Collagen is the most abundant protein in your body found in your skin, hair, bones, and tendons. Our body produces less and less of it as we age. I’ve long read about the benefits, including improved skin and nails and even pain reduction, of replenishing our depleting collagen stores with a form easily assimilated by the human body including hydrolyzed collagen and gelatin. I became particularly interested in collagen for hair loss when I read about a study published in Science in 2016. It all started with investigating the hair follicle stem cells of mice where researchers discovered that age-related DNA damage triggers the destruction of a protein called Collagen 17A1. The hair follicles of older people then convert themselves into skin cells, and over time baldness ensues. Think of the image of each hair follicle on your head disappearing leaving behind bare skin one at a time and on and on. My favorite brand is Vital Proteins Collagen Peptides grass-fed and pasture-raised.
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. 

Hair lost to male-pattern and female-pattern baldness won't grow back on its own, but there are medications that can help slow hair loss and even regrow hair. Minoxidil (Rogaine) is a topical medicine that is available over the counter to treat men and women. Finasteride (Propecia) is a pill that is available to men only by prescription. Injectable cortisone may also help regrow hair lost to certain conditions.
Somehow stress has an effect on the hair cycle. Typically about 90 percent of hairs are in a growing stage, and about 10 percent are in a resting stage, and it’s these resting-stage hairs that shed. Stress seems to prompt more of the growing hairs to go into the resting phase and then fall out. The good news is that this type of hair loss is temporary; after the hair falls out, a new hair usually will replace and prevent stress-induced hair loss, maintain a healthy lifestyle with regular exercise, and a nutritious diet.
First, hair grows and gets longer in the anagen phase which can go on for several years. Then, during the ~10-day catagen phase, hair stops actively growing and separates from its follicle, which is what holds the hair in place beneath the skin. Finally, in the telogen phase, the follicle goes into rest mode for several months until the hair falls out. Then, the process starts anew.

For as long as men have been fretting over their expanding foreheads, they've been scrounging for hair loss treatments. From hippo fat pomades to the urine of young foals, history is full of just-so-crazy-they-might-work concoctions. They didn’t work. And a quick Googling reveals that most of the products and services marketed today are only slightly less absurd.


It will be a mistake if lack of volume does not appear on the list of common hair problems. Happening for both men and women, lack of volume can be the factor that destroys one’s hair and affects his or her look. There are plenty of reasons leading to the lack of volume of flat hair, including thyroid problems, hormone-related conditions, low iron levels, and nutrition. It is believed that the wrong shampoo or inappropriate conditioner can make your hair too heavy and result in lack of volume. Sometimes, product build-up can be the hidden causes for most of the common hair problems, including lack of volume.
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.

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.
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.
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.
3. Nutriceuticals. Rogers recommends that her patients try Viviscal Dietary Supplements ($50 for a one-month supply) or Nutrafol ($88 for a one-month supply), both of which can often be picked up in a salon. The former contains marine-based proteins meant to beef up thinning hair. The latter is packed with antioxidants, like ashwagandha and curcumin, and boasts impressive clinical results.
Fenugreek. Fenugreek seeds have been found to help in treating hair fall and hair loss. They contain hormones and protein that rebuild the follicles and stimulate growth of hair. Soak a cup of fenugreek seeds in water overnight. Grind it to a paste and apply on your hair. Cover your hair with a shower cap and let it stay for 40 minutes, and then rinse. You can do this every day for a month.
Choosing where and who will perform your hair transplant is as important a consideration as to what kind of hair transplant to get. Of utmost consideration is that this should be done by the dermatologist /surgeon, and not his/her technician. The surgeon himself/herself should also oversee the design of your hairline and how the extraction of the graft will be done.

Giovanni Mele, a stylist who owns Giovanni and Pileggi in Center City, said many women with thinning hair try to wear their hair long. He thinks they're much better off with short, pixie-like styles with light layering on top. He recommends that lighter-skinned women choose colors that are a little darker than blond or gray. He is a fan of a hair-thickening product made by Nioxin.

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.


3. Surgical hair replacement. If you opt for hair transplantation (which runs $5,000 and up), your dermatologist or hair-replacement surgeon will remove single hair follicles from the back of the head, near the nape of the neck, where your hair is fullest. Once those follicles are harvested, they are then dissected and reimplanted into an area of the scalp where hair is thinning. The procedure takes anywhere from three to six hours, and newly implanted hair will usually begin to grow on its own 3 to 12 months after the treatment session. Traditionally, hair transplantation required removal of an entire strip of scalp, Sadick says, but this new follicle-by-follicle technique looks more natural when it heals and allows patients to get heads of hair as dense-looking as before they started losing it.
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’.
The Rogaine rep we spoke to explained that the different packaging (and therefore different prices) has to do with the FDA-approval process: “We discovered in clinical trials that the hair loss patterns between men and women are different,” she said by way of explanation. “Men typically have that bald spot on the crown of their head, where women generally have a general thinning throughout, but concentrated more on the top of the head. So for FDA approval, we had to come up with two different, gender-specific products, so the directions were more explanatory.”
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.
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.
Minoxidil (Rogaine): This topical medication is available over the counter, and no prescription is required. Men and women can use it. It works best on the crown, less on the frontal region. Minoxidil is available as a 2% solution, 4% solution, an extra-strength 5% solution, and a new foam or mousse preparation. Rogaine may grow a little hair, but it's better at holding onto what's still there. There are few side effects with Rogaine. The main problem with this treatment is the need to keep applying it once or twice daily, and most men get tired of it after a while. In addition, minoxidil tends to work less well on the front of the head, which is where baldness bothers most men. Inadvertent application to the face or neck skin can cause unwanted hair growth in those areas.
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).
Finasteride is available on private prescription in a tablet form. It prevents the hormone testosterone being converted to another hormone called dihydrotestosterone (DHT), which is known to shrink hair follicles. Blocking this action can help the hair follicles to return to their normal size. It usually takes three to six months of daily use to see an effect, and the process starts again if treatment is stopped.
“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).
There’s no such thing as a drug that’s without side effects completely. However, finasteride isn’t as harmful as some of the other types of medicine on the market. In fact, such a small percentage of men experience side effects at all, making the medicine effective and safe. With that said, there are a few things that you should know about the drug before you start taking it.
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.
NATURAL INGREDIENTS BACKED BY SCIENCE: We all know how biotin alone can do wonders for your hair, but most aren't aware that it also interacts incredibly well with other ingredients to boost its effectiveness. Our team of experts has formulated a natural, synergistic blend that combines several essential vitamins, minerals, and amino acids that work in conjunction to create a truly superior blend for maximum results.
Because hair concealers work like wigs, choosing one that's right for you is important. More than anything, it should be as natural looking and as subtle as possible. Pick one that matches your natural hair color. Most hair fibers come in nine colors, and if you want to achieve a good color fit, you can blend two colors. Apply first the dark color and then the lighter color.
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.
Women lose hair on an inherited (genetic) basis, too, but female pattern hair loss tends to be more diffuse, with less likelihood of the crown and frontal hairline being lost. Although some women may notice hair thinning as early as their 20s, the pace of hair loss tends to be gradual, often taking years to become obvious to others. There seems to be a normal physiologic thinning that comes with age and occurs in many women in their early to mid-30s. More women have underlying causes of hair loss than men. These include treatable conditions like anemia and thyroid disease and polycystic ovary syndrome (PCOS). These conditions are diagnosed by blood tests along with a historical and physical evidence. Although a few studies have suggested that baldness may be inherited through the mother's family genes, these theories require further testing. Current studies are inconclusive. Although not indicated for female pattern balding, spironolactone (Aldactone) has had some success in treating this condition.

Always shampoo and condition your hair regularly. Let your hair breath by avoiding wigs that are made with cotton and nylon caps that absorb moisture and lead to drier and more damaged hair. Instead, choose those with netted caps. Make sure your wig isn't too tight. Secure it with hypoallergenic double-sided tapes. Do not put your wig on over wet hair to avoid the growth of mildew and bacteria.


Finasteride is one of the few hair loss treatments to be clinically tested, FDA approved and proven to work for the majority of men. In fact, 83% of the men who take the medicine have successfully stopped male pattern baldness and kept the hair they already have. And 65% of the men who take finasteride have even experienced a noticeable regrowth of lost hair over the course of three months.


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’. 

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.
Tissue expansion. In this procedure, a material called a tissue expander is inserted under portions of the scalp with hair. Saline water is injected for six to eight weeks in order to expand or stretch this portion of hair-bearing skin. The bags are eventually removed and the expanded hair-bearing skin is cut away and moved to the adjacent bald area. This is typically used to address hair loss as a result of burns or injuries on the scalp.
Laser treatments. Low-level laser therapy (LLLT) is used for the prevention and reversal of hair loss. Also known as red light therapy, cold laser, and soft laser, it is a form of light/heat treatment (therefore generally safer) that is used on cases of pattern baldness and alopecia areata. The procedure uses a device that emits light that penetrates into the scalp. The more commonly used lasers are the excimer, helium-neon and fractional erbium-glass. The procedure can increase the blood flow in the scalp to stimulate the follicles that are in resting or dormant phase to go into anagen, and at the same time, prevent the production of DHT, which destroys the hair follicles.
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.
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.
Minoxidil (Rogaine). This is an over-the-counter (nonprescription) medication approved for men and women. It comes as a liquid or foam that you rub into your scalp daily. Wash your hands after application. At first it may cause you to shed hair as hair follicles. New hair may be shorter and thinner than previous hair. At least six months of treatment is required to prevent further hair loss and to start hair regrowth. You need to keep applying the medication to retain benefits.
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.
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