men’s Rogaine Extra Strength, Nioxin Minoxidil 5% Hair Regrowth Treatment Extra Strength for Men, Perfect Hair 5% Minoxidil for Men, REDKEN Cerafil Retaliate 5% Hair Regrowth Treatment for Men
There is no hard and fast answer. With Regaine Extra Strength results may be seen after 8 weeks. Clinical studies have shown that for Regaine Regular Strength or Regaine Gel for men regrowth can occur as early as 16 weeks. But remember that everyone is different so you need to be patient. Studies suggest that Regaine should be tried for 6-12 months before deciding whether to continue.
“There’s people selling pills and creams and lotions and whatever else, and sometimes you can’t even trust what ingredients they have in there,” he warned us when we spoke to him over the phone. Key takeaway: The hair loss industry is crazy dishonest, so we eliminated any treatments (especially homeopathic methods) that aren’t based in concrete, peer-reviewed science.

This is a short-term cure, applied while waiting for hair to grow, and therefore recommended for those with a mild to medium case of hair loss. In addition to being non-invasive, hair concealers and hair fibers are instant and affordable. Like wigs and hairpieces, they are used to effectively cover up balding spots while not getting in the way of growing hair. Compared to wigs, however, they are more natural looking and blend well with your natural hair, therefore drawing less attention when you're out in public.
Egg mask. Eggs are one of the riches sources of protein, which is the building block of keratin, as well as other minerals like zinc, iron, selenium, phosphorous and iodine. Mix an egg white with a tablespoon of olive oil and honey to make a paste. Apply it on your hair and leave on for 20 minutes. Rinse and shampoo using cold water. You can apply this egg mask on your hair once a week.

Blow dryers, flat irons, and other devices: Frequent use of a blow dryer tends to damage hair. The high heat from a blow dryer can boil the water in the hair shaft leaving the hair brittle and prone to breakage. Dermatologists recommend that you allow your hair to air dry. Then style your hair when it is dry. Dermatologists also recommend limiting the use of flat irons (these straighten hair by using high heat) and curling irons.


My name is Marsha… I have hypothyroidism… Type 2 diabetic. I’m currently taking Levothyroxine and Metformin… I am so depressed. My hair is brittle everytime I brush or comb it comes out in clumps. It’s very thin it literally feels like a Brillo pad no matter how much I moisturize it comes falling out I can just brush my hand across it and the hair just falls out like snow. I just went to the doctor last week and he says everything is normal and He suggests that I see a dermatologist is the dermatologist the person I should see? Or should I see an endocrinologist. I’m at my wit’s end I’m tired of searching for the right wig to wear nothing is more appealing than my own hair and a long to get it back. But I need to find the right doctor that can perform the right test. My doctor doesn’t seem to be helping me I don’t even know where to start. I don’t go out anymore… I’m just home hibernating period. A woman’s hair has a lot to do with the self esteem in mind is very low at this time. My whole wardrobe consist of every color scarf and hat you can imagine… Where should I start what doctor should I see first?
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.
Post surgery care is important if you've undergone a hair transplant or surgery. Expect some swelling of the face and on the scalp a couple of days after the procedure. To fast track hair growth, you may be asked to use Minoxidil or Finasteride. Saline is applied on the grafts for a few days, while you will be prescribed to use a diluted shampoo that is softer and less harsh on the scalp. Hair growth in the transplanted areas becomes visible in three - six months.
You lose up to 100 hairs from your scalp every day. That's normal, and in most people, those hairs grow back. But many men -- and some women -- lose hair as they grow older. You can also lose your hair if you have certain diseases, such as thyroid problems, diabetes, or lupus. If you take certain medicines or have chemotherapy for cancer, you may also lose your hair. Other causes are stress, a low protein diet, a family history, or poor nutrition.

Hair changes about as fast as grass grows, which is to say it’s extraordinarily slow and not visible to anyone checking impatiently in the mirror every day. But during regular follow-up appointments, Harklinikken uses high-tech equipment to photograph and magnify the scalp and count new hairs and active follicles, which motivates users to adhere to the regimen. Too many people give up on treatments like Rogaine and low-level-light devices before they’ve had a chance to work, Dr. Senna said.
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’.

Men may also experience some sexual and emotional side effects while taking it: In a study published in the June 2011 issue of The Journal of Sexual Medicine, Dr. Michael Irwig of George Washington University found as many as 92 percent of test subjects reporting problems in the bedroom. The study also reported that “the mean duration of finasteride use was 28 months and the mean duration of persistent sexual side effects was 40 months,” meaning that side effects lingered long after subjects stopped taking the pill.


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’.

Just like with your hair color and hairline, your genes often determine whether you’ll experience thinning hair. It’s a myth that you inherit your hair loss gene from your mother’s father, says Dr. Zeichner. “There are many genetic causes. Women tend to develop a widening of their part line and thinning of hair on the top of the head, but typically do not fully lose their hair in the way that men do.”   You can help stem the tide of hair loss by reducing stress, avoiding very tight hairstyles (ponytails, braiding) that contribute to hair loss, and eating a nutrient-rich diet, but once the hair is gone, your best bet may be camouflage. “In situations where there is no treatment, women can hide bald or thinning spots by changing their hairstyle or wearing hats, headbands, and scarves,” says Ramon Padilla, founder of EverTrue, a Microblading Salon in Manhattan. “But a more long-term solution is permanent makeup, such as our Hairline Rescue treatment, where we re-create the look of hair strands stroke-by-stroke.” The Hairline Rescue treatment is like a semi-permanent tattoo that lasts about 18 months.

However, researchers are still working to determine the best dose needed, whether the results are lasting, and whether they can develop a topical form of the drug, Day said. She added that patients should be aware that Tofacitinib has side effects. It's already associated with an increased risk of serious infections, as well as stomach and intestinal tears, according to Pfizer, the manufacturer.
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