Tag Archive for: Alopecia Areata

Is There a Genetic Test that Can Predict Hair Loss?

Nowadays, there’s a genetic test for just about everything.  Even to determine our dog’s lineage.   Just one quick saliva sample or blood test and, within days, you can find out if you’re destined for cancer, diabetes, or heart disease.  There’s even a DNA test to determine whether you’re likely to experience anxiety.  

Suppose a genetic test can give you accurate information to guide your health care plan and prevent future disease.  Can it also accurately predict whether you’re predisposed to losing your hair?  If a genetic test shows that you are likely to inherit your Great Uncle Bernie or Aunt Bonnie’s hairline, is there a way to ensure that you don’t follow in their footsteps?  Are genetic hair tests reliable?  Do dermatologists use DNA tests to help make diagnoses? Before you click “Buy Now” to order a genetic test kit, keep reading.  We’re here to answer your questions about genetic testing for male and female pattern baldness.

Can Alopecia Really be Inherited?

When people hear the word “alopecia,” they often think of hair loss caused by a medical condition.  Types of alopecia such as alopecia areata and lichen planopilaris are caused by autoimmune conditions.  Androgenetic alopecia, however, is a type of alopecia that is inherited.  It’s the most common type of alopecia.  As many as 80 percent of all men will experience male pattern baldness in their lifetime. (01)  In addition, many women experience female pattern baldness, usually around menopause.  

What’s the Link Between Genetics and Pattern Baldness?

A study conducted on twins confirms what we’ve long suspected.  Male and female pattern baldness have a genetic component. (02)  About 79 percent of men who were balding in the study could attribute their hair loss to their genes.  But, there’s a catch.  Researchers are still working to fully understand which genes are affected.  We’re still learning.  Here’s what we do know.  There are 63 genes that could potentially cause baldness.  Six of those are associated with the X chromosome, where the Androgen Receptors (AR) are found.  It’s also possible that not one isolated gene is the culprit.  Several genes working together may be to blame.

Can You Take a DNA Test to Determine Whether You Will Go Bald?

Ads make genetic testing very tempting, especially if your Mom or Dad starts losing their hair in their 20s.  It would be nice to know whether you will lose your hair too.  But, unfortunately, we’re not quite there yet.  As mentioned previously, there are still too many unanswered questions about which genes are involved and how the genetic process affects your locks. Also, false positives are not unusual with genetic testing.  You don’t want a test to tell you that you’ll experience androgenetic alopecia if that isn’t really the case. (03)

How do you Know if the Type of Alopecia You Have is Genetic?

When men and women experience androgenetic alopecia, they see specific hair loss patterns.  The first sign for men is usually a receding hairline.  The hair loss then progresses to the top, creating a horseshoe pattern above your ears that circles around to the back of your head.  Female pattern hair loss typically presents differently.  Women usually notice thinning on the top and crown.  Often, women will notice a widening of the center part.  Many other conditions cause hair loss besides androgenetic alopecia.  If you think your hair loss is genetic, be sure to have your dermatologist confirm your findings.  Early diagnosis is key to preventing further hair loss and to stimulating new growth.  You also want to make sure you’re addressing the right condition with the right treatment.  

Do Dermatologists Use Genetic Testing to Diagnose Male and Female Pattern Baldness?

The truth is that dermatologists don’t need high-tech tests to determine whether or not patients have androgenetic alopecia.  Most of the time, they can tell from your hair’s appearance and your hair loss pattern.  If there is any doubt, he or she may use a densitometer to magnify your hair follicles to see if miniaturization is occurring.  Miniaturization is when the hair follicles shrink, causing existing hair to fall out and preventing new growth.  Your dermatologist may order a biopsy and blood test to rule out other causes. Patients often ask about the benefits of running a hair analysis based on what they hear about on social media.   Hair analysis is not used to diagnose male or female pattern baldness.  Instead, it’s used to determine whether there’s lead, arsenic, or another substance causing your hair loss.  

What Can You Do to Treat Hair Loss Caused by Genetics?

Treatment for male or female pattern baldness is designed to meet two goals.  The first is to stop the progression of your hair loss.  The second is to promote new hair growth.   The best way to accomplish those two goals is by using a combination of medications simultaneously.  Here are medications often included in treatment plans for androgenetic alopecia:

  • Minoxidil topical foam – A vasodilator that enlarges the hair follicles
  • Finasteride, Dutasteride, or Spironolactone  – Prevents testosterone from converting to DHT that attacks the hair follicles and causes hair loss
  • Topical or oral cortisone – Treats any redness or irritation (not needed for evey patient)

Some men are concerned about experiencing sexual side effects with oral Finasteride.  If this is the case, topcial Finasteride has been proven to be just as effective without the side effects. (04)  Even better, topical solutions which mix Finasteride with Minoxidil, Cortisone and Retinol offer an even more effective all-in-one solution.  The retinol improves absorption of the other three medications.  

Are There Other Causes of Hair Loss Besides Genetics?

Male and female pattern hair loss are the only types of genetically induced alopecia.  However, other types of alopecia exist and treatment plans are designed to treat the type of alopecia you are experiencing.  Examples of other types of alopecia include:

  • Temporary Alopecia (Telogen Effluvium) – Occurs due to sudden illness, stress, or shock and usually reverses itself without treatment
  • Autoimmune Alopecia (Alopecia Areata and Lichen Planopilaris) – People experience flares and periods of remission
  • Trauma-induced Alopecia (Traction Alopecia and Trichotillomania) – Alopecia results from hairstyles that pull on the hair follicles or when people pull out their hair as a stress response)

Can You Prevent Hereditary Hair Loss?

Let’s play pretend for a minute.  Let’s say that a genetic test does exist that will determine whether or not you will lose your hair.  The tests come back showing that you are genetically predisposed to androgenetic alopecia.   Is there a way to prevent hair loss before it begins?  Sure, eating right, exercising, and managing stress never hurt.  But, even with that, you can’t necessarily fight Mother Nature.  That would be nice, though.  If male or female pattern baldness does rear its head, then it’s time to take action.  

Can You Reverse Hereditary Hair Loss

If you’re experiencing male or female pattern baldness and want to learn more about products available, contact us.  Although there isn’t a way to prevent androgenetic alopecia from occuring in the first place, there are things you can do to reverse the condition.   Minoxidil, Finasteride and other medications have been found to be safe and effective. Our board-certified dermatologists and hair specialists are available to answer your questions and help you develop the ideal treatment plan for your needs and lifestyle. 

 

Resources:

(01) https://www.ncbi.nlm.nih.gov/books/NBK538178/

(02) https://academic.oup.com/biomedgerontology/article/60/8/1077/545174

(03) https://www.nature.com/articles/gim201838

(04) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6609098/

 

What Causes Hair Loss at a Young Age?

Hair loss is never easy to accept, but most people know that it comes with getting older. Losing hair at a young age, however, is a different story. For teenagers and twenty-somethings, unexpected hair loss can be a distressing experience. Fortunately, there are ways to reduce the chances of further hair loss. Let’s take a deep dive into what causes hair loss at a young age and options for addressing the issue. 

Typical Daily Hair Loss

The body loses hair each day as a natural part of each hair’s growth cycle. The American Academy of Dermatologists estimates that a person loses about 50 to 100 strands daily. With approximately 100,000 hair follicles on an average human head, 100 strands a day doesn’t create a noticeable change. Hair loss that’s caused by hair’s natural growth cycle is called “shedding.” (01)

Furthermore, most people will experience some level of hair loss with age. Roughly 40% of women lose more hair each day than men, probably due to heated hair styling tools, regular hair coloring, and hormonal changes. (02) For both men and women, as people age, the rate of normal hair growth slows. 

Hair Loss as a Teen or Young Adult

Losing hair at a young age is not typical. The teen years and young adulthood are a crucial time for building identity and self-confidence; hair loss at this stage can lead to low self-confidence and increased self-consciousness. (03) The following are a few potential causes of hair loss at a young age. 

Alopecia areata

Alopecia areata is an autoimmune condition that results in balding patches throughout the head. In an autoimmune disorder, the body’s immune system mistakenly attacks healthy cells. Unfortunately, in the case of alopecia areata, it’s cells within hair follicles that are damaged by the immune system. As a result, the hair follicles weaken, which leads to hair loss.

About 2% of all people will develop alopecia areata sometime in life. Along with balding patches, the condition can also lead to hair loss on the body, eyebrows, or eyelashes. A majority of people who develop alopecia areata do so before the age of 30. In some cases, however, the condition may begin as early as adolescence or childhood. (04)

Malnutrition

A lack of appropriate nutrients can lead to malnutrition. It’s essential to understand the difference between calorie intake and nutrition. An individual may consume sufficient calories but remain malnourished. A diet consisting of high-calorie foods without an adequate amount of vital nutrients can lead to a state of malnutrition. Malnutrition may also result from not eating enough food or being unable to process foods appropriately.

To maintain a healthy head of hair, hair follicles need the proper nutrients from a well-rounded diet. The following are some of the most vital nutrients necessary for hair growth: (05)

  • Vitamin A
  • Vitamin C
  • Vitamin D
  • Vitamin E
  • Niacin
  • Zinc
  • Biotin
  • Iron
  • Selenium 

A few potential causes of malnutrition in adolescents and young adults are inadequate access to food, eating disorders, restrictive dieting, or health problems. Additionally, a teen diet full of junk food and low on nutrients can lead to hair loss!

A Family History of Hair Loss

People who have close relatives with hair loss are at a higher risk for androgenetic alopecia. Androgenetic alopecia, a genetic condition leading to hair loss, usually begins in adulthood. Although in some cases, this condition may start as early as adolescence. Both men and women can experience androgenetic alopecia, and other names for the condition are male-pattern baldness or female-pattern baldness. 

In males, androgenetic alopecia is usually a gradual balding at the crown or hairline. For women, the condition begins as a slow thinning of hair throughout the head. Both teenage boys and girls can develop androgenetic alopecia, particularly if there’s a family history of the condition. (06)

Polycystic Ovary Syndrome

Polycystic ovary syndrome, also known as PCOS, causes an excess of androgens (male sex hormones) in women and girls of reproductive age. This hormone imbalance can result in female hair loss, even in teenage girls. 

Women typically produce low levels of male hormones, but PCOS causes an overproduction of them.  Due to these extra androgen levels, a woman with PCOS might develop masculine features and hair loss, especially throughout the head. Thinning hair due to hormonal imbalance such as PCOS is called androgenic alopecia or female pattern hair loss. (07)

Thyroid Conditions

The thyroid is a small — but powerful — gland. This gland at the neck produces hormones that control metabolism, heart rate, and mood. The thyroid also manages how the body uses oxygen and controls growth, which is why a low-functioning thyroid (hypothyroidism) can lead to hair loss at any age. 

Thyroid hormones keep hair growing consistently. Without enough thyroid hormones in the system, the hair’s shedding phase lengthens. More hair is shed, and less hair grows, leading to hair loss. Symptoms of an under-functioning thyroid include: (08)

  • Depression 
  • Tiredness
  • Unexplained weight gain 
  • Constipation
  • Dry skin
  • Puffy or swollen face 
  • Joint pain
  • Irregular menstrual cycle

People of all ages can experience thyroid issues. In children and adolescents, untreated thyroid disorders can lead to developmental delays. Thyroid conditions require medical treatment and should not be overlooked. 

Lupus

Like alopecia areata, lupus is an autoimmune condition. Though lupus is typically known for its hallmark symptom of a “butterfly-shaped” rash on the face, another symptom people with lupus experience is hair loss. Unlike alopecia areata, however, two types of hair loss are associated with lupus: scarring and non-scarring. 

Non-scarring hair loss stems from the inflammation caused by lupus. Widespread inflammation can affect the scalp and hair follicles, resulting in non-scarring hair loss. With lupus, hair loss may occur all over the body, including the eyebrows and external limbs. 

Lupus also causes discoid sores that may result in permanent scars. These sores, lesions, and scars can damage hair follicles, resulting in “scarring” hair loss. The hair loss doesn’t cause scarring. Instead, the scarring from lupus can prevent hair from growing, possibly making hair loss in most areas permanent. (08)

Telogen Effluvium

Does stress cause hair loss? Sometimes. Telogen effluvium is a temporary hair loss caused by physical or psychological stress. Events like severe illness, psychological trauma, childbirth, or significant weight loss can result in telogen effluvium.

Telogen effluvium is a temporary form of hair loss that causes excessive hair shedding. Stress, illness, childbirth, or weight loss are some of the many potential causes. Fortunately, this condition typically resolves itself after the stress lifts. 

Traction Alopecia

A tight bun or high ponytail may look chic, but it can pull hair and cause hair loss. Tight hats or headgear may also cause loss of hair over time. This type of hair loss is called traction alopecia and occurs in both men and women. 

In traction alopecia, repeated pulling may cause small pimple-like bumps on the scalp. As traction alopecia worsens, hair begins to fall out. Other symptoms of traction alopecia are: (09)

  • Scalp Redness
  • Folliculitis
  • Scalp tenderness 
  • Itching
  • Scaling 

Identifying and addressing traction alopecia in its early stages is essential because if follicles become too damaged, they will no longer produce and hold new hair.

Hair Styling and Treatments 

Experimenting with hair color is part of adolescence for many teens, and a bottle or two of Manic Panic purple dye will (most likely) not result in hair loss. Bleaching hair, however, can dry hair out and make strands brittle, resulting in breakage. Furthermore, heated styling tools and chemical straighteners also damage hair and lead to broken strands. 

The good news is that these processes don’t usually affect the scalp or hair follicles. However, this can make the hair appear thinner and unhealthy. To prevent breakage, try to keep the use of heated tools to a minimum and use them at a low setting. 

Hair Loss in Teen and Young Adults: Should You Worry?

Thinning hair and balding can occur at any age for various reasons. Obtaining an assessment and treatment as soon as possible, especially for adolescents and young adults, can help prevent issues with self-esteem and improve the chances of successful hair growth. 

Happy Head includes an assessment from a licensed dermatologist with every subscription, ensuring that each person gets to the root of their problem! Every treatment is individualized, and ongoing support is there to help you every step of the way. Take advantage of Happy Head’s six-month money-back guarantee and see what Happy Head can do for you. 

Resources:

(01) https://www.aad.org/public/skin-hair-nails/hair-care/hair-loss-vs-hair-shedding

(02) https://www.ncbi.nlm.nih.gov/pubmed/29193553

(03) https://pubmed.ncbi.nlm.nih.gov/34984078/

(04) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC55

(05) https://www.hairscientists.org/hair-and-scalp-con

(06) https://pubmed.ncbi.nlm.nih.gov/22106721/

(07) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8291365/

(08) https://www.webmd.com/connect-to-care/hair-loss/how-your-thyroid-may-be-causing-hair-loss

(09) https://www.medicalnewstoday.com/articles/320648

How to Avoid Side Effects from Finasteride

If you’ve seen television ads for any medication, you know that almost all of them have potential side effects.  By the time the announcer gets to the end of the (sometimes very long) list, you’re probably wondering why doctors even prescribe the medication in the first place.  But, of course, some medications have more side effects than others.  And, some medications get a bad rap just because one or two out of thousands had unusual reactions.  

Fast forward to Finasteride.  Finasteride, also known as Propecia or Proscar, is often prescribed to treat hair loss due to various conditions.  Finasteride was originally marketed to treat men with enlarged prostates.  During drug trials, doctors noticed that men who took Finasteride as a prostate treatment experienced hair growth.  Finasteride was then FDA-approved to treat hair loss too.  In this case, the side effect was a good one.  However, some male Finasteride users have reported some undesirable sexual side effects.  Should you be concerned?  Not really.  The side effects aren’t typical.  Plus, there are ways to avoid the side effects if that’s a concern.  We’re here to share why you shouldn’t worry if your doctor has prescribed Finasteride to treat your hair loss.         

 

Why is Finasteride Prescribed for Hair Loss?

Finasteride is what’s called a DHT blocker.  DHT is an acronym for dihydrotestosterone, which is an androgen, a male sex hormone. When men and women experience androgenetic alopecia, an enzyme called 5-alpha-reductase converts testosterone to DHT.  When this happens, DHT can bind to the receptors on your hair follicles, shrinking the follicles during a process called miniaturization.  Over time,  the anagen phase of the hair growth cycle is reduced.  The result is hair that is shorter and thinner.  Eventually, new hairs become so small that they can’t penetrate the hair follicle.  As a DHT blocker, Finasteride prevents this process from happening, so you maintain your existing hair and continue to grow healthy new hair.    

What Hair Loss Conditions Does Finasteride Treat?

Oral Finasteride is FDA approved to treat androgenetic alopecia, male and female pattern hair loss.  Male and female pattern hair loss is the most prevalent type of alopecia worldwide.  There isn’t a way to predict who will experience pattern hair loss.  The condition is genetic and can be inherited from either the maternal or paternal sides of the family.  There isn’t a specific test to diagnose androgenetic alopecia.  Dermatologists and hair specialists can make the diagnosis by evaluating a patient’s hair loss pattern. 

Finasteride is also used to treat other types of alopecia, including alopecia areata and lichen planopilaris, which are caused by autoimmune conditions.  However, the prescription is considered off label when prescribed to treat hair loss other than androgenetic alopecia.   

Is Finasteride Effective in Preventing Hair Loss and Stimulating Growth

If you’re wondering whether Finasteride is worth the risk of whatever side effects could occur, that’s a valid question.  Although deciding whether to use Finasteride is highly personal, research indicates that Finasteride is highly effective in promoting growth and preventing further hair loss.  Over 80 percent of men who use Finasteride see improvement, and over 65 percent see new hair growth.  Not only that, the results are long-term.  A study of 1879 men indicates that hair count present after one year was maintained during the second year of treatment.

What are Finasteride’s Side Effects?

Side effects caused by oral Finasteride are usually mild and disappear after you stop taking the medicine.  Here are a few signs to watch:

  • Anxiety 
  • Depression
  • Dizziness
  • Weakness
  • Headache
  • Inability to urinate
  • Testicular pain
  • Runny nose
  • Rash, itching, swelling of the face, lips, or tongue, or other signs of an allergic reaction
  • Swelling of your hands or feet

Although these side effects aren’t exactly desirable, they aren’t most mens’ biggest fear.  Most are more concerned about potential sexual side effects such as:

  • Decreased libido
  • Erectile dysfunction
  • Decreased semen volume
  • Breast enlargement & tenderness
  • Premature ejaculation

The good news is that these side effects aren’t common.  Some men who do experience the sexual side effects find that their symptoms disappear over time as their bodies acclimate to the medication.  If not, discontinuing the use of Finasteride usually resolves the issue.

How Common are Side Effects from Finasteride?

As mentioned previously, side effects from Finasteride aren’t common.  The main reason is that the dosage typically prescribed to treat alopecia is usually very low, much lower than the dosage prescribed for prostate treatment.  As a matter of fact, only 3.8 percent of men who took Finasteride experienced side effects during the drug’s clinical trials.  That’s compared to 2.1 percent of men who took a placebo.  

Want to Avoid Finasteride Side Effects?  Use Topical Finasteride Instead

If you’re still a little worried about using Finasteride, even though the risk of side effects is low, there’s a simple solution. Use topical Finasteride instead of oral Finasteride.  The topical solution has been proven to be just as effective in treating male and female pattern baldness without the same risk of side effects.  Whereas oral Finasteride is metabolized in your stomach, topical Finasteride is not systemic.  Even better, topical Finasteride has less impact on serum DHT concentrations.  Think of it as a highly effective spot treatment for your hair.     

Research also indicates that combining Minoxidil with Finasteride yields even better results than using either medication alone.  Adverse reactions among patients were rare, indicating that the combined medication is not only a good choice, but a preferable one.  

Are You a Good Candidate for Finasteride?

Finasteride is often prescribed to both men and women to treat androgenetic alopecia.  The medication is generally safe for most people.  There are some exceptions though.  Finasteride is not recommended if you have kidney problems, prostate cancer, liver disease, or any other liver-related issues.  The medication is also not recommended to women who are pregnant, trying to get pregnant, or are breastfeeding.

What Should You Do if you Experience sexual or Other Side Effects from Finasteride?

If you think Finasteride is causing side effects, stop taking the medication and contact your dermatologist.  The side effects usually go away after the medication is out of your system.  However, you’ll want to work with your dermatologist to identify a substitute.  

When considering a new medication, it’s important to do your research and feel confident about your choice.  Finasteride is no exception.  If you have questions and are looking for answers, we’re here to help.  Our board-certified dermatologists and hair specialists look forward to giving you the information you need, when you need it, to get the healthiest, most effective hair loss treatment.  

 

Resources:

(01) https://pubmed.ncbi.nlm.nih.gov/9951956/

(02) https://pubmed.ncbi.nlm.nih.gov/9951956/

(03) https://pubmed.ncbi.nlm.nih.gov/34634163/#:~:text=Conclusion%3A%20Topical%20finasteride%20significantly%20improves,impact%20on%20serum%20DHT%20concentrations.

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

 

The Real Story Behind Vitamins that Prevent Hair Loss

I hate to start with a spoiler, but I’m going to start with a spoiler.  Neither vitamins nor supplements are FDA-approved or regulated for any type of hair loss.  Or, for any other health condition for that matter.  This means that information required to establish safety and effectiveness has not been submitted to or approved by the FDA.  Yet, do an Amazon search using the terms “vitamins for hair loss,” and pages and pages of products appear with assurances that the vitamins will help you regrow your hair.  Biotin, keratin, saw palmetto, and proprietary collagen blends are just a few that pop up on the first page, with prices varying from $11 to over $176.  Trying to figure out which ones are effective and worth the investment can make your head spin.   

If your hair is thinning or balding, it’s smart to question whether vitamins will help or if manufacturer promises are too good to be true.  So which ones do dermatologists and hair specialists recommend?  We’re here to answer your questions and set the story straight.  

Get Diagnosed Before You Buy Vitamins to Treat Your Hair Loss

Before you even think about trying any vitamins, you need to start with a diagnosis.  After all, you need to know what condition you’re treating.  Here are the three most common types of alopecia that cause either temporary or permanent hair loss:

  • Telogen Effluvium

Telogen effluvium is a type of temporary hair loss that can occur up to several months after a traumatic or stressful incident.  The condition can be triggered by various events, including high fevers, surgery, certain medications, nutritional deficiencies, and autoimmune diseases.  When physiologic stress occurs, hairs that would normally be in a growing phase are abruptly pushed into a resting phase, resulting in shedding.  The shedding can occur in either small or large amounts.  While hair loss from telogen effluvium can be upsetting in the short term, the long-term prognosis for regrowth is good.  No medication is typically needed.  Hair usually grows back within six months to a year.  

  • Androgenetic Alopecia

Androgenetic alopecia is also known as male or female pattern baldness.  The hair loss condition occurs when too much testosterone converts to an androgen called dihydrotestosterone (DHT).  The condition is genetic and can come from either the maternal or paternal sides of your family.  The hair loss pattern among men with androgenetic alopecia differs from that of women.  Men tend to lose their hair on the front and top of their heads.  Women usually notice their hair loss first along their widening center parts.  Oral and topical medications have been proven to help prevent further hair loss and facilitate growth.  

  • Alopecia Areata

Alopecia areata is an autoimmune hair loss condition that can affect women, men, and children.  Hair loss is usually noticed first in small round or oval patches.  In some cases, hair spontaneously regrows, and in others, the hair loss becomes permanent.  Treatment usually focuses on treating any underlying conditions and using topical and oral medications.

Determining whether you have one of these forms of alopecia is a multi-step process.  Your dermatologist will likely order blood work as part of the diagnostic process.  The lab results will indicate whether vitamin deficiencies could be contributing to your alopecia.  If so, you may benefit from supplementation.  

Vitamins are Helpful When People with Alopecia Have Deficiencies

Much conflicting information exists about the role that vitamins and supplements play when it comes to hair loss.  More research is clearly needed.  The general rule of thumb when it comes to vitamins is to supplement if there’s a deficiency.  Particular deficiencies can be associated with the three types of alopecia we discussed.  Here are the three most common:

Vitamin D

Research has demonstrated that people with telogen effluvium, androgenetic alopecia, and alopecia areata are likely to have vitamin D deficiencies. (01)  The greater the deficiency, the greater the hair loss.  Vitamin D is absorbed into the skin by keratinocyte cells.  The cells process keratin which is found in your hair, nails, and skin.  When your body has a vitamin D deficiency, the keratinocytes in your hair follicles have difficulty regulating the growth and resting phases of the hair cycle.  

Iron

In addition to checking for Vitamin D3 deficiencies, dermatologoists typically check their patients’ iron levels. Iron deficiency inhibits hemoglobin production which produces the oxygen responsible for hair cell growth and repair.  Low iron is a common cause of alopecia and can easily be remedied with a supplement.  

Biotin

People don’t typically have Biotin, Vitamin B7, deficiencies in industrialized countries.  A regular diet typically provides enough nutrients to ensure adequate levels.  However, some research studies have demonstrated that biotin deficiencies often exist in people with hair loss. (02)(03)  Experts have conflicting views on whether biotin supplements are necessary, even when there’s a deficiency.  It’s best to consult with your dermatologist on this one.  

Should You Take Vitamins if You Don’t Have a Deficiency?

Even if you don’t have a deficiency, it’s tempting to take vitamins to see if they will help regrow or thicken your hair.  More isn’t always better though, especially in this case.  Taking too many supplements or the wrong type of supplements can create issues.  For example, extra vitamin A or vitamin E can cause hair loss, which is what you are trying to prevent in the first place.  

Prescription Medications Are Often Used With Vitamins to Get Better Results

If your dermatologist doesn’t think that you are a good candidate for vitamin supplementation, prescription medications may be a good alternative.  This is especially true if you have been diagnosed with male or female pattern baldness.  Medications commonly prescribed include:

Minoxidil (FDA Approved)

A vasodilator designed to enlarge the hair follicles so you can start to regrow your hair.  

Finasteride, Proscar, Propecia (FDA Approved)

A medication that blocks the conversion of testosterone into DHT that attacks your hair follicles.

Dutasteride, Avodart (Not FDA Approved)

A DHT blocker prescribed as a second-line medication if Finasteride does not give the desired results.

Spironolactone (Not FDA Approved)

A DHT blocker prescribed only to women as a second-line medication if Finasteride does not give the desired results.

Minoxidil and Finasteride are both available in oral and topical formulas.  Topicals are often preferred, especially among men, because they do not cause sexual side effects such as lower libido.  Topical medications have been proven to be just as effective as oral medications.

The most effective hair loss plans often combine vitamins and other over-the-counter treatments with prescription medications. Vitamin D, Minoxidil, and Finasteride would be a logical combination if a person with androgenetic alopecia has a vitamin D deficiency.  Prescriptions that effectively combine multiple topical medications into one are available and are convenient and easy to use.  

Some Supplements Have Shown Moderate Improvement in Hair Loss

Although they are supplements rather than vitamins, there has been a lot in the news lately about pumpkin seed oil, saw palmetto, and rosemary oil.  While not quite as effective as Finasteride, these supplements have demonstrated a significant increase in hair growth. (04)  These supplements may be a good adjunct therapy when combined with prescription hair loss medication.

Curcumin, the active ingredient derived from turmeric, is known as a natural anti-inflammatory.  Interestingly, curcumin did not improve hair growth on its own, but it did give positive results when combined with Minoxidil.  The hypothesis is that the curcumin helped the Minoxidil better penetrate the scalp.  However, more research still needs to be conducted.  

Garlic gel, derived from onions, scallions, shallots, leeks, and chives, doesn’t live up to the hype.  Users did not see a significant difference in hair growth.  

As with any product you try as a hair loss solution, make sure to consult with your dermatologist first.  Even products that seem innocuous can have side effects or contradict other medications.  Your dermatologist is the best person to evaluate your treatment plan and determine the best mix of prescription and over-the-counter options.  

What To Do If Vitamins Aren’t the Answer to Your Hair Loss

Vitamins can be helpful if your bloodwork indicates that you have certain deficiencies.  If not, proceed with caution.  Even the most effective supplements aren’t typically as strong as prescription medications to slow hair loss and stimulate growth.  If you need an alternative solution for your thinning or balding hair, Finasteride, Minoxidil, and other medications are effective and are available by prescription.  For more information about your options, contact us.  Our board-certified dermatologists and hair specialists are available to answer your questions and make recommendations based on the type of alopecia you have.  We can even customize a formula to meet your specific needs.

Resources:

(01) https://pubmed.ncbi.nlm.nih.gov/34553483/

(02) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4989391/#:~:text=Biotin%20deficiency%20was%20found%20in,risk%20factors%20for%20biotin%20deficiency.

(03) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6388561/

(04) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6388561/

(05) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6388561/

 

Why Self-diagnosing Your Hair Loss is a Bad Idea

“When did you graduate from medical school?” my husband asks me on a regular basis.  I didn’t, but I am a self-proclaimed expert in the medical field anyway.  Why wouldn’t my Google education make me highly qualified to diagnose the whole family’s symptoms and illnesses?  Evidently, I’m not the only one self-diagnosing.  A survey conducted in March 2020  indicated that nearly one-third of all Americans do their own medical research. (01)

Being your own doctor can work against you though.  In fact, when I first started losing my hair, I didn’t even think to have it checked.  Based on what I read, postpartum hair loss is normal, and I had two babies in two years.  I would never in a million years have guessed that I had alopecia.  However, knowing what I know now, I do not recommend waiting to consult with a medical professional if you’re noticing an unusual amount of hair loss.  Treating hair loss early helps you prevent further shedding and even regrow your hair.  Here are seven more reasons why you should schedule an appointment with a board-certified dermatologist and hair specialist if you’re concerned about the amount of hair you’re losing. 

Reason #1:  Dermatologists are familiar with hair loss patterns associated with specific hair loss conditions.  

Your dermatologist has spent countless hours studying and memorizing the different types of hair loss.  Many times, just looking at patients’ hair loss patterns gives your dermatologist clues as to where to start with a work-up to get a diagnosis.  Common hair loss conditions and associated patterns are:

  • Androgenic alopecia (men) – Receding hairline and gradual thinning on top
  • Androgenic alopecia (women) – Widening of the part 
  • Alopecia areata – Patchy or circular bald spots on the head, eyebrows, or beard
  • Telogen effluvium – Overall thinning due to sudden hair loss
  • Fungal infection – Scaly patches that spread over the scalp
  • Alopecia totalis – Full-body hair loss

If your dermatologist suspects that you have androgenic alopecia, known as male or female pattern baldness, he or she may use the Norwood scale, a scale of 1 to 7, to track the progression of your hair loss.  The scale helps your dermatologist recommend the best possible treatment options to prevent further hair loss and stimulate growth based on the amount of recession or thinning you have.  

Reason #2:  Your doctor can determine the severity of your hair loss

Losing a certain amount of hair is normal and is part of the hair growth cycle.  How do you know if the amount you’re seeing in the sink or shower is too much?  You don’t.  However, once your dermatologist has an idea of your hair loss pattern, he or she has a number of tools and tests he or she can use to determine the extent of your hair loss.  The most common are:

Pull Test

A pull test is pretty much as the name indicates.  During the test, your doctor will gently tug on small sections of hair from parts of your scalp.  Usually, the litmus test is six or more strands.  If you lose that much, your hair loss is active.  

Scalp Biopsy

A scalp biopsy, also known as a punch biopsy, is often used to determine what type of alopecia you have. It allows pathologists to see inflammation and can distinguish whether the alopecia is scarring or non-scarring.  To take the biopsy, your dermatologist numbs the area and uses a pencil-sized device to remove a small amount of tissue that is sent to a lab for analysis. The incision is closed with a couple of small stitches.   

Trichometric Analysis

If your dermatologist wants to analyze your scalp and hair, he or she may do a trichometric analysis using a small handheld device with a high-definition camera.  The device magnifies images by up to 100 times so your hair, hair follicles, and scalp can be seen in great detail.  The tool shows how much hair is covering your scalp, and the diameter of each hair strand.  Dermatologists often use this camera to monitor progress after you begin treatment.  

Fungal Culture

If your dermatologist suspects that your hair loss is due to a fungus in your hair or scalp, he or she may run this test.  Fungal cultures determine if a condition called tinea capitis, scalp ringworm, is causing your hair loss.  During the test, a small sample of skin or hair is sent to a lab for incubation.   

Reason #3:  Your vitamin levels may need to be checked

Often one of the first questions dermatologists often ask new patients is whether they have recently had a routine blood test.  The reason why is because simple vitamin deficiencies can cause hair loss.  Fortunately, if this is the case, supplements will usually solve the problem quickly and easily.  The two most common vitamin deficiencies that cause hair loss are vitamin D and iron.  

Studies have shown that vitamin D has anti-inflammatory properties and affects the hair cycle. (02)  When your body has a vitamin D deficiency, regulation of the hair follicles is challenging.  Growth and shedding cycles are disrupted causing your hair to suddenly fall out.

Iron deficiency stunts the production of hemoglobin which transports oxygen to the cells in your body, including the cells that make your hair grow.  The hair follicles lack the nutrients they need to thrive.  With an iron deficiency, hair sheds and thins, giving the appearance similar to androgenic alopecia.

 

Reason #4:  Your hormones may be out of whack

 

Your dermatologist may also run blood tests to check for hormonal imbalances.  Hormone imbalances can cause hair to get dry, brittle, thin, or fall out altogether.  The only way to know if this is the case is to have your levels checked.  

Contrary to popular belief, high or low testosterone is not an indicator of hair loss.  Research has continually demonstrated that there is not a link between serum androgen levels and androgenic alopecia. (03)  Instead, male pattern baldness could be linked to an androgen sensitivity or high androgen density. 

Factors that can affect your hormone levels include:   

Menopause

Estrogen levels fall before, during, and after menopause while testosterone levels inversely increase.  During the process, the testosterone converts to dihydrotestosterone (DHT) which attacks your hair follicles, and makes your hair fall out.  

Stress

Stress is a bigger contributor to hair loss than most people realize.  When you are stressed out, your body creates cortisol which disrupts the function and regulation of your hair follicles as well as your hair growth cycle.  

Pregnancy

During pregnancy, estrogen levels rise, causing your hair to get fuller and thicker. After the baby is born, however, those levels drop rapidly, making the excess hair shed.  It can take a while for your estrogen levels and hair loss to balance out.  

Thyroid

Both hypothyroidism and hyperthyroidism have been linked to alopecia.  In a 2013 study, patients aged 21-40 with thyroid disfunction were likely to have diffuse alopecia and alopecia areata.  Patients older than 40 were more likely to have alopecia areata and androgenic alopecia. (04)  The findings confirm the importance of checking thyroid levels when there is a hair loss issue.  

Reason #5:  You could have a scalp infection 

A number of scalp infections can cause hair loss.  These infections can easily be confused with various types of alopecia, but once treated, hair typically regrows.  Examples include:

Ringworm

Ringworm is a fungal infection that forms scaly, raised, red patches.  Itching is a common complaint among patients with scalp ringworm and is typically treated with anti-fungal medications.  

Scalp Psoriasis

Psoriasis is an autoimmune condition that causes thick red patches, and sometimes scaling.  There isn’t a cure, but proper management can help prevent hair loss.

Seborrheic Dermatitis

Seborrheic dermatitis causes dandruff in adults, characterized by dry, flaky skin, and typically does not cause hair loss.  Shampoos and topical medications are often recommended. 

Lichen Planus

Lichen planus causes inflammation and can leave tiny red bumps on your scalp.  The cause is not known for certain, although autoimmune dysfunction is one of the possible causes.  Topical creams are often used to treat symptoms, but in many cases, lichen planus will disappear without treatment.  

Your dermatologist has been trained to address and treat all of these infections.

Reason #6:  Sometimes you need an outside perspective

When your dermatologist takes your medical history, he or she may be able to identify bad habits that are affecting your hair and contributing to your hair loss.  Some of these habits may include:

  • Smoking
  • Poor diet filled with processed foods
  • Stress
  • Tight buns, ponytails, braids, or other hairstyles that can pull on your hair and cause traction alopecia
  • Compulsively pulling on your hair (trichotillomania)

Reason #7:  The most effective medications are only available by prescription

Hair loss products are similar to skincare products in that very few over-the-counter (OTC) products are truly effective.  If you have a graveyard of barely or partially used tubes and containers under your bathroom sink, you get the picture.  The reality is that besides Minoxidil which is sold OTC as Rogaine in a 5 percent formula, you’re wasting your money on OTC hair loss products.  You’ll need a doctor to write a prescription.  Some of the most effective and widely used prescription hair loss medications that your doctor may prescribe are:

Minoxidil

Designed to enlarge the hair follicles and prevent miniaturization.  Used to treat a broad spectrum of hair loss conditions.  

  • Sold OTC in foam and liquid formulas
  • Available by prescription in higher dose pills and topical formulas

Finasteride

Prevents testosterone from converting to DHT, which attacks the hair follicles and causes hair loss.  Often used to treat male and female pattern hair loss.  

  • Available only by prescription
  • Reported sexual side effects such as lower libido by some users
  • Used by both men and women, but not recommended for women of childbearing age
  • Topical formula is proven to be equally as effective as the pill without the undesirable side effects since it is not systemic.  

Retinol

A derivative of Vitamin A that improves the absorption of Minoxidil, Finasteride, and other medications that stimulate hair growth.

  • Typically not used as a stand-alone hair loss solution
  • Low OTC doses not as potent as prescription doses

Spironolactone

A DHT blocker used to treat female pattern hair loss.

  • Available only by prescription
  • Safe for women who have not been through menopause

When to see a doctor

In a 2015 study conducted by the National Library of Medicine, nearly one-third of people surveyed reported avoiding the doctor, even those with major health problems. (05)  The result was later detection, reduced survival rates, and more suffering than necessary.  You won’t die if your hair falls out, but why lose your hair if you don’t have to?  If you are experiencing hair loss, be sure to seek medical treatment from a licensed dermatologist.   Early medical intervention not only prevents further hair loss but in many cases, can help you regrow your hair.  

If you have hair loss concerns and if accessibility and/or affordability is an issue, visit us at happyhead.com.  You will have the opportunity to consult with one of our board-certified dermatologists and hair specialists.  No insurance or co-pay is required.  You only pay for the product if deemed necessary and appropriate.

Resources:

(01) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7084283/#:~:text=Surveys%20suggest%20that%20a%20large,self%2Ddiagnose%20using%20online%20information.

(02) https://pubmed.ncbi.nlm.nih.gov/34553483/

(03) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7432488/

(04) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3746235/

(05) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4351276/#:~:text=People%20often%20avoid%20seeking%20medical,survey%20reported%20avoiding%20the%20doctor.&text=Even%20individuals%20with%20major%20health,12%20avoid%20seeking%20medical%20care.

Devastated About Your Hair Loss? Tips to Help You Cope.

Hair loss can be devastating. At Happy Head, we always have tips ready to help our customers cope with the loss of their hair. You can also get treatment while you work through the effects. Don't worry, Happy Head is here to help.

“It seems to me that being “not okay” is a perfectly acceptable response to this unwanted, unannounced situation.  There’s nothing wrong with feeling “not okay” on some days or in some situations.  We are grieving the loss of our hair, the loss of our identity, the loss of our sense of self, and the loss of our confidence.”

– Sarah, Member of Alopecia Areata, Find a Cure (01)

In January of 2020, Massachusetts Representative Ayanna Pressley made an announcement with a video that she has alopecia.  Much like Jada Pinkett Smith, Pressley is in the public eye and tried to hide her condition as long as she could.  Pressley decided that she was done hiding.  She took off her wig and shared her story.  The video helped Pressley make peace with her condition.  Coming forward helped Pinkett Smith in a similar way. “Me and this alopecia are going to be friends,” said Pinkett Smith.  

Alopecia may not be life-threatening, but it’s upsetting no matter what type you have.  Whether you have androgenic alopecia, alopecia areata, telogen effluvium, or any other kind of alopecia, men and women go through a similar grieving process when losing their hair. (02)   

Society’s expectations of what’s attractive don’t make it easy to accept your hair loss. Somehow we can talk about sex, curse, and even be openly rude to each other, but revealing that you’re balding or completely bald is shocking and newsworthy.    

So how do you get to the point when you’re “okay” when it feels like you never will be? We asked Rachel, one of our staff writers with lichen planopilaris, an autoimmune alopecia, how she got there. 

Q. How did you find out that you had alopecia?

Rachel: When my son was about one and a half, I noticed a lot of hair in the shower and sink. My hairline also started to recede on one side.  I had just had two babies back-to-back, and I figured that my hair was falling out from the hormonal changes.  I thought it would grow back.

Then, during a routine visit to the dermatologist, I had my doctor take a look.  He took a biopsy, which I thought was overkill for a slight hormonal imbalance, and I didn’t think about it again until I got a phone call.  The call wasn’t from a nurse or an assistant.  The dermatologist called me himself.  I knew right away that the news wasn’t going to be good. 

Q. How did you react when you found out that you have alopecia?

Rachel: I remember being really upset and desperately hoping that my dermatologist was wrong.  I was a ballet dancer all of my life and always had my hair back in a ponytail or a bun.  There wasn’t a way to hide the recession, and I wasn’t sure how to make my hair look presentable. 

Q. How did your alopecia diagnosis affect you emotionally?

Rachel: It was a tough time.  I hated the way my hair looked, and I kept imagining what I would look like as the rest of it fell out. On top of that, I felt guilty about being so vain.  People get all kinds of horrific diseases as they age, yet I was lucky enough only to get something cosmetic.  I didn’t think I had the right to be so upset about my hair.  Looking back, I wish I could tell my younger self that it’s okay to be upset.  It’s a natural part of the healing process.    

Q. How did you treat your alopecia? Did it help?

Rachel: Shortly after I was diagnosed, I found a top dermatologist in my area who specializes in hair loss. Initially, I was treated with steroid injections (yes, they hurt), topical Clobetesol, five percent Minoxidil, and Tacrolimus. The goal was to prevent further hair loss and strengthen the surrounding hair.  

My alopecia went into remission for over ten years, but recently flared up again. My treatment this time around is a bit different.   It’s amazing how much research has been conducted and how much has been learned since I first started on this journey. My dermatologist added Finasteride to my treatment plan.  Much to my surprise, I’m seeing small areas where hair is growing back.  I didn’t expect that to happen.

Q.  What did you do to get to a better place emotionally when you were feeling down about your hair loss?

Rachel: I set a time limit to allow myself to be upset. I gave myself a week and decided that after the week was over, I would let my sadness go and focus on other things. The time limit gave me power over my emotions and the situation when I didn’t have any control.   

When the lichen planopilaris flared up after being in remission for so long, I regressed a bit. I wasn’t as upset as I was the first time because I had some experience, but I definitely got emotional. I had to go through the same process of limiting my grief.  I think emotions tend to ebb and flow with alopecia. Everyone has to find what works for them when managing those strong emotions.

Q. A lot of people with alopecia are at a loss about how to style their hair.  What did you do?

Rachel: I visited my hair salon and got a sassy, short haircut.  I wasn’t sure that I would like short hair, but it’s since become my style.  If my alopecia gets so bad at some point that I have to cut it shorter, I will.  

Ironically, this process has given me confidence and taught me to own my look, whatever that is at the time.  Although it’s not a choice that everyone would make, I found that cutting my hair was liberating. I followed the protocol that my doctor prescribed for me, but I stopped fretting about every hair that I saw in the sink.

Q. What advice do you have for other men and women who are experiencing hair loss?

Rachel: Most importantly, find a board-certified dermatologist who you like and respect. You’re going to need a supportive partner. If you don’t think you have the right professional on your side, get second opinions until you find the right person.   

Secondly, I’m in a few Facebook groups for people with alopecia and read about how many are apprehensive about testing.  If your dermatologist recommends getting blood work or a biopsy, do it. The blood test isn’t a big deal, and the biopsy area is small.  Your dermatologist will numb the area. You won’t feel anything, and the site heals quickly. The small bit of aggravation is worth knowing if you have a form of alopecia. You can then move quickly into treatment.  

Lastly, be kind to yourself. It takes time to come to terms with your hair loss. If you visit online or in-person support groups, you’ll see that you’re not the only one experiencing alopecia. Millions of other people are in your boat. It’s common for people with alopecia to suffer from anxiety or depression. (03) If this is the case for you, don’t hesitate to seek help from a professional therapist or psychologist.  

Healing from the sting of learning that you have a form of alopecia isn’t easy. Now that we’ve heard Rachel’s story, we would love to hear yours. What tricks have you used to make yourself feel better emotionally when dealing with alopecia? And if you’d like to get your FREE consultation with a Happy Head dermatologist and get prescribed a custom hair loss treatment all online, take the questionnaire here. 

 

Resources:

(01) Name has been changed for confidentiality

(02, 03) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1261195/#ref11

Hair Loss Reversal 101: What You Need to Know

Older man looking at his thinning hair in the mirror. Happy Head dermatologists can help you get your hair back with a custom topical treatment made with the strongest hair growth medicine available online.

If you’re experiencing hair loss, you’re not alone. According to the American Hair Loss Association, at least two-thirds of all American men will have noticeable hair loss by the time they turn thirty-five. Women account for forty percent of all Americans experiencing hair loss. (01) Those numbers are much higher than you thought, right?

Sure, most people expect to get some gray hair, wrinkles, and a few extra pounds as they age, but hair loss? That’s not usually part of the plan. We can color our hair, use Botox for our wrinkles, and spend some extra time at the gym. But what can be done about a receding hairline? More than you think.

There are Different Types of Hair Loss

The first step is to understand the different types of hair loss. All hair loss is not the same, so not all hair loss will respond to the same treatment. We’re here to give you a crash course.

The Term Alopecia Encompasses More Conditions Than Most People Realize

When people think of alopecia, they usually think of alopecia areata, the type that Massachusetts Representative Ayanna Pressley and actress Jada Pinkett Smith have. However, if you use Dr. Google, you’ll see that WebMD defines alopecia areata as an “autoimmune disorder that causes your hair to come out, often in clumps the size and shape of a quarter.” The definition is accurate, but not all hair loss is alopecia areata. Alopecia is an umbrella term for many different hair loss conditions.

There’s a Difference Between Non-Scarring and Scarring Alopecia

Alopecia falls under two broad categories:  non-scarring and scarring alopecia. There’s a big difference between the two types.

When people have non-scarring hair loss, their hair just falls out. No redness, scaling, flaking, itching, or burning occurs. The alopecia can come on fast and furiously, leaving people holding clumps of hair in their hands, or gradually over a long period of time.

Scarring alopecia is a different story. Also known as cicatricial alopecia, scarring alopecia is an inflammatory condition that occurs in otherwise healthy people. The hair follicle is destroyed and replaced with scar tissue. The hair loss can happen over time and go unnoticed, or it can happen quickly, causing symptoms such as severe itching and burning. (02) Speed is essential when it comes to treating scarring alopecias. The goal is to slow or stop further hair loss and promote hair regrowth in unaffected areas.

What Type of Alopecia Do You Have?

Many different types of hair loss fall under the categories of non-scarring and scarring alopecia.  Once you know what type you have, your dermatologist will work with you to develop a treatment plan.

Examples of Non-scarring Alopecia

Telogen Effluvium

Telogen Effluvium is a form of temporary hair loss caused by stress, severe chronic illness, high fever, childbirth, thyroid disorders, major surgery, dieting, certain medications, etc.  Telogen Effluvium usually resolves itself over time.

Androgenic Alopecia

Also known as male and female pattern baldness, androgenic alopecia is a genetic condition experienced by up to 50 percent of men and women. (03) Experts believe that pattern baldness is due to an excessive androgen dihydrotestosterone (DHT) response which causes hair follicles to miniaturize. When the hair follicles shrink, hair loss occurs. Androgenic alopecia typically causes frontal hair loss in men and diffuse hair loss at the crown and top of women’s heads.

Alopecia Areata

If your hair falls out in clumps around the size and shape of a quarter, you may have alopecia areata. This condition is an autoimmune disorder that occurs when your body attacks its own hair follicles. With alopecia areata, hair loss is unpredictable and can happen anywhere on your body. Sometimes the condition resolves itself. However, it can also reoccur without notice. Many research studies are currently underway to understand the cause and effective treatment. (04)

Traction Alopecia  

Constant pulling on hair due to tight ponytails, buns, braids, cornrows or dreadlocks, hair extensions, weaves, and more can cause traction alopecia. This condition, that’s common among actresses and models, can cause small bumps that resemble pimples. Fortunately, traction alopecia can be reversed if you stop pulling your hair back.

Examples of Scarring Alopecia

Lichen Planopilaris

Lichen Planopilaris is the most common type of scarring alopecia. Although it can affect both genders, lichen planopilaris is more likely to affect women aged 40 to 60 than men. (05)  Redness, itching, burning, and tenderness can accompany frontal or other pattern hair loss.

Central Centrifugal Cicatrical Alopecia (CCCA)

CCCA is found almost exclusively among black women aged 30 to 55 year-old. The cause is still unknown and is being researched. Women who experience CCCA experience inflammation and associated hair loss in the crown area. (06)

Effective Hair Loss Treatment Complements Your Diagnosis

After your dermatologist determines the cause of your hair loss, he or she will discuss treatment options with you.  Keep in mind that hair reversal treatments are not one-size-fits-all.  In some cases, “cocktails” which combine specific medications and protocols may be needed. Just to give you an idea of what’s out there, here are some of the most frequently used medications and treatments:

Minoxidil (Rogaine)

Minoxidil, also known as Rogaine, is available over-the-counter as a topical foam and liquid and by prescription as an oral pill.  Minoxidil is a vasodilator reduces miniaturization of the hair follicles and elongates the growth phase.

Minoxidil has proven to promote growth among men and women with male and female pattern hair loss. Minoxidil is also often recommended to patients with scarring alopecia to promote growth in unaffected areas.

Once you start using Minoxidil, you need to continue. When you stop using the medication, any new hair that grows will most likely be shed.

Finasteride (Propecia, Proscar)

Finasteride is a 5 alpha-reductase inhibitor originally designed to treat enlarged prostates. The medication, available both as a pill and a topical solution, blocks the conversion of Testosterone to dihydrotestosterone (DHT), a hormone that inhibits hair growth.

Clinical studies have found Finasteride to be highly effective in reversing hair loss in both men and women with scarring and non-scarring alopecias. (07, 08) Topical Finasteride is often used to treat androgenic alopecia, while oral is typically recommended for scarring alopecias.

Finasteride is only available by prescription and is not recommended for women of childbearing age. Check with a board-certified dermatologist to see if you are a good candidate for the topical or oral treatment. Don’t have time to make an appointment? Don’t worry, you can get custom topical treatments and oral medications prescribed by a Happy Head board-certified dermatologist, have a consultation and get it all shipped to your door each month. Just fill out our quick questionnaire, send us a few photos, and get started on growth here.

Corticosteroids

Topical or injected steroids are often used to treat hair loss that is induced by autoimmune diseases such as alopecia areata and lichen planopilaris. The corticosteroids allow hair to grow by inhibiting the autoimmune disease.

Steroid treatments are only available by prescription and should be surprised by a qualified dermatologist.

Platelet-rich Plasma (PRP) Injections

PRP injections have become a popular treatment for healing wounds and regrowing tissue such as tendons, ligaments, and muscles.

PRP has regenerative properties and has been primarily tested on patients with androgenetic alopecia. (09) When injected into the scalp, PRP is believed to stimulate hair growth by increasing blood flow to the hair follicles and increasing the size of the hair shaft.

As the name suggests, PRP injections are made from platelets derived from your blood. Blood is first drawn, and then spun at super high speeds to separate the blood components. The resulting plasma is highly concentrated.

PRP use is still in its early stages and can be expensive. Research also indicates that PRP is most effective when used with Minoxidil, Finasteride, and other hair growth treatments.

Biotin

Biotin, also known as Vitamin B7 or Vitamin H, has become a familiar hair growth supplement. Sold in supplements or as an ingredient in hair care products, Biotin is promoted as a way to make your hair grow longer and healthier.

Does it work? Well, the jury is out. Not enough research has been conducted to say yeah or nay. (10) It won’t hurt you to try a new shampoo that contains Biotin, but there’s no evidence to indicate that it will help. Biotin deficiency is rare. (11) Most people get adequate amounts through their regular diets.

Many Biotin supplements sold are not FDA approved, and high concentrations of Biotin can interfere with the results of some lab tests. (12) As with any oral supplement, check with your doctor before testing it out.

Hair Transplants

Hair transplant procedures and techniques continue to improve over time. Rather than using noticeable plugs, today’s surgeries move hair strips or carefully selected hairs from one area to another to promote growth that looks natural.

When determining whether a patient is an ideal candidate for a hair transplant, dermatologists consider several factors, including:

  • Type of hair loss
  • Degree and pattern of baldness
  • Patient age
  • Hair color
  • Donor hair density
  • Patient expectations

Although hair transplants are expensive and time-consuming, they are an effective, reliable, and safe way to get lasting results.

It’s Important to Set Realistic Expectations When Treating Alopecia

We’re fortunate to live during a time when hair loss research is prolific, and the list of hair replacement options is growing.  Whether you’re 25 or 55, you don’t have to live with bald spots, a receding hairline, or thinning hair, even if your genetics or immune system are working against you.

The first step is to find a board-certified dermatologist and hair specialist you trust and get diagnosed. He or she will help you select the right treatment option for your type of alopecia and lifestyle.  Remember to set realistic expectations for your hair regrowth. Treatments don’t work overnight, so be patient and track your progress over time. After all, small signs of stubble today can lead to a fuller head of hair tomorrow. To get in touch with a Happy Head dermatologist and do your consultation over the phone, get started here and you can do it all from home.

Resources:

(01) https://www.americanhairloss.org/

(02) https://rarediseases.org/rare-diseases/cicatricial-alopecia

(03) https://www.ncbi.nlm.nih.gov/books/NBK430924/

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

(05) https://www.ncbi.nlm.nih.gov/books/NBK470325/

(06) https://jamanetwork.com/journals/jamadermatology/fullarticle/2768748

(07) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4809380/

(08) https://pubmed.ncbi.nlm.nih.gov/9951956/

(09) https://www.health.harvard.edu/blog/platelet-rich-plasma-does-the-cure-for-hair-loss-lie-within-our-blood-2020051119748

(10) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5582478/

(11) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5582478/

(12) https://www.fda.gov/medical-devices/in-vitro-diagnostics/biotin-interference-troponin-lab-tests-assays-subject-biotin-interference