Tag Archive for: Alopecia Areata

You Should Get Patchy Hair Loss Checked Out.  Here’s Why.

Here's an example of what patchy balding looks like for someone experiencing patchy hair loss. Happy Head hair loss and regrowth specialists take a deeper dive into the disorder to help you understand what signs to look for and how to treat it with prescription-grade home treatments by Happy Head dermatologists.

You’re brushing your teeth, look up, and notice a patchy round bald spot on your head. Wait, that wasn’t there yesterday. Was it? Should I wait a few days and see what happens? Could it get bigger? This can’t be happening. Can I just pretend that it’s not? 

Yes, it’s normal to lose some hair each day. And, yes, you may have inherited your Mom, Dad or Grandparent’s hairline. Genetic hair loss happens gradually over time, though. Sudden, excessive, or patchy hair loss is another story. Get to the root cause and find out if treatment options are available. And finally, yes, you should get patchy hair loss checked out by a dermatologist, here’s why: 

1. To Rule Out Underlying Medical Conditions

Alopecia areata is a medical condition that occurs when a person’s immune system attacks his or her hair follicles resulting in hair loss. Although alopecia areata is rare, only affecting about two percent of the world’s population (01), patchy hair loss is often a symptom. Hair usually falls out in small, round patches the size of a quarter. Some people experience more extensive hair loss, though. With alopecia areata, you may not have any other symptoms besides hair loss. 

Alopecia areata is a non-scarring form of alopecia, meaning that the hair follicles are left intact. Hair may spontaneously regrow. While some people have recurring hair loss, others only have one episode. The condition is unpredictable.   

Not all patchy hair loss is due to alopecia areata, though. Patchy hair loss can also be a sign of another autoimmune disease. Lupus and thyroid disease can both cause hair loss. Infections, hairstyles, and hair treatments such as straighteners and perms can also be to blame. Visiting a doctor will help you rule out these causes and any others. Identifying and treating the underlying condition early in the game can help prevent further hair loss. 

2. Diagnosing Hair Loss Isn’t as Simple as It Seems

Distinguishing one type of alopecia from another isn’t something you can do yourself. While androgenetic alopecia, male and female pattern baldness, can be diagnosed by a dermatologist during a visual exam, scarring and other types of alopecia require a closer look with a magnifier called a dermatoscope or a biopsy. Happy Head’s dermatologists can diagnose online, but in some cases may recommend scheduling an in-person appointment. To get a free consultation with a Happy Head board-certified dermatologist, take our quick questionnaire here

Hair growth toolkit to get your hair back with Happy Head.

3. Treatments Can Be Customized

Medications and treatments vary based on the cause of your hair loss, so your dermatologist needs to nail down the underlying condition to develop an effective treatment plan. Telogen effluvium, temporary alopecia due to stress, illness, medications, or other causes, doesn’t require any treatment. Hair typically regrows within six months to a year. A different approach is required for alopecia areata. Depending upon the severity, treatments may include steroid injections, JAK inhibitors, which are a new class of medication showing great promise (02), and oral or topical medications such as Minoxidil, Finasteride, or Dutasteride. Just as not every case of hair loss is the same, not every person responds the same to hair loss treatments. It may take some time to determine the right mix of medicines for you. 

4. Emotional Support & Guidance

Although seeing bald patches may be new, upsetting, and embarrassing to you, dermatologists see cases like yours regularly. Not only do they know what to do to help you, they know what to say. You don’t have to worry that they will think you’re being an alarmist. Instead, your dermatologist can offer reassurance and help you navigate the psychological aspects of losing your hair. They also may be able to refer you to a support group or other resources to help you deal with the emotional challenges you may be facing. Remember, that you don’t have to do it alone. Hair growth is a journey.

5. Prevent Further Hair Loss

The last thing you want is for your alopecia to progress, so early intervention is key when it comes to patchy hair loss. In some cases, once you’ve lost a certain percentage of hair, it’s more challenging to manage or reverse the effects. Early treatment minimizes long-term damage by keeping the hair follicles viable, preventing further hair loss, and jump-starting the growth process. 

If you notice patchy hair loss, it’s not only okay to seek treatment; it’s recommended. A dermatologist can determine whether you have alopecia areata or another form of autoimmune hair loss, offer treatment options, and help you wrap your head around what’s happening. 

If you have patchy hair loss, thickening shampoo, conditioner, hair growth supplements, and oral or topical medications such as Minoxidil, Finasteride, Dutasteride, or Spironolactone may complement your treatment plan. Visit us to see the array of products available. Need help making a selection? We have dermatologists licensed to practice in every state who can make recommendations. Simply fill out a brief form with your medical history to get started. 

 

Resources:

(01) www.ncbi.nlm.nih.gov

(02) www.ncbi.nlm.nih.gov

 

What the Experts Know About Alopecia

Happy Head customer with thinning hair reviewing his progress with our custom topical treatment made my board-certified dermatologists.

Did you know that dermatologists treat more than just skin issues? During their twelve-plus years of training, dermatologists are also taught how to diagnose and treat patients’ hair and nail conditions. That’s why a licensed dermatologist should be your first stop if you’re experiencing hair loss that seems more than the norm. Yes, it’s possible that Covid-19 or the flu temporarily shocked your hair, and it will grow back on its own. However, some types of hair loss require attention. If that’s the case, you don’t want to risk losing valuable time and hair when you could be in treatment.  

So, if seeing hair everywhere but on your head is stressing you out, go ahead and schedule an appointment. Don’t have time to head to an office? Take our online questionnaire and we’ll match you with a dedicated dermatologist to help answer your questions. Don’t worry about your dermatologist thinking you’re crazy or an alarmist. They have seen it all. Meanwhile, here’s a sneak peek at what expert dermatologists know about alopecia and what may be in store for you.  

Alopecia is a Broad Term

Type “alopecia” into Google, and what comes up? Lots of results on alopecia areata. Alopecia areata is one very specific type of alopecia (we’ll talk more about it in a minute). However, there are many different types of alopecia, ranging from there’s nothing you can do but wait for your hair to grow back to it’s time to get on some medication. Alopecia is more of a finding than an actual condition. The word is used by professionals whenever there is some disorder causing hair loss. If you’re losing facial hair, that’s considered alopecia too. So, if your dermatologist uses the word alopecia, don’t worry. It’s a broad term that encompasses many types of hair loss.  

There Are Different Types of Alopecia

Hair loss is not one-size-fits-all. Symptoms and treatments vary based on what type of alopecia you are experiencing. Here’s a primer to help you understand what your dermatologist may look for during your consultation.  

Temporary Hair Loss

Finding hair everywhere but on your head can be upsetting. Before you plan for the worst, though, consider this. Not all hair loss is permanent. Certain medications, illnesses, surgery, and even ultraviolet rays from the sun disrupt your hair’s growth cycle and cause a condition called telogen effluvium. Telogen effluvium is self-limiting, which means that peace will be restored to your scalp once the trigger is removed.  

Insider Advice:  Although hair usually grows back on its own within six months to a year, the waiting game can feel long.  Supplements, thickening shampoos, conditioners, and regular trims can help support healthy hair growth while you wait.  

Genetic Alopecia

Have you ever heard of androgenetic alopecia?  Maybe not, but you’re probably familiar with Male and Female Pattern Baldness (MPB or FPB) which is the same thing.  But wait!  Isn’t that something that only happens to old people?  Well, not exactly.  Anyone who has gone through puberty can experience male or female pattern baldness, a form of genetic hair loss.  As a matter of fact, many people who experience MPB or FPB realize that they started losing their hair before the age of 40. (01)  Androgenetic alopecia is inherited through your family tree and occurs when testosterone converts to a substance called Dihydrotestosterone (DHT).  DHT attaches to your hair follicles and gradually shrinks them until they close up.  Hair falls out in easily distinguishable patterns that can be compared to a Norwood-Hamilton Scale to determine the extent of your hair loss.  

Insider Advice:  Don’t fall for any “grow hair fast” gimmicks.  The most effective way to strengthen and regrow your hair is by using vasodilators and prescription DHT blockers.  Topical or oral Minoxidil, Finasteride, Dutasteride, and Spironolactone are all good options.  Don’t expect miracles overnight, though.  You’ll need to be patient.  It takes six months to a year to see results.  

Autoimmune Hair Loss

Autoimmune diseases occur when your body mistakenly attacks healthy cells in your body. When your hair is involved, your hair follicles are attacked, leaving you scrambling to find ways to fight inflammation that blocks your hair follicles’ openings. Autoimmune hair loss falls into two different categories: Non-scarring and scarring. Alopecia areata is a non-scarring alopecia.  Hair falls out in sporadic round or oval patches on the scalp. In some alopecia areata cases, hair will spontaneously grow back on its own.  

Scarring alopecias behave differently and do what their name indicates. Scars grow over the hair follicles and close them off, leaving doctors and patients to play a game of beat the clock. The goal is to keep hair follicles open and to preserve existing hair before the hair follicles are shrunken to the point where they are closed off.  

Insider Advice: Autoimmune hair loss can be tricky to manage. What works for one person may not work for another. Treatment may also require multiple medications. Be patient through the trial process while your dermatologist determines which combination of medications works best for you.  

Facial Hair Loss

If you’re losing facial hair, it’s nothing to be ashamed of. It’s a real thing called alopecia barbae, and it’s usually autoimmune related. Alopecia barbae can cause hair to fall out in small round patches in men’s beards or mustaches. Hair can spontaneously regrow, or patches may stick around for a while. It’s difficult to predict the condition’s path.

Insider Advice: Don’t feel like you have to live with facial hair loss. Many of the treatments used to treat scalp hair loss can be used on your face too. These treatments may include steroids, topicals such as Minoxidil, or, in extreme cases, a class of medications called JAK inhibitors that calm the immune system.  

Give Yourself Time to Grieve, Then Move On

It’s only natural to go through a grieving process, regardless of the type of alopecia you’re battling. For some people like Congresswoman Ayanna Pressley, hair can be part of your “brand,” something you’re known for. When that hair is gone, you can feel like you’re losing part of your identity. That’s completely normal. Although nobody wants to have any form of alopecia, keep in mind that the awful feeling you get during your diagnosis won’t last forever. Over time, you and the people surrounding you will get used to your new look.

Topical treatment by Happy Head, being piped out of the glass pipette. Each topical treatment is customized to your patient profile.

If you have difficulty accepting your new normal, try giving yourself a time frame. Say something like, “Self, it’s been a while since I’ve been happy. ’m giving you one more week to be down in the dumps, and then I’m making an appointment for a new haircut.  Then, I’m moving on.” If that doesn’t work for you, a support group or counseling may be what you need to get in the right frame of mind. 

So let’s recap what experts know about alopecia. You’d be surprised how many people suffer from hair loss before consulting a dermatologist. If you think your hair is thinning or balding, get an expert opinion. Your hair woes may be nothing to worry about, or there may be something that can be treated. You won’t know unless you talk with a professional.  

Tight on time? Happy Head can help. Our board-certified dermatologists are available to help answer your pressing questions and help you regrow your hair. Remember one-size-fits-all treatments are a thing of the past, so let’s create a custom treatment that’s formulated to your needs. Fill out our short questionnaire and add a few photos to get started.

Resources

(01) https://pubmed.ncbi.nlm.nih.gov/9865198/

Are You Losing Your Hair? What You Should Do.

Do you suspect you’re losing hair? Don’t panic. Take a breath and make a plan. 

Time is on your side. Hair loss is very rarely something that happens overnight. For most people, hair loss is a slow and stealthy process. Hair loss takes time. Sometimes, it takes years or decades. 

Also, you’re not alone on your hair loss journey. Losing hair is hard to talk about. The hair loss experience is a touchy subject, and friends and family may hesitate to discuss the topic. Fortunately, hair care professionals are available to discuss hair restoration with you. And best of all, these experts know how to create a game plan to slow your hair loss. 

Steps to Take If You Suspect Hair Loss 

Being concerned about losing your hair is not vain – it’s human! Your hair plays a significant role in your appearance and self-confidence. If keeping as much hair as possible is crucial to you, then treating hair loss is an integral part of your self-care strategy. With that said, the following are essential steps to take if you think you’re experiencing hair loss.

Learn About Hair’s Growth Cycle

According to the American Academy of Dermatology Association (AADA), every individual can expect to lose about 50 to 100 hairs daily. Hair undergoes a definite growth cycle, with a percentage of hair undergoing different portions of the growth cycle at any given time. At the end of each cycle, the strands fall naturally, and new hair grows in. The stages of hair growth are: (01,02)

  • Anagen (growth phase)
  • Catagen (transition phase)
  • Telogen (resting and shedding phase)

Excessive hair loss is not a regular part of this growth cycle. This type of hair loss occurs when there is a disruption in one of the three phases. For example, too many strands may fall simultaneously (in the Telogen phase) or fail to regrow after falling (in the Anagen phase). 

Identify the Signs of Hair Loss

Spotting the signs of hair loss might take some investigating. To determine whether you’re experiencing excessive hair loss, keep an eye out for: (03)

  • The development of bald patches. 
  • Hair that feels lighter. 
  • A more visible scalp. 
  • Foreheads or temples appear larger. 
  • More hair than usual on bedding, hairbrushes, or in the bathtub.
  • Hair that doesn’t fall in your typical hairstyle.
  • Intense itching or burning (may be a sign of infection.)
  • Scaly patches. 

Hair loss typically appears in three forms: 

  • Patterned: People with patterned hair loss see progressive thinning or balding at the hairline, sides, or top of the head. Patterned loss is typically seen in hereditary types of hair loss, like androgenetic alopecia.
  • Diffuse: A consistent and even loss of hair throughout the scalp is called diffused hair loss. This hair loss usually occurs in cases of illness, nutrient deficiency, or during periods of severe stress. 
  • Focal: Focal hair loss occurs as patches on the scalp, face, or the body, and is usually linked to autoimmune disorders.

Discovering hair loss is no doubt a distressing event. But it’s better to know so you can take steps to treat it. The earlier you can identify hair loss, the higher your chances for a successful hair restoration. 

What’s Causing Your Hair Loss? 

A few common causes of hair loss are: 

    • Age: Most people experience hair loss with age to some degree. Some people may see more loss of hair than others. Treatments may help to regrow hair or slow hair loss if caught early. 
    • Stress: Stress can cause excessive shedding. Often, hair will regain its fullness after reducing stress, or a stressful experience has passed. In some cases, treatment is necessary to regrow hair. 
    • Medical Conditions: Illnesses can lead to hair loss. Alopecia areata, as an example, is an immune disorder that attacks hair follicles, resulting in loss of hair. Thyroid disorders can also impact hair growth and cause diffused hair loss. (04)
    • Hair Care Treatments: Chemical relaxers, hair dyes, and perms may injure hair follicles, preventing healthy hair regrowth. Hair restorations may help to regrow hair in many cases. 
    • Hormonal Imbalance: Women, in particular, may lose hair due to birth control pills, pregnancy, perimenopause, or polycystic ovary syndrome (PCOS). Medical care combined with hair treatments may help to restore hair. 
    • Friction: Frictional alopecia may occur when headgear or clothing repeatedly rubs against the skin or scalp. Hair typically regrows by removing the source of friction, but hair growth treatment may be necessary in some instances. 
    • Genetic Factors: The cause of thinning or balding may have a genetic cause if hair loss runs in the family. Androgenetic alopecia, also known as male-pattern baldness or female-pattern hair loss, is thought to have a genetic component. Hair growth treatments can help to regrow hair in cases of androgenetic alopecia. (05)
    • Diet: A diet high in processed foods and low in nutrients is bad for your health and may even contribute to hair loss. For example, a 2020 study found that a nutrient-deficient diet may cause a hair loss condition called telogen effluvium. Telogen effluvium may also occur during times of severe stress or illness. A multi-targeted approach, like hair treatments, dietary supplements, and a healthy diet, may help counter the effects of a poor diet. (06)

Determine Your Options 

Speaking with a hair restoration professional can confirm or correct your suspicions about hair loss. Once hair loss is confirmed, a hair expert can help you determine the appropriate treatment to restore your hair. 

  • Medication: Hair strands grow from – and are held in place by – hair follicles. These follicles are sensitive to a hormone called dihydrotestosterone (DHT). DHT can injure and miniaturize these hair follicles, which causes hair to fall out faster. Furthermore, DHT impedes new hair growth. Medications targeting DHT limit damage by the hormone and may successfully regrow hair. 
    • Finasteride and Minoxidil are FDA-approved medications that help encourage hair growth and slow hair loss. Both Finasteride and Minoxidil are available as either a topical or oral medication. 
    • Dutasteride is another effective medication used to counter DHT levels. This medication suppresses the production of DHT, therefore reducing the overall amount of DHT. (07)
  • Hair Care: Harsh shampoos, oily conditioners, and thermal hair tools harm the health of your hair. Using hair products that cleanse and nourish the scalp, follicles, and hair strengthens each strand and keeps more hair on your head. 
  • Diet and Supplements: A nutrient-dense diet full of antioxidants and protein increases the likelihood of thicker hair. Unfortunately, diet changes may not always be enough. In these cases, health supplements containing hair-boosting ingredients like keratin, saw palmetto, and vitamins A and D. 

Remember that there’s no magic bullet to regrow hair. Furthermore, hair restoration treatments are not one-size-fits-all.  Finding the appropriate treatments and balance of medications requires the help of an experienced hair loss professional. 

Consult With a Happy Head Hair Loss Professional

If you think you’re losing your hair, contact our hair loss experts at Happy Head. Do you see more strands falling? Do you notice bald spots forming? There’s no need to worry, because Happy Head can help.  We collaborate closely with you to halt your hair loss. Whether you need oral medication, a topical, or a nutrient supplement, our experienced hair loss professionals will work with you to determine the best path to meet your needs. With Happy Head’s wide array of hair products, you’re sure to find the right treatment to regrow your hair. 

 

Resources: 

(01) https://www.aad.org/public/diseases/hair-loss/insider/shedding

(02) https://www.ncbi.nlm.nih.gov/books/NBK499948/

(03) https://www.aad.org/public/diseases/hair-loss/insider/begin

(04) https://www.niams.nih.gov/health-topics/alopecia-areata

(05) https://www.aad.org/public/diseases/hair-loss/types/female-pattern

(06) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7320655/

(07) https://pubmed.ncbi.nlm.nih.gov/28294070/

Is Minoxidil (Rogaine) Safe for Women?

Young woman with curly hair looking at herself in the mirror and combing hair with hand, photographed from behind

You may be familiar with Minoxidil that’s used to treat thinning hair and bald spots. The medication was initially tested, marketed, and FDA-approved for men with male pattern baldness. If you’re a woman experiencing hair loss, you may wonder if Minoxidil is safe and effective for you too. After all, Minoxidil is available under the brand name Rogaine over the counter at most big box retailers and pharmacies. It’s easy to buy and use.  

Dermatologists Often Recommend Minoxidil to Their Female Patients

Minoxidil is safe, and it’s the medication most often recommended to women by dermatologists to treat their hair loss conditions. Before you run to the store, though, there are a few things you should know.  

Minoxidil Is FDA Approved for Women

If you’re considering using Minoxidil to treat your hair loss, you’ll be happy to know that the five percent topical foam and solution was FDA-approved for women in 2014. The medication was used off-label for women before it was approved. Why is FDA approval notable? Because it means that the manufacturer proved that its product is safe and effective for its intended use. FDA approval also means the product is manufactured to federal quality standards.  

Higher Doses of Minoxidil are Available by Prescription

Oral Minoxidil and topical Minoxidil doses above five percent are available to women but only off-label by prescription. Don’t be concerned about using prescription medication off-label, though. The FDA knows that medical providers do that. Off-label means that dermatologists may prescribe a drug for use that isn’t approved when the provider determines that the medication is medically appropriate.  

Minoxidil Is Used to Treat Female Pattern Baldness and Other Hair Loss Conditions

Minoxidil is most often recommended and prescribed to treat androgenetic alopecia, commonly known as female pattern baldness. Female pattern baldness occurs in women who are genetically predisposed to hair loss. When women experience this condition, they typically see hair loss along their parts first. Over time, the part widens as the hair in the area continues to thin and fall out. While men who experience male pattern baldness can lose all of their hair over time, women typically don’t. Women are more likely to see diffuse thinning on the crown of their heads.  

Minoxidil is often prescribed for other hair loss conditions as well. Dermatologists often recommend Minoxidil to their female patients with alopecia areata, frontal fibrosing alopecia, lichen planopilaris, and other types of alopecia.

Minoxidil is Available to Women in Different Forms & Doses

Liquid & Foam Rogaine

If you go to the store, you’ll find foam and liquid Minoxidil in two and five-percent formulas. Minoxidil is the same as Rogaine. You may also find generic store brands of Minoxidil under names such as Equate and Kirkland Hair Regrowth Treatment, which contain the same active ingredients.  

Initially, only two percent formulas were marketed for women. However, research indicates that higher doses are more effective for treating female pattern hair loss. Although both two and five percent solutions increased hair growth, the five percent demonstrated statistical superiority over the two percent. (01) When choosing between the liquid and foam, you may want to consider foam that does not contain propylene glycol which can be an irritant to some women. 

Oral Minoxidil

Oral Minoxidil is an alternative to topical and is available by prescription.  The medication is effective in regrowing hair in women with female pattern baldness. (02)  Oral Minoxidil was initially tested in higher doses to treat high blood pressure.  When used to treat genetic hair loss, much lower doses are prescribed.   

Minoxidil With DHT Blockers

The most effective treatments attack hair loss from different angles. Women often use Minoxidil simultaneously with DHT blockers such as Finasteride or Spironolactone. Minoxidil enlarges the hair follicles, while Finasteride or Spironolactone prevents Testosterone from converting to DHT. When DHT is blocked, it can’t bind to the receptors in your hair follicle so your hair won’t be at risk.  

Customized Topical Minoxidil Formulas

Treatments for female pattern baldness may differ from woman to woman. What works for one may not work for another, which is why customized formulas are often best. The most effective treatments attack hair loss from different angles. A benefit of customized formulas is that Minoxidil can be prescribed up to 10 percent, which is significantly higher than what’s available over the counter. Retinol can be added to increase absorption, and cortisone can be added if necessary to prevent irritation from higher concentrations of Minoxidil. Many women also like the convenience of having all of the hair loss medications they need to be compounded into one formula rather than having to take or use multiple medications.       

Minoxidil Side Effects are Usually Minimal

Minoxidil users usually don’t experience many side effects. Topicals can cause some redness, flaking, and irritation. However, eliminating propylene glycol usually resolves the issue. Oral Minoxidil was originally tested and marketed to treat high blood pressure. Because oral medications are systemic, side effects such as a fluctuating heart rate are possible. Side effects are rare, though. Doses of oral Minoxidil prescribed for hair loss are typically significantly lower than for high blood pressure.  

Minoxidil Can Cause Initial Shedding

If you’ve been researching Minoxidil for your hair loss, you may have heard about the “dread shed” that can occur when first using Minoxidil.  Yes, some women find that they lose more hair at first. The reason why is because Minoxidil speeds up your hair’s growth cycle. The resting phase occurs faster than it otherwise would. Everyone doesn’t experience an increase in shedding. However, If you do shed initially, don’t panic. Your hair’s growth cycle will regulate within a few weeks.  

Trying Minoxidil is the Best Way to Determine Whether it Will Work for You

It would be nice if there were a way to know whether Minoxidil will help regrow your hair. A response test has been designed and marketed to do just that. The test measures the amount of sulfotransferase enzyme activity in plucked hair follicles to predict whether or not Minoxidil will be effective. Research indicates that the sulfotransferase activity predicts treatment response with 93 percent sensitivity and 83 percent specificity. (03) There’s a catch, though.  

The test will only help determine if women will respond to two or five percent topical Minoxidil. The test does not indicate whether or not women will potentially respond to higher topical dosages or to oral Minoxidil. It also does not indicate whether Minoxidil will be effective when used with a DHT blocker such as Finasteride or Spironolactone. The best way to know if Minoxidil will work is by trial. It typically takes six to twelve months to see results. 

If you have been diagnosed with female pattern baldness and are thinking about trying Minoxidil, here’s the takeaway. Minoxidil is safe for women to use and has been proven to be an effective treatment for many. Minoxidil often works best with Finasteride, Spironolactone, or another DHT blocker.  A topical with a percentage higher than five or oral Minoxidil will require a prescription. If you have more questions about whether Minoxidil is right for you, Happy Head’s board-certified dermatologists can help. Contact us and our hair growth experts will help select the best solution for you, without a visit to the doctor’s office. 

Resources:

(01) https://pubmed.ncbi.nlm.nih.gov/15034503/

(02) https://pubmed.ncbi.nlm.nih.gov/32851744/

(03) https://pubmed.ncbi.nlm.nih.gov/24773771/

 

7 Reasons Why Your Hair Is Falling Out (And How to Stop It)

It’s easy to fall down a rabbit hole when doing internet research.  A pimple can turn into cancer or flesh-eating disease in minutes.  The same thing can happen when you lose your hair.  First, you see a few strands of hair on the shower floor.  Then, you find hair all over your towels and pillowcases.  Worst of all, you’re starting to see receding, thinning, or balding areas.  Before you know it, you’re online typing “Why is my hair falling out?” into the search bar.  In no time, you’re convinced that you have some rare, fatal illness that’s making your hair shed.  The truth is that there are some simple explanations for why you may be losing your hair.  Although we don’t recommend self-diagnosis (we’ll talk more about that later), here are the most common reasons your hair may fall out.  

1. You Can’t Fight Genetics

If one of your parents or relatives experienced thinning or balding hair, you might be next in line.  Male and female pattern baldness, androgenetic alopecia, is passed from generation to generation and can stem from either side of your family.  Male pattern baldness accounts for 95 percent of hair loss in men. (01)  Although genetic hair loss is typically considered a “guys issue,” androgenetic alopecia is the most common cause of hair loss in women also.

How do you know if your hair loss is hereditary?  There are some tell-tale signs, namely specific patterns of hair loss.  Men usually see their hairline receding into an “M” shape.  The circular area on the back of their heads thins and expands to create an “O” shape.  Men can go bald from the condition.   Women, on the other hand, don’t usually go completely bald.  Instead, they get diffuse thinning that begins on the part line and expands out.  

If your hair loss is hereditary, early action with the right medication can help slow down or stop your hair loss and help regrow new hair.  Minoxidil is a well-known option that prevents or reverses the miniaturization of the hair follicles.  It allows existing hair to remain healthy and new hair to grow.  DHT blockers are often needed in conjunction with Minoxidil to prevent testosterone from converting to DHT and attacking your hair follicles.  The most commonly prescribed DHT blockers are Finasteride, Dutasteride, and Spironolactone for women.  

2. You’re Having an Autoimmune Response 

Some types of alopecia are due to an autoimmune disease called alopecia areata.  Before you freak out, though, consider this.  Your lifetime risk of experiencing alopecia areata is only 2.1 percent. (02)  Alopecia areata causes circle-shaped patches of hair loss on various parts of your scalp.  Hair can spontaneously regrow without any treatment.  However, some people experience relapse.  Alopecia areata is diagnosed via visual examination, blood tests, and possibly a small biopsy.  

First-line treatments may include corticosteroids and Minoxidil.  A psoriasis medication called Anthralin or Oluminant, a new medication that was recently FDA approved, may be prescribed for more severe cases.  

3. You’ve Had Surgery or Been Sick

You may not realize that surgeries requiring anesthesia and illnesses that cause high fevers can cause a temporary type of alopecia called telogen effluvium.  Some people who had severe cases of Covid were affected.  When there’s a rapid increase in stress levels in your body, your hair goes into a type of shock called telogen effluvium.  Telogen effluvium speeds up your hair’s growth cycle and pushes it into the resting stage.  During the resting stage, your hair falls out.  The disruption is temporary, though, and usually only lasts for a few months.  After that, your growth cycle gets back on track, although it may take a few months more to see regrowth.  

4. You’re Stressed Out

If you’ve been under a lot of pressure at work or are experiencing a breakup, the stress could take a toll on your hair.  During a 2021 study, researchers discovered that a particular stress hormone called corticosterone can impair the stem cells needed to promote hair growth in mice.  When mice were subjected to mild stress for many weeks, corticosterone levels increased, resulting in telogen effluvium. (03)  Life happens, and you can’t always get rid of your stressors, so finding ways to manage your stress may help if you  notice hair loss.  Exercise, deep breathing, meditation, progressive muscle relaxation, and connecting with others are good ways to unwind and help your body reset its hair growth cycle.  

5. Your Hair Needs Some TLC

Do you know why Ariana Grande first started wearing her signature high ponytail?  It was because her hair was damaged by the dye she used while filming the series Victorious.  Yes, harsh chemicals and hairstyles, such as tight braids pulling on your scalp can make your hair break or fall out.  Straightening treatments, including Brazilian blow-outs, are also very harmful.  If your hair is suffering, there are still things you can do to make it healthy again and prevent further hair loss.  A hair mask or deep conditioning treatment can bring some moisture back.  A haircut can remove dead ends.  If your hair is falling out due to traction alopecia, hair loss caused by pulling on your hair too much, don’t despair.  Your hair will grow back once you stop damaging it.  If you find that your hair isn’t growing back, be sure to check with your dermatologist.  

6. You’re Experiencing Side Effects From A Medication

Hair loss isn’t one of the side effects usually listed on medications, and it’s relatively rare, but it can happen.  Antidepressants, certain nonsteroidal anti-inflammatory drugs (NSAIDs), thyroid medications, steroids, and hormone replacements can be culprits.  If you think one of your medications could be to blame, don’t stop taking it.  Always consult with your doctor before making any changes.  

7. Your Lifestyle Could Use Some Improvement

We’re human, and we all have some vices.  But iif you’re concerned about your hair falling out, it may be time to rethink your lifestyle.  Let’s start with smoking.  Smoking could affect your hair by causing vasoconstriction and damaging your hair follicles.  If you’re prone to androgenetic alopecia, it can also make you produce more DHT. (04

Then there’s alcohol.  There isn’t any scientific evidence out there that indicates that drinking alcohol affects your hair.  Excessive drinking, however, can cause or contribute to medical issues that could affect your hair.  Remember how we talked about stress causing telogen effluvium?  Alcohol in excess could become a stressor if it affects your overall health.  

You may also want to evaluate your diet.  Certain foods can increase testosterone, which can potentially convert to DHT.  Processed and sugary foods are an example.  Too much sugar can cause your body to produce more insulin, increasing androgens.  According to Dr. Ben Behnam, board-certified dermatologist and founder of Happy Head, people who are concerned about hair loss should also choose their protein carefully.  Caged chickens produce more testosterone due to the stress of being held captive.  It’s best to choose free-range chicken.  Whey protein is also an excellent source of protein, but choose the type you use carefully.  Whey protein isolate is highly processed and can contribute to hair loss, while whey protein concentrate supports hair health and regrowth.  

Early Hair Loss Treatment is the Best Hair Loss Treatment

Now that we’ve shared the most common reasons why our patients experience hair loss, we want to go back to why we don’t recommend self-diagnosis.  The key to reversing hair loss is catching it early and beginning treatment while your hair follicles are still viable.  You could lose valuable treatment time If you diagnose yourself and are wrong.  Be sure to visit your dermatologist for an exam.  

We’re Here to Help

If you don’t have access to a dermatologist or have questions about whether hair loss treatment is right for you, we’re here to help.  Simply answer some brief questions designed to help us better understand your hair loss concerns, and a board-certified dermatologist and hair specialist will be assigned to your case.  

 

Resources:

(01) https://www.americanhairloss.org/men_hair_loss/index.html

(02) https://www.naaf.org/alopecia-areata

(03) https://www.nih.gov/news-events/nih-research-matters/how-stress-causes-hair-loss

(04) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9069908/#:~:text=Smoking%20may%20lead%20to%20hair,enhancing%20senescence%20and%20hormonal%20effects.

 

Alopecia Areata: Is it Hereditary?

Genes play a major role in our appearance. For example, you may have inherited your father’s striking eye color and his sunny smile. But did you inherit his bald patches? If you’re reading this article then you’ve probably noticed a family member’s thinning hair and wondered, “Is alopecia areata hereditary?” Let’s find out. 

What is Alopecia Areata?

The term “alopecia” means hair loss. Therefore, alopecia occurs under a variety of conditions, like chemotherapy-induced alopecia and frontal fibrosing alopecia. Alopecia areata is an autoimmune condition that results in discrete bald patches throughout the scalp, face, or body. The immune system mistakenly targets hair follicles, which results in hair loss. In some cases, the entire head is affected causing complete baldness. (01)

Alopecia areata is not life-threatening, but it can negatively affect a person’s mental health. A study of individuals diagnosed with alopecia areata found high levels of anxiety (62%) and depression (38%) among participants. Therefore, hair loss conditions like alopecia areata don’t cause physical pain – but they can cause a great deal of psychological distress. (01)

What Causes Alopecia Areatea?

The body’s immune system fights against foreign invaders, protecting the body from pathogens. For the most part, the immune system does their job excellently. In some cases, however, the immune system can attack the body’s own cells. In the case of alopecia areata, the immune system strikes at the hair follicles, triggering an early start of the hair follicle’s “resting phase,” also called the telogen phase. The follicle loses its strand of hair and stops producing more strands.  The exact cause of alopecia areata is yet unknown. 

What are the Symptoms of Alopecia Areata?

Most people visualize a bald head when they hear the term alopecia areata. However, alopecia areata can affect any part of the body, like the legs or beard area. Symptoms of alopecia area include: 

  • Distinct oval or round-shaped patches on the scalp.
  • Areas of hair loss that get larger with time.
  • Two or more patches that grow larger and connect. 
  • Hair loss that affects one side of the head more than the other (asymmetrical). 
  • Fragile or white-spotted nails. 

One of the hallmarks of alopecia areata are the short broken hairs or “exclamation point” hairs located at the perimeter of bald patches. These hairs are narrower at the base and thicker at the tip. A frustrating aspect of alopecia areata is the condition’s unpredictable nature. The condition may come and go, with hair regrowth and then subsequent episodes of hair loss. Some individuals may experience a complete loss of hair on their body, though this occurrence is very rare. (01)

What are the Types of Alopecia Areata?

Alopecia areata shows up differently in each person. For example, one person may find small bald patches on one side of their head, while another person with alopecia areata may experience total hair loss. 

The three primary types of alopecia areata are: (02)

  • Patchy Alopecia Areata. Individuals with patchy alopecia areata develop one or more round bald patches on the scalp, eyebrows, armpits, or eyelashes. 
  • Alopecia Totalis. Alopecia totalis causes complete baldness, resulting in total loss of hair on the scalp. 
  • Alopecia Universalis. People with alopecia universalis experience a total loss of hair throughout their body, including the hair on their finger and toes. 

Fortunately, lost hair from alopecia areata often grows back, particularly with treatment. Even with the loss of hair, hair follicles remain “alive” and operational. Therefore, it’s possible to regrow hair, even after long periods of hair loss. People with alopecia areata may experience cycles of hair loss and regrowth throughout their lives. New hair may appear fragile and white, at first, then slowly return to their original color. (02)

Who Gets Alopecia Areata?

According to the National Alopecia Areata Foundation (NAAF), about 7 million people in the U.S. are affected by the condition. Alopecia areata also affects all racial and ethnic groups throughout the world. Any person at any age can develop alopecia areata, but the condition appears before the age of 20 in about 60% of people with the disorder. When alopecia areata develops in children under 10, however, hair loss tends to be more extensive and progressive. (03)

People with following disorders have a higher risk of developing alopecia areata: 

  • Vitiligo
  • Eczema
  • Allergies
  • Hypothyroidism
  • Down Syndrome
  • Systemic Lupus Erythematosus 
  • Ocular Cicatricial Pemphigoid 
  • Diabetes
  • Rheumatoid Arthritis

Cancer patients receiving treatment may also develop alopecia areata. For example, a cancer drug called nivolumab has been known to cause alopecia areata a few months after treatment. This form of alopecia areata is called nivolumab-induced alopecia. In this case, hair loss is thought to be a good sign that the cancer medication is doing its job well. (03)

Having a family member with alopecia areata may raise a person’s risk of developing the condition. Data indicates that approximately 10% to 20% of people with alopecia areata have a blood relative with the condition. Having said that, having a family member who is diagnosed with alopecia areata does not guarantee that you will develop the condition. (02)

Is Alopecia Areata Hereditary?

Whether alopecia areata is hereditary or not is unknown. Research into the condition has identified hair follicle specific genes, such as (peroxiredoxins) PRDX5 on chromosome 11q13. PRDXs are enzymes within hair follicles, and may be responsible for influencing autoimmune disease. Additionally, autoimmune disorders in general are thought to have genetic components, making them likely to have hereditary factors. (04)

However, the environment, lifestyle choices, and individual health may also play significant roles regarding whether an individual will develop an autoimmune condition like alopecia areata. A recent article in the journal Nature stated that autoimmune diseases occur due to a combination of variables, like genetic predisposition and environmental triggers that disturbs the immune system’s ability to decipher the body’s own tissues. (04)

It’s important to keep in mind that more than half of people who are diagnosed with alopecia areata do not have a family link to the condition. Furthermore, genetic diseases often skip generations or people in families with no predictable pattern. In short, there is no definite answer – at this time– whether autoimmune diseases like alopecia areata are hereditary. 

As with many health conditions that have a genetic component, alopecia areata’s genetic links are not the only deciding factor.

So, is alopecia areata hereditary? All the signs point to a definite “maybe.” 

Managing Alopecia Areata

Will your children develop alopecia areata? They may, but the chances are more likely that they will not. Will you develop alopecia areata if your mother has the condition? Your risk is higher than people who do not have a family member with the condition, but the chances are that you won’t develop alopecia areata. The crystal ball is murky when it comes to alopecia areata. 

That said, the true issue is managing alopecia areata if and when it appears. Hair loss can cause psychological anguish. Getting a handle on alopecia areata symptoms before they worsen helps prevent undue stress. Happy Head’s board-certified dermatologists and hair specialists are here to help. Whether hair loss is due to alopecia areata, male pattern baldness, or telogen effluvium, we can answer your questions and assist in finding the right treatment. Contact us and start regrowing your hair today.

 

Resources: 

(01) https://www.sciencedirect.com/topics/medicine-and-dentistry/alopecia-areata

(02) https://www.aad.org/public/diseases/hair-loss/types/alopecia

(03) https://www.naaf.org/alopecia-areata

(04) https://www.nature.com/articles/d41586-021-01839-6

Is Your Hair Healthy?

Has your hair been a little drier and frizzier than usual?  Is it less manageable than it used to be?  Figuring out whether or not your hair is healthy can be challenging.  It can be difficult to distinguish between when it’s time for a deep conditioning treatment and a haircut or if something else is affecting your hair.  If you know what to look for, though, assessing your hair’s health is easy.  Here’s a simple guide designed to help.    

How Do You Know When Your Hair is Healthy?

Is your hair smooth and shiny or dull and coarse?  Hair that’s shiny and smooth is deemed more healthy, even when hair is wavy or curly. (01)  As we age, natural graying can make hair seem dull or frizzy, but that doesn’t have to be the case.  Daily conditioners, moisturizing treatments, and shine-boosting sprays can help.

Androgenetic alopecia, a fancy name for male and female pattern baldness, can also change your hair’s texture and appearance.  Sometimes hair becomes finer due to miniaturization of the hair follicles.  Because the hair becomes thinner, it could become curlier.  In other cases, previously curly or wavy hair can flatten and be less able to hold its curls or waves.  

Healthy Hair From the Inside Out

Healthy hair isn’t just what you see on the outside.  What’s on the inside also counts.  Hair is primarily made of keratin, which is a protein.  Keratin is made out of amino acids and other molecules that come from foods we eat.  That’s why eating a balanced diet and ensuring that you have all the right vitamins are so essential.

Your hair grows from a follicle beneath your scalp’s skin.  A hair shaft extends from the follicle.  The shape and angle of your hair shaft are what determines what type of hair you have.  It’s made out of three layers:

  1.  Medullar- Inside layer 
  2. Cortex – Middle layer that determines your hair color and elasticity
  3. Cuticle – Outside layer that makes your hair look shiny

When the cuticle is damaged by the sun, chemicals, blow drying, or other elements, the cells in the cortex can break or unravel, making your hair look dull or brittle. 

What Damages Healthy Hair?

Typically, the hair’s cortex is filled with keratin, and the cuticle is smooth, allowing light to reflect.  When the cuticle is damaged, your hair may seem dry and frizzy.  The ends may be thinner than they used to be, but there is still an opportunity for repair.  A haircut, deep conditioning, and time to regrow usually solve the problem.  When the cortex is damaged, salvaging the hair is more complicated.  At that point, hair is coarse and dull with split ends and some breakage.  

Does Healthy Hair Fall Out?

According to the American Academy of Dermatologists, losing about 50 to 100 hairs per day is normal as part of the hair’s growth cycle. (02)  So, even if your hair is healthy, you might still see a few strands in the sink.  When you lose more than that, there’s a problem.  Hair loss due to physical defects is unusual compared to other types of alopecia.  Here are four of the most common ones:

  1. Loose anagen syndrome – When hair is loose and easily pulls out of the follicle because the root sheaths are not fully formed.  More common in children than adults.  
  2. Traction alopecia – When hair is pulled out of the follicle by tight hair bands, braids, or any other styling habits.
  3. Trichotillomania – A type of obsessive-compulsive behavior when people pull out their own hair.
  4. Overprocessing – Straighteners, perms, bleach, and dyes use harsh chemicals that can break down your hair’s fiber.  Using these harsh chemicals too often or incorrectly can irreversibly damage the hair’s fiber.  

Other Reasons for Hair Loss

If you are losing your hair, and it’s not due to a physical defect, it may be due to alopecia.  Here are some examples:

  • Telogen effluvium is a temporary form of hair loss that can happen after sudden illness such as Covid, surgery, or a stressful occasion.  Hair spontaneously regrows after a few months.  
  • Androgenetic alopecia (male or female pattern baldness) is the most common form of alopecia.  Although it commonly occurs during middle age, people in their 20s may have this type of hair loss due to an overproduction of Dihydrotestosterone (DHT).  Minoxidil, Finasteride, Dutasteride, and Spironolactone are prescription DHT blockers often prescribed to reverse hair loss caused by male and female pattern baldness.
  • Alopecia Areata is an autoimmune condition that causes circular bald patches about the size of a quarter.  In addition to Minoxidil and Finasteride, immunosuppressants have recently been found effective in helping people with alopecia areata regrow their hair.  

How to Keep Your Hair Healthy

Want your hair to look shiny and healthy?  Here are some tips to help you keep your hair in top condition:

  • Diet – Eat a well-balanced diet with plenty of vegetables, fruit, and plenty of protein
  • Vitamins – Check your vitamin levels, especially biotin, iron, vitamin C, niacin, and zinc.  Work with your dermatologist to supplement if any levels are low 
  • Exercise – Regular exercise not only helps manage your weight and keep your heart healthy, but it also reduces stress which has been proven to affect your hair
  • Habits – Quit smoking and only drink in moderation
  • Sun protection – Wear a hat when you’re in the sun to prevent damage from ultraviolet rays
  • Chlorine – Wear a swim cap when swimming, or rinse your hair before or after swimming to get all of the harsh chlorine out
  • Wet Hair – Use a wide-tooth comb and treat wet hair gently
  • Condition – Use a quality conditioner each time you wash your hair
  • Styling – Watch heat styling, eliminate or minimize chemical treatment, and avoid tight hairstyles (ponytails, braids, buns, etc.)

No matter your age or gender, having healthy hair is a confidence booster.  If you have questions about your hair’s health or are concerned about hair loss, let us know.  One of our board-certified dermatologists will review the information you provide and let you know if you would benefit by using one of our customized prescription medications.

 

Resources:

(01) https://pubmed.ncbi.nlm.nih.gov/18004288/

(02) https://www.aad.org/public/diseases/hair-loss/insider/shedding#:~:text=It%27s%20normal%20to%20shed%20between,this%20condition%20is%20telogen%20effluvium.

 

Does Stress Cause Hair Loss?

Stressed man on the computer in his kitchen, looking into hair loss solutions.

People often joke around about how stress causes hair loss.

“I was so stressed I was losing my hair.” 

“All these bills have me pulling out my hair.” 

“This new job is making my hair fall out.”

But for many, stress causing hair loss is no laughing matter. So does stress really cause hair loss? Yes, stress can cause you to lose your hair. And when you’re trying to keep as much hair on your head as possible, managing stress becomes a top priority. 

Stress: The Good and the Bad

When you feel your heart rate rise because you’re running late or you start to sweat during a work presentation, what you’re feeling is stress. This emotional and physical tension is part of the body’s natural response to potentially dangerous or new situations. 

Known as the body’s stress response or the “fight-or-flight” response, stress can be positive. This emotion keeps you alert and driven, pushing the body to work harder and think faster. Stress works well for short periods, giving you enough energy to power through a challenging event. Long-term (chronic) stress, however, compromises your well-being – and may cause you to lose your hair. (01)

The Physiological and Psychological Effects of Chronic Stress

The stress response comes from your body’s autonomic nervous system, the same system responsible for your heart rate, vision changes, blood pressure, and breathing. 

During a stressful situation, you may experience the following: 

  • Increased heart rate
  • High blood pressure
  • Faster breathing
  • Sweating
  • Tremors

With chronic stress, you can see these additional symptoms: 

  • Headache
  • Muscle tension or pain
  • Chest pain
  • Restlessness
  • Insomnia
  • Fatigue
  • Stomach upset

Chronic stress can lead to health problems like high blood pressure, skin conditions, obesity, and heart disease. (01)

Why Stress Causes Hair Loss

To understand why stress causes hair loss, you first need to know the basics of hair growth. Hair grows in a cyclical pattern, with new hair growth to replace older hair once it falls out. Every healthy strand of hair typically grows in three primary stages: 

  • Anagen Phase
  • Catagen Phase
  • Telogen Phase

Anagen Phase 

The anagen phase is also known as the “Growth Phase.” During this phase, a strand of hair grows from the hair follicle. As it grows, sebaceous glands condition and lubricates the hair. Hair grows at an average rate of six inches a year for most people. At any given time, about 80% of hair is in the anagen phase. This phase of rapid growth usually lasts about 2 to 8 years. 

Catagen Phase 

Unlike the anagen phase, the catagen phase lasts only briefly. The catagen phase lasts about ten days, though some people may have hair that remains in the catagen phase for up to 4 weeks. This phase accounts for about 1 to 2 percent of a person’s hair. It is at this point that growth stops, and the hair follicle shuts down to rest. (02

Telogen Phase

Hair falls out of the follicle during the telogen phase. The telogen phase is aptly named the “resting phase” because the hair follicle shuts down for a short rest. During this phase, the follicles no longer supply nutrients, which causes the air to fall out. 

The hair that’s lost is usually hairs that are at the very tail end of the telogen phase, called the exogen phase. Approximately 15% of hair is in the telogen phase at any given time. The scalp sheds an average of 100 hairs a day. With about 100,000 hair follicles on the scalp, the daily loss of 100 hairs is negligible. (03)

Hair Loss and Stress 

Hair growth is determined by the stem cells within the follicles. Chronic stress affects the adrenal glands. A recent study published in the journal Nature–with support from the NIH’s National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), showed how the hormone corticosterone is impacted by the adrenal glands, which respond to stress. (04

Stress increases corticosterone levels. Corticosterone prevents the stem cells within hair follicles from activating hair growth. Instead, hair follicles remain in an extended resting phase – in the telogen phase. 

Telogen Effluvium

Telogen effluvium is the primary condition responsible for hair loss during stress. Stress can cause a greater than usual amount of hair to suddenly shift to the telogen phase all at once. During telogen effluvium, many strands stop growing, and hair follicles become dormant. Fortunately, hair typically regrows within 6 to 9 months. (05)

Signs of Telogen Effluvium 

With telogen effluvium, hair loss is often abrupt. However, hair loss may begin only a few months after experiencing significant stress. Hair follicles prematurely enter the telogen phase, and the follicles may take up to 3 months to start regrowing hair. 

Unlike other hair conditions, like alopecia areata, the hair loss pattern typically experienced by individuals with telogen effluvium is diffuse hair loss. In other diagnoses like female pattern hair loss or alopecia areata, hair falls off in a patchy pattern, or they may experience a widening of the hair part. In telogen effluvium, hair loss occurs throughout the head resulting in an overall thinning rather than bald spots. (05)

Other Hair Loss Conditions Caused by Stress

Telogen effluvium is the second most common type of hair loss for men and women, but it’s not the only hair loss condition due to stress. Chronic stress may also indirectly cause the following conditions:

Alopecia Areata

Although alopecia areata (AA) is an autoimmune disease, It results in hair loss. In alopecia areata, the immune system mistakenly targets hair follicles, causing patchy hair loss throughout the scalp. Stress may be a trigger for the immune sustain, resulting in further hair loss. There’s no cure for AA, but some prescription hair medications can help manage hair loss. (06)

Trichotillomania

During a bout of trichotillomania, known as “hair pulling disorder,” an individual may feel compelled to pull or tug at their hair. People with trichotillomania have episodes of the disorder during times of significant stress. Trichotillomania causes patches of bald areas where the hair pulling occurred. (07)

Does stress cause male pattern baldness? 

Male pattern baldness, also known as androgenic alopecia, is not caused by stress. The condition is caused by genetics. Unlike telogen effluvium, androgenic alopecia is not temporary. With early treatment, however, individuals with androgenic alopecia can slow hair loss or regrow hair. 

In general, hair loss can be caused by a variety of factors. Finding the reason for your hair loss is important in addressing the issue. Our Happy Head licensed, board-certified dermatologists can help you determine the best approach to your hair loss including a custom topical hair regrowth treatment that’s made for you. Our hair regrowth products are made for both men and women, so there’s a solution for everyone. Contact us to learn what Happy Head can do for you.

Resources: 

(01) https://medlineplus.gov

(02) https://www.ncbi.nlm.nih.gov

(03) https://www.nejm.org

(04) https://www.nih.gov

(05) https://www.ncbi.nlm.nih.gov

(06) https://www.niams.nih.gov

(07) https://www.sciencedirect.com

September is Alopecia Awareness Month – 5 Facts You Need to Know

In 1986, the National Alopecia Areata Foundation (NAAF) declared September Alopecia Awareness Month.  Throughout the month, public service and fundraising campaigns will generate awareness about alopecia areata and support people who live with the condition.  If you see someone sporting a blue ribbon this month, odds are they are promoting alopecia awareness.  

As a telemedicine company dedicated to helping people regrow their hair, Happy Head is proud to support the movement.  Being diagnosed with alopecia can make people feel powerless. However, recent advances give patients more options and hope than ever before.  Here are some facts about the condition and what you can do if you or someone you know is diagnosed.  

1) 6.8 Million People in the United States Are Affected by Alopecia Areata (01)

If you have alopecia, there’s a whole community out there who can relate.  Alopecia areata is an autoimmune disease affecting about 2.1% of the American population. (02)  The percentage may seem small, but it isn’t.  

Three types of alopecia areata exist:

  1. Patchy Alopecia Areata is the most common type.  It leaves small, round spots on your scalp
  2. Alopecia Totalis is when people lose all of the hair on their scalps
  3. Alopecia Universalis occurs when people lose all of the hair on their entire bodies

Alopecia areata can occur with little to no warning in otherwise healthy people.  The condition occurs when a person’s immune system attacks the hair follicles, causing inflammation and hair loss.  Usually, the head and face are affected, but people can lose hair from any part of their bodies in small or large patches.  Neither doctors nor researchers fully understand the cause, but they believe that genetic and environmental factors are involved.  

Alopecia areata is unpredictable, which makes it especially frustrating.  Some people are only affected once, while others have recurrences.  Hair regrowth is unpredictable as well.  Some people can fully regrow their hair, while others cannot.  Treatments to help people regrow their hair are available, but unfortunately, there isn’t a cure.  

2) Alopecia Areata Has Some Common Symptoms

If you think you may be experiencing alopecia areata, you may see: 

  • Round patches about the size of a quarter on your scalp or other areas.  Keep in mind that everyone is different. The patches may be smaller or larger. 
  • Hair growing and falling out at the same time in different parts of your body
  • Substantial hair loss, quickly
  • Asymmetrical hair loss on one side of the scalp rather than on both sides
  • Hair that is narrow at the base and next to the scalp that looks like exclamation marks
  • Rows of tiny dents in your fingernails 

Keep in mind that alopecia areata presents differently in every person.   If you lose your hair, it’s difficult to determine how much you will lose or how long the episode will last.  Trying to self-diagnose alopecia areata is not recommended if your hair is thinning or balding.  Make an appointment with a board-certified dermatologist and hair specialist to get a professional evaluation and diagnosis.  

3) Other Types of Alopecia Can Cause Hair Loss Too

Many conditions can cause hair loss besides alopecia areata. Examples of common types include:

  • Telogen Effluvium causes temporary hair loss due to illness or stress.
  • Androgenetic Alopecia results when too much testosterone converts to an anagen called Dihydrotestosterone (DHT) and is the most common cause of baldness and thinning among men and women.
  • Traction Alopecia occurs when hair is pulled back too tightly into buns, braids, or ponytails.
  • Cicatricial Alopecia (scarring alopecia) occurs when scars form over the hair follicles causing existing hair to fall out and blocking the growth of new hair.

 

The best thing to do if you notice that your hair is thinning or balding is to consult with a medical professional.  He or she can evaluate your case and run any tests necessary to make a diagnosis.  In many cases, treatments such as Minoxidil and Finasteride are available to help regrow hair that has been lost.  

4) New Medications Are Showing Promise in Treating Alopecia Areata

Some people with alopecia areata experience spontaneous hair regrowth.  Others do not.  When hair does not regrow on its own, treatment is available.  

Exciting progress has been made recently in helping people with alopecia areata regrow their hair.  It has recently been discovered that a category of medications called Janus Kinase (JAK) inhibitors can effectively block the inflammatory response thought to be the cause of alopecia areata, allowing for hair growth.  Although JAK inhibitors are often prescribed off-label, one JAK inhibitor was FDA approved in June.  Olumiant (Baricitinib), a medication used to treat rheumatoid arthritis, was approved for adult patients with severe alopecia areata.  In clinical trials, the medication helped a significant number of people regrow their scalp hair to 80 percent compared to a placebo.  (03)

Other treatments often used to treat alopecia areata include:

  • Corticosteroids help calm inflammation and suppress the immune system to prevent further hair loss and allow new growth
  • Minoxidil stops hair from thinning and induces hair growth by enlarging the hair follicles
  • Topical Immunotherapy can be used to suppress the immune response
  • Phototherapy is ultraviolet light therapy sometimes used in conjunction with other treatments

Not every treatment works for every patient.  Often, patients need to try different medications to determine which works best for them.  Using multiple medications that achieve different objectives is also common.  For example, a patient may use Minodixidl with steroid injections and an oral immunosuppresant.  It’s also important to know that some patients will need to continue medications, even if their hair has regrown.  Discontinuing medication may cause a relapse.  

5) You Don’t Have to Leave Your House to Find a Support Group

Coping with alopecia areata is difficult for many people.  Stress, anxiety, and depression can easily accompany hair loss.  For many people, losing their hair is like losing part of their identity.  The grief process takes time.  In the meanwhile, a support group may help.  Thanks to social media, phones, and Zoom, you don’t even need to leave your sofa to access some services.  

The National Alopecia Areata Foundation (NAAF) offers support networks, a youth mentor program, and access to a free online community.  There are also Facebook groups, including one called Alopecia Areata, one called Alopecia Areata, Find a Cure, and another one for Parents of Children with Alopecia Areata.  The networks are a fast, easy way to connect with others who may have had similar experiences.  

Although the cause of alopecia areata is still unknown, thanks to alopecia awareness activities, determined patients, and dedicated doctors, great progress is being made in the development of treatment options.  If you have any questions about alopecia areata or any other type of hair loss condition, contact us.  Our board-certified dermatologists are happy to help point you in the right direction.  

Resources:

(01) https://www.naaf.org/alopecia-areata

(02) https://www.naaf.org/alopecia-areata

(03) https://www.fda.gov/news-events/press-announcements/fda-approves-first-systemic-treatment-alopecia-areata

5 Facts All Men Should Know About Hair Loss

Man looking at his hairline in the mirror, wondering what to do. Happy Head can help you stop hair thinning and loss in its tracks with custom topical solutions made with fda approved ingredients that are just for you.

A few weeks ago, my husband pointed out a Facebook meme that made us laugh. It showed two photos of hair and body care products. One photo included products that women use in the shower, and another photo showed the products that men use.  The women’s photo was loaded with products, including body wash, face wash, two different types of shampoos, and a couple of different types of conditioner. The men’s photo only had one product, a lone all-in-one bottle of body wash, shampoo, conditioner, shaving cream, and toothpaste. Not only was it funny, but it also depicted the scene in our shower pretty accurately. The truth is, though, although some men don’t give their hair a lot of thought, I don’t know of any who are thrilled about the idea of going bald. It’s a super sensitive topic. As nonchalant as my husband is about his hair, even a hint that his hairline is receding results in a very alarmed “What?” and a close scalp examination in the mirror that night.  Hair loss in men is common, but that doesn’t mean you’re okay with it. Nor does that mean that you have to accept your fate. So, if you’re a guy with some recession, thinning, or balding, this one’s for you. We’re here to fill you in on what you need to know about male pattern hair loss and what you can do about it.  

1. Hair Loss in Men is More Common Than You Realize

According to the American Hair Loss Association, by age 50, 85 percent of all men will have significantly thinning hair. (01)  Yes, you read that correctly. The majority of men will deal with some type of hair loss in their lifetime.  Men lose their hair for a lot of different reasons.  Balding or thinning hair can be due to autoimmune conditions, Covid, or even stress. The most common reason, though, is genetics. The vast majority of men with thinning or balding hair have androgenetic alopecia, male pattern baldness. Yup, that’s right. Your parents or grandparents may have passed along a baldness gene.  

Male pattern baldness, also known as androgenetic alopecia, occurs when your testosterone is converted to an androgen (a sex hormone) known as Dihydrotestoterone (DHT). The DHT attacks your hair follicles and causes a reaction called miniaturization which shrinks the follicles. When that happens, the hair that is already there falls out. New hair has trouble emerging through the shrunken follicles, and eventually, the hair stops growing.  

Although Male pattern baldness is the leading cause of hair loss among men; it’s not the only reason men lose their hair. Other forms of alopecia can cause hair loss among men as well. For example, Covid or other illnesses can cause a temporary hair loss called telogen effluvium. In this case, your hair will grow back within six to twelve months. Alopecia areata is an autoimmune condition that causes sporadic bald patches. Some men’s hair spontaneously regrows, but flares can occur at any time without notice.  Lichen planopilaris is another type of alopecia that causes inflammation, leading to scars over the hair follicles that prevent new hair growth.         

2. Timing is Everything When It Comes to Hair Loss Treatments

Many men avoid doctors like the plague. (02)  However taking a “let’s wait and see what happens” attitude isn’t recommended when it comes to hair loss. If you don’t get treatment when you first notice that your hair is thinning, then your hair loss will most likely progress, leaving you with a higher number on the Hamilton-Norwood Scale. In case you don’t know what that is, the Hamilton-Norwood Scale is a classification system developed to measure the extent of baldness. You don’t want to get high scores on that test.  

If you visit a board-certified dermatologist as soon as you see signs of thinning or balding, your doctor will identify the cause of your hair loss. Once you are diagnosed, your dermatologist can recommend treatments to stop your male pattern hair loss and to promote new growth.  

3. Hair Loss Consultations Are Not a Big Deal (Really!)

If the idea of any medical procedure secretly has you a bit nervous, don’t let that prevent you from seeing a dermatologist.  The exam is much easier than you would expect, and trust me, your dermatologist will not think you are vain for seeking treatment.  Dermatologists evaluate men for hair loss conditions all the time.  So, while you may be out of your comfort zone, your dermatologist certainly isn’t.   

Your dermatologist will ask questions about your health, medications, family history, and lifestyle during your exam. The more detailed information you provide, the better. Your dermatologist will examine your scalp to evaluate your hair loss pattern and possibly do a pull test. A pull test measures the severity of your hair loss. During the test, your dermatologist will gently tug on small sections of your hair to see if any strands fall out.  If six or more do, you have active hair loss. Dermatologists usually diagnose androgenetic alopecia based on visual exam. A blood test or a small biopsy may be ordered if he or she suspects another type of alopecia. Don’t stress if you need a biopsy. You’ll be numb, the biopsy area is small, and it heals within a week.

4. Today’s Hair Loss Treatments are Effective and Natural Looking 

After you get a diagnosis, you’ll have many treatment options. The good news is more data than ever is available on hair loss treatments. Research indicates that many are not only safe, they’re highly effective. Here are some examples of the most popular prescription hair loss treatments used:

Minoxidil 

  • FDA approved to treat hair loss
  • Available in oral or topical formulas
  • Brings oxygen to the hair follicles, enlarging them so existing hair does not fall out and new hair can emerge

Finasteride

  • FDA approved to treat hair loss
  • Available in oral and topical formulas
  • Prevents testosterone from converting to DHT and attacking your hair follicles
  • First-line treatment for androgenetic alopecia

Dutasteride

  • Used off label to treat hair loss
  • Only available as a pill like our SuperCapsule
  • Prevents testosterone from converting to DHT and attacking your hair follicles
  • Prescribed if patient does not respond to Finasteride
  • Lower dosage prescribed for Dutasteride than Finasteride

Cortisone

  • Available in pill and topical formulas
  • Reduces irritation and inflammation

Retinoic Acid

  • Available in topical formula
  • Proven to improve absorption of topical Minoxidil and Finasteride

Compounded Topical Formulas

Research has shown that combinations of topical formulas are more effective than monotherapy.  For example, topical Finasteride combined with topical Minoxidil works better than one of the medications alone. (03)  Finasteride and Minodixil combined with Retinoic Acid is more effective because the retinol helps the scalp better absorb the other two medications. (04)

Alternative Hair Loss Treatments for Men

You may also be a candidate for treatments such as Protein Rich Plasma (PRP), laser light treatments, and hair transplant surgery. Let’s talk about what these are and how they work.

Protein Rich Plasma

PRP acts similarly to Minoxidil by bringing oxygen to the hair follicles to enlarge them. During a PRP procedure, your dermatologist draws your blood. The blood is then separated. The plasma is then injected into sites where your hair is thinning or balding. 

Laser Light Treatment

You may have seen ads for laser light caps. Do they work? Well, the jury is out. The philosophy behind them is that the light increases blood flow to the areas on your scalp that are thinning. More oxygen and nutrients are able to reach the hair follicles, allowing the hair to grow thicker and longer. Although research indicates that laser lights show promise for treating hair loss, the most effective intensity and frequency is still to be determined. (05, 06)  

Hair Transplant Surgery

In the 70s and 80s, you could always tell when a man had hair restoration surgery. You could actually see little circular holes where the plugs were implanted. It looked like a doll’s head. Over time, dermatologists have been perfecting the surgery and today’s techniques give a natural appearance. Dermatologists now move individual hairs from a place where the hair is dense to an area where the hair is thinning. (07) You can’t even tell that the hair has been transplanted.  

5. Perceptions of Bald or Balding Men Have Changed for the Better

Men with thin or thinning hair tend to have lower self-esteem and lack confidence, which could explain negative perceptions of their appearance. (08)  The key is to work with what you do have so you feel as confident as possible.  

Yes, there was a time when bald or balding men were deemed less attractive. That’s no longer the case, though. Today, men who embrace their look are seen as intelligent, successful, and confident. (09) Jeff Bezos, Samuel L. Jackson, Ed Harris, and The Rock are prime examples. So if your hair is thinning or balding, work with your barber or hair stylist to find and own a fresh new look. That look can evolve as you undergo hair loss treatment.  

If you notice some recession, thinning, or balding, and are concerned, contact us for a discrete consultation from the comfort of your home, on your schedule. Our board-certified dermatologists and hair specialists are available to evaluate how much hair you’ve lost and your scalp’s condition. Most importantly, they can offer a customized prescription solution to give you the desired results.  

 

Resources:

(01) https://www.americanhairloss.org/men_hair_loss/introduction.html

(02) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6560804/#:~:text=At%20the%20societal%20level%20masculine,not%20go%20see%20the%20doctor.

(03) https://pubmed.ncbi.nlm.nih.gov/32166351/

(04) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2693596/

(05) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8906269/

(06) https://www.karger.com/article/fulltext/509001

(07) https://www.aad.org/public/diseases/hair-loss/treatment/transplant

(08) https://pubmed.ncbi.nlm.nih.gov/16307704/

(09) https://journals.sagepub.com/doi/abs/10.1177/1948550612449490