Tag Archive for: Alopecia

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/

What Every Man Should Know About Male Pattern Baldness

 

Close your eyes and visualize a middle-aged guy.  What do you see?  Maybe a few distinguished worry lines?  A slight bulge around the middle saying, “Hey, go back to the gym”?  A receding hairline or a shaved head?  Whoa, stop right there.   Do all men go bald?  Is that really your fate too?  

While it’s true that data indicates over 50 percent of men have extensive hair loss by the age of 50, there are ways to avoid becoming part of that statistic. (01)  There are many reasons why men go bald, and more effective treatments are available than ever before.  If you’re a guy worried about losing your hair, read on.  This one’s for you.  

Why Do Men Go Bald?

If you find sacred strands of hair scattered in your sink every time you comb or brush, you may wonder why.  Do you have a rare disease?  Are you using your cell phone too much?  Are there toxins in your water?  Most likely not.  The explanation is much simpler than you would think.  

Most Guys Are Genetically Predisposed to Hair Loss

Genetics is the most common cause of hair loss among men. (02)  If a family member on your mother or father’s side has experienced hair loss, you may have inherited a baldness gene that causes male pattern baldness.  Let’s talk about what that means.  

Male Pattern Baldness is a Type of Alopecia

Because of your genetic make-up, an enzyme called 5a reductase converts testosterone naturally found in your body to a substance called Dihyrotestosterone (DHT).  DHT tells your hair follicles, “Hey, there’s an invasion.  Close up shop and hunker down.”  The hair follicles shrink, and healthy new hair can no longer grow.  

What About Genetic Testing?

Are you thinking, “No problem, there’s genetic testing for just about everything these days, right?”  If so, it’s true that genetic tests for androgenetic alopecia (aka male pattern baldness) exist.  The only catch is that they aren’t quite perfected yet.  So, what can you do if you think your hair loss has a genetic link?

First, consult with a licensed dermatologist who specializes in hair loss.  If you’re anti-doctor and procedure-phobic, don’t stress.  Male pattern baldness has specific hair loss patterns that allows diagnosis without any invasive testing.  If it turns out male pattern baldness is causing thinning or recession, many treatment options are available.

Treatment Options for Male Pattern Baldness

The best way to treat male pattern baldness is to hit your scalp from different angles with various medications.  One that you’ll want to consider is Rogaine.  You’ve probably heard of it before.  Rogaine liquid and foam is sold over the counter (OTC) to help open up your hair follicles.  The generic version, Minoxidil, is sold by prescription in higher doses than what’s available OTC.    

You’ll also want to use a prescription DHT blocker to prevent DHT from being produced in the first place.  Finasteride and Dutasteride are the ones most commonly prescribed to men.  Finasteride is effective in most men and is used as the first-line treatment.  Dutasteride is a bit stronger and can be prescribed if Finasteride isn’t doing the trick.  Retinol and cortisone are often added to the mix to improve absorption and prevent irritation.  

Do Finasteride and Dutasteride Have Undesirable Side Effects?

Finasteride and Dutasteride are both prostate medications prescribed for men with male pattern baldness.  Finasteride is FDA-approved and Dutasteride is used off-label.  You may have heard friends or family members talking about the medicines.  And, you may have rumors about some side effects like impotence that make you nervous. 

Don’t worry, though.  You don’t have to choose between your hair or your sex life.  You can have both.  If you’re thinking about taking oral Finasteride or Dutasteride, consider this.  The percentage of men who experience side effects is really small.  During Finasteride’s clinical trials, less than two percent of men taking the drug experienced side effects. (03)

If you’re worried about becoming one of the two percent, topical Finasteride or Dutasteride may be a good option.  Topicals have been proven to be equally effective as oral DHT blockers (04) and don’t carry the same risk of side effects since they work at the scalp and aren’t systemic.   

How do Topical Brands Compare?

It’s no great secret that the hair loss industry is booming.  Prescription hair loss medications that used to only be available at a pharmacy are now available via telemedicine.  Deciding which ones to use can be difficult.  Are the formulas the same?  Do the brands work differently?  To help you answer those questions, Fin vs. Fin recently compared topical hair loss treatments based on active ingredients, ease of application, and price.  Check out their review to see how industry leaders stack up.

Although Not as Common, Men Experience Alopecia for Other Reasons

Male pattern baldness accounts for most hair loss among men.  However, other conditions can also cause alopecia.  A small percentage of men experience alopecia due to autoimmune conditions.  Alopecia areata is an autoimmune disease that causes small, round patches of hair loss.  Lichen planopilaris can cause recession, smooth white patches, and an itching or burning sensation.  It’s important to see your dermatologist for a diagnosis and treatment plan if you’re experiencing hair loss.  If you have one of these conditions, early intervention is key to preserving your hair.

Thinning or Balding Can Be Temporary

When your body experiences sudden changes, temporary hair loss called telogen effluvium can occur.  Covid, the flu, and having surgery can shock your body and cause hair in the resting state of your hair’s growth process to fall out all at once.  Stress can cause the same effect.  If continual conflicts at home or work burnout is an issue, finding ways to cope will help.  You may also want to get your vitamin levels checked.  Vitamin D and iron deficiencies can also lead to temporary hair loss.  

So, let’s recap.  Even if you are predisposed to balding, there are ways to preserve your hair.  Get checked out by your dermatologist to determine the cause and know that treatments are available.  If you need advice, we’re here to help.  Happy Head has licensed dermatologists in every state who are available to answer your questions.  We also offer tested hair growth pills, topicals, shampoo, conditioner, and supplements developed by hair loss specialists Dr. Ben and Sean Behnam.   

 

Resources:

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

(02) https://pubmed.ncbi.nlm.nih.gov/16127116/

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

(04) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7648777/

 

Men’s Hair Can Be Damaged and Dry Too. Here’s What You Can Do.

Men usually worry more about losing their hair than about if their hair is healthy.  Women are generally the ones who stress over dry, damaged hair.  After all, hair dryers, flat irons, bleaching, coloring, tight ponytails, and braids can take a toll.  Most men are happy not to deal with all of that.  Even so, it’s not ideal when men’s hair looks dried out or frizzy.  Not to mention that hair that doesn’t look healthy sometimes isn’t.  So, guys, let’s talk about your hair’s appearance and texture.  We have some tips on how to improve your hair’s condition and what to do if you think there’s something causing damage that’s out of your control.

What Causes Men to Experience Dry Hair?

Before we talk about what you can do to repair your hair, let’s discuss the reasons why your hair may be dry or damaged.  Let’s start understanding what happens when your hair gets dried out.  Oils that keep your hair healthy are produced in your hair’s roots.  There isn’t a source of natural lubrication.  When your hair’s natural oil and moisture are lost, it also loses its smooth texture and shine.   There are many reasons why this could happen.  The most common reasons are aging, health conditions such as thyroid disease, and the effects of sun, wind, and other weather-related conditions.  If your hair begins to thin due to male pattern baldness, your hair’s texture can also change.  Thinner hair can become wavy, dry, and brittle.  

How Does Men’s Hair Get Damaged?

Here’s what happens when your hair gets damaged.  Each strand of your hair is protected by a cuticle, which is a protective layer.  When your hair cuticles are healthy, they sit closely together and lock in moisture.  The cuticle protects your hair from elements such as chlorine and sun exposure.  However, those cuticles can peel away from your hair when they separate.  Your hair can’t hold moisture or natural oils.  Contrary to what many people believe, you cannot repair damaged hair.  It’s not a living tissue and doesn’t have regenerative abilities.  However, damaged hair that is cut can grow healthy cuticles.   

How Guys Treat Dry or Damaged Hair

If your hair doesn’t look in tip-top shape, all is not lost.  Here are some tips that can help:

  • Use the Right Shampoo 

If a two-in-one is your go-to for the shower, you may want to rethink your shampoo.  A good quality shampoo helps not only clean your hair, but will help balance your scalp’s chemistry.  Shampoos include detergents, pH adjusters, preservatives, thickeners, scents, and additives.  Harsh ingredients strip the oils out of your hair.  If your hair is dry, you’ll want to avoid lauryl sulfates, sarcosinates, and other harsh ingredients known for deep cleaning.   Instead, look for mild cleaning agents such as polyoxyethylene fatty alcohols, polyoxyethylene sorbitol esters alkanolamides, betaines, sultaines, and other gentle cleansers that also help make your hair more manageable. (01)

  • Remember the Conditioner

Skipping conditioner may save time, but it also means that you’re missing the opportunity to add moisture.  Conditioning seals your hair’s cuticles to keep the moisture locked in between washes.  Topical hair loss treatments such as Minoxidil or Finasteride may affect the texture of your hair, especially at the beginning when the medications first start working.  A good conditioner can help by making your hair more shiny and manageable.  Conditioners will often include ingredients such as hydrolyzed silk, animal protein, and glycerin.  When selecting a conditioner, look for protein-derived substances.  Protein works with the keratin in your hair to hold the cortex fragments together.  Your split ends will mend temporarily until the next time you shampoo. (02) 

  • Hair Masks Aren’t Just for Women

If you’re looking for a quick-fix to make your dry, brittle hair softer and more manageable, we’re going to share a secret weapon to treat your hair: hair masks.  Yes, women are the ones who usually use hair masks.  But, not only can men use them once or twice per week, they give short-term results that make your hair stronger, shinier, and tamer.  Keep in mind that you should only apply a hair mask from the roots to the ends of your hair.  Hair masks aren’t meant to be used on your scalp. The hair mask that you choose will depend on your hair’s texture.  It’s helpful to look for keywords such as “fine” or “coarse” that match your hair type.  Hair masks with all-natural ingredients and keywords such as “keratin” and “biotin” are good choices.  

  • Visit Your Barber Regularly

Sure, it was probably fun having long Covid hair and not having to visit the barber every five weeks.  However, if your hair is dry or damaged, it’s important to keep those appointments.  Overgrown split ends make your hair look messy and frizzy.  Not to mention that when men go too long between trims, they end up with an awkward, unflattering shape that’s tricky to camouflage.  No matter how many styling products you use, your hair will still look unkempt. 

  • Eat a Protein-rich Diet

If your hair is dry or damaged, make sure you’re eating plenty of protein.  Protein will strengthen and repair the keratin in your hair strands.  You’ll still need a trim to get rid of the damaged ends, but more protein and keratin means your hair will grow stronger.  A lack of protein has actually been linked to hair loss. (03)  When your body doesn’t get enough protein, your body will conserve what it has by shifting hair into a resting phase when your hair falls out.  Good protein sources include eggs, chicken, shrimp, fatty fish, nuts, tofu, legumes, and cottage cheese. 

  • Ask Your Dermatologist About Vitamins or Supplements

If your hair is dry or damaged and you aren’t sure why, it may be a good idea to have your vitamin, iron, thyroid, and other blood levels checked.  Hyper and hypothyroidism can both cause dry, brittle hair.  Low iron and other vitamin deficiencies can cause the same effect.  Balancing your thyroid or supplementing with vitamins usually brings noticeable improvement.  

  • Stop Using Harsh Coloring Products

If you color your hair and notice signs of damage, it’s a good idea to stop.  In some cases, hair dye lifts the cuticle from the hair and changes the texture.  The hair that’s been colored won’t return to its natural state.  However, only the hair that has been dyed will be affected.  New hair that grows from your scalp will have your original texture and sheen. 

  • Don’t Wait to Get a Professional Opinion

By the time you notice that your hair’s texture and finish has changed, there’s a good chance that damage has already occurred.  A visit to the dermatologist can help you understand why your hair doesn’t seem as smooth or manageable as before.  Once you identify the culprit, you can start to get your hair back on the road to good health.

Sometimes men don’t realize that the change in their hair’s texture or appearance is due to male pattern baldness, telogen effluvium, or another type of alopecia that can be treated.  If you aren’t sure why your hair’s texture or appearance has changed and want a professional opinion, we’re here to help.  Simply fill out the questionnaire.  One of our board-certified dermatologists will review your case and make recommendations on what you can do to get your hair back on track.   

 

Resources:

(01) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4458934/

(02) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4458934/

(03) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5315033/

 

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/

 

Hair Loss Reversal 101: What You Need to Know

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.

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.

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/safety-communications/update-fda-warns-biotin-may-interfere-lab-tests-fda-safety-communication