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).


It’s also possible that some of Harklinikken’s users are women whose hair would have grown back even if they’d done nothing. Many women who arrive in a dermatologist’s office with prior diagnoses of female pattern hair loss actually have what’s called telogen effluvium. That’s a period of acute shedding of hair — meaning up to 60 percent of hair — three months after a triggering event like pregnancy, significant weight loss or starting or stopping hormone medications.

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.


Losing your hair in the typical male pattern (where your hairline starts receding before getting thinner at the crown and the temples) is very common. When these two areas meet, it leaves hair at the sides and the back – in a horseshoe pattern. Eventually some men may go completely bald, while others might keep their hair around the back and sides (although some choose to shave these areas off anyway ).
Trichotillomania, classified as an “impulse control disorder,” causes people to compulsively pull their hair out. “It’s sort of like a tic, the person is constantly playing and pulling their hair,” says Dr. Glashofer says. Unfortunately, this constant playing and pulling can actually strip your head of its natural protection: hair. Trichotillomania often begins before the age of 17 and is four times as common in women as in men.
Finasteride (Propecia): This medication is FDA approved for use in only men with androgenic hair loss. Finasteride is in a class of medications called 5-alpha reductase inhibitors. It helps reduce hair loss by blocking the action of natural hormones in scalp hair follicles. Propecia is a lower-dose version of a commercially available drug called Proscar that helps shrink enlarged prostates in middle-aged and older men. Women of child-bearing potential should avoid finasteride. Propecia 1 mg tablets are available by prescription and taken once daily. Propecia may grow and thicken hair to some extent for some people, but its main use is to keep (maintain) hair that's still there. Studies have shown that this medication works well in some types of hair loss, and patients should use it for about six to 12 months before full effects are determined. This medication does not "work" in days to weeks, and its onset of visible improvement tends to be gradual. It may be best for men who still have enough hair to retain but also can help some regrow hair. Possible but very unlikely side effects include impotence or a decreased sex drive (libido). Studies show that these side effects were possibly slightly more common than seen in the general population and are reversible when patients stop taking the drug. The cost is about $70-$100/month, and most health insurers do not reimburse for the expense.
The only nonchemical option offered up by the dermatologists I spoke with — short of a surgical hair transplant or platelet-rich plasma therapy, which is like Kim Kardashian’s vampire facial but for your scalp — was the laser comb. First cleared by the FDA in 2009, the HairMax LaserComb is a handheld laser device that is designed to promote hair growth. As the manufacturer explains in a letter to the FDA, “The device provides distributed laser light to the scalp while the comb teeth simultaneously part the user’s hair to ensure the laser light reaches the user’s scalp,” which, in turn, stimulates the hair follicles.

Losing your hair in the typical male pattern (where your hairline starts receding before getting thinner at the crown and the temples) is very common. When these two areas meet, it leaves hair at the sides and the back – in a horseshoe pattern. Eventually some men may go completely bald, while others might keep their hair around the back and sides (although some choose to shave these areas off anyway ).
There’s no cure for baldness, but there are ways to hold on to what you've got. The six dermatologists and the clinical studies point to three methods: minoxidil, laser treatments, and prescription finasteride. The key is finding the combination and hair loss regimen that works for you. A doctor is your best bet for that kind of guidance — but we found a few trustworthy products that will work for most people.
Hair loss doesn't happen fast, our strands grow in cycles, which means it can take up to 3 months for hair to fall out after a trigger has caused it. "If you notice excessive daily hair shedding for longer than 3 months, see a trichologist or your GP, there could be an underlying factor that needs to be addressed", Anabel advises. "Very importantly, try not to panic. Telogen effluvium (excessive shedding) is almost always self-eliminating and hair will start to grow back as usual once any internal imbalance is put right".
There can be several factors behind hair loss such as environmental effects, aging, too much stress, excessive smoking, nutritional deficiencies, hormonal imbalance, genetic factors, scalp infections, use of wrong or chemically enriched hair products, certain medicines and medical conditions like thyroid disorder, autoimmune diseases, polycystic ovary syndrome (PCOS), iron-deficiency anemia, and chronic illnesses.
The hormonal process of testosterone converting to DHT, which then harms hair follicles, happens in both men and women. Under normal conditions, women have a minute fraction of the level of testosterone that men have, but even a lower level can cause DHT- triggered hair loss in women. And certainly when those levels rise, DHT is even more of a problem. Those levels can rise and still be within what doctors consider “normal” on a blood test, even though they are high enough to cause a problem. The levels may not rise at all and still be a problem if you have the kind of body chemistry that is overly sensitive to even its regular levels of chemicals, including hormones.

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Being stressed affects nearly every aspect of our life—even your strands. “Stress affects hormonal levels, specifically cortisol, which then causes hair loss, which only adds more stress to an already stressful situation,” says Penny James, IAT-certified trichologist and owner of Penny James Salon in New York City. “The positive side to all this is once you reduce the stress in your life, your hair will grow back to normal.” She recommends incorporating activities such as yoga or meditation to reduce stress levels. Here’s how to repair damaged hair with items you already own.
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.
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.
Surgical options, such as follicle transplants, scalp flaps, and hair loss reduction, are available. These procedures are generally chosen by those who are self-conscious about their hair loss, but they are expensive and painful, with a risk of infection and scarring. Once surgery has occurred, six to eight months are needed before the quality of new hair can be assessed.

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.


^ Jump up to: a b Blumeyer, A; Tosti, A; Messenger, A; Reygagne, P; Del Marmol, V; Spuls, PI; Trakatelli, M; Finner, A; Kiesewetter, F; Trüeb, R; Rzany, B; Blume-Peytavi, U; European Dermatology Forum, (EDF) (October 2011). "Evidence-based (S3) guideline for the treatment of androgenetic alopecia in women and in men". Journal of the German Society of Dermatology. 9 Suppl 6: S1–57. doi:10.1111/j.1610-0379.2011.07802.x. PMID 21980982.

A substantially blemished face, back and limbs could point to cystic acne. The most severe form of the condition, cystic acne, arises from the same hormonal imbalances that cause hair loss and is associated with dihydrotestosterone production.[9] Seborrheic dermatitis, a condition in which an excessive amount of sebum is produced and builds up on the scalp (looking like an adult cradle cap), is also a symptom of hormonal imbalances, as is an excessively oily or dry scalp. Both can cause hair thinning.
Testosterone replacement is becoming popular for men. Cotsarelis warns that this may accelerate hair loss. Propecia might help -- but because it prevents testosterone breakdown, it might affect the dose of male hormone replacement therapy. Cotsarelis warns men taking both Propecia and testosterone replacement to make sure their doctor carefully monitors their testosterone levels.
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. 

Medications and vitamins: Cancer chemotherapy, which attacks hair follicles in its attempt to kill all fast-growing cells around the body, is a well-known reason for hair loss. Other medications’ side effects include hair shedding as well, such as some that treat high blood pressure and gout (a painful joint condition caused by a buildup of uric acid). Excessive levels of vitamin A also contribute.
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. 

Again, as we've mentioned at the start, these treatments and cures are dependent on the cause and type of hair loss. While massage oils and a hair spa treatment can work on hair loss in men caused by a skin or scalp infection, these may not work for cases of pattern baldness that are hereditary or caused by DHT associated with male hormones. Even medications like minodixil and finasteride cannot offer a permanent cure. In cases of permanent hair loss like pattern baldness, sometimes the best type of cure is simply management of your condition.
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.
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.
While thinning generally worsens after menopause, doctors said hormone treatments typically do not improve hair growth. Minoxidil lotion or foam, which can be purchased over the counter, is the first line of treatment. About half of women who use it have not lost more hair a year later, Cotsarelis said. Spironolactone, a blood-pressure drug, can also help, doctors said. Some may also try finasteride — approved to treat baldness in men — off-label. The evidence that it works in women is weak, Patel said.
Minoxidil (Rogaine). Minoxidil is one of the most common and popular forms of medication for hair loss, particularly pattern baldness, but also generally used in cases of alopecia areata. It is an over-the-counter drug that comes in either liquid or foam form and is applied on the scalp, particularly on the bald patches, to promote hair growth and stop further hair loss.
Hair transplantation is usually carried out under local anaesthetic. A surgeon will move healthy hair from the back and sides of the head to areas of thinning. The procedure can take between four and eight hours, and additional sessions can be carried out to make hair even thicker. Transplanted hair falls out within a few weeks, but regrows permanently within months. Hair transplants, takes tiny plugs of skin, each which contains a few hairs, and implants the plugs into bald sections. The plugs are generally taken from the back or sides of the scalp. Several transplant sessions may be necessary.[33]
Cyclosporine is used to suppress the immune system in psoriasis and other immune-mediated skin conditions. Although cyclosporine helps hair regrowth in alopecia areata, the risks of using it may outweigh the benefits, as oral cyclosporine can suppress the immune system and increase the risk of serious infection. Other common adverse effects are hypertension and renal impairment, but these are usually reversible.
To us, that meant any product with zero proven ingredients, case studies, or FDA clearance — which shrunk our list by a whopping 180 contenders. That’s right, there are only three treatments that have actually been cleared by the FDA and supported with clinical studies: finasteride (commonly marketed as Propecia), minoxidil, and laser treatments. And, since finasteride is prescription-only, it left us with two.

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.


Retin-A, or topical tretinoin, is sometimes used as a combination therapy with minoxidil for androgenic alopecia. It’s important to use this type of medication under the guidance of your doctor. In some circumstances, tretinoin can actually cause hair loss. Some people who have used it at home report that topical retinol creams, serums, and lotions may make hair loss worse.
"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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