Tag Archive for: Androgenetic Alopecia

Are These Ordinary Things Damaging Your Hair?

It’s not surprising that elements like chlorine and salt water can make your hair look dry and frizzy.  Or that flat irons, hair dryers, and other heat styling can cause heavy-duty breakage.  Bleach and highlights, well, no surprise there, either.  You’re probably careful about avoiding these known troublemakers, especially if your hair is thinning or balding.  After all, you want the hair that’s remaining to stay as healthy as possible.  It’s difficult to avoid things you don’t know can damage your hair, though.  You don’t know what you don’t know.  So, we’re here to fill you in on some very ordinary things that could wreak havoc on your tresses.  

Hard Water Can Cause Bad Hair Days

Finding the right shampoo and conditioner is usually top of mind when it comes to hair care.  But do you ever think about what kind of water you’re using to wash your hair?  Is the water coming out of your showerhead hard or soft?  Hard water isn’t harmful, but it can be harsh on your hair.  

First, let’s talk a little bit about what hard water is.  When you look at water, you usually see a clear liquid.  What you can’t see is the concentration of minerals and chemicals in the water.  The concentration of minerals, specifically calcium and magnesium, determines your water’s hardness.  The higher the amount of calcium and magnesium, the harder the water.  You may be unable to tell if your water is hard or soft.  A couple of signs that it’s hard are if your drinking glasses get cloudy or your hands still feel slippery after you’ve washed them with soap and water.  

Now, what does hard water mean for your hair?  One research study found that hard water can actually damage your hair. (01)  When hair samples were washed in hard water versus distilled water for 30 days, the distilled water samples were thicker and less crumpled looking.  If your hair is dull, brassy, has a green hue, breaks or tangles easily, check your water. 

If you discover that your water is hard, there are some things you can do to protect your hair.  One option is to use a vinegar rinse  or clarifying shampoo once a week.  Another option is to install a showerhead with a filter.  Whole house water softener filtration systems are also available.  Filters and water softening systems reduce the mineral concentration in the water, leaving your hair softer and silkier.  

Addicted to Hairspray or Gel?

Most of us were not born with that perfect hair we see in ads.  You know what we mean, that glossy, thick hair that falls exactly into the right place, even in the rain and wind.  So, we resort to the next best thing.  Hairspray or gel that freezes our hair in place and gives us that extra hold.  It works, right?  But is it really good for you?  

Hairspray or gel probably won’t make your hair fall out.  They could, however, dry out your hair and cause breakage.  Alcohol, ethanol, parabens, and fragrances tend to cause the most damage.  Also, formulas that clog your hair follicles could make it harder for new hair to grow.  If you can’t live without something to give your hairstyle a little extra hold, look for products that contain all-natural and hydrating ingredients such as argan oil and biotin.  

What about sea salt sprays?  They’ve become popular for adding volume and texture.  Are they okay since salt is a natural ingredient?  Yes and no.  In moderation, sea salt spray is fine.  Too much, however, will have the same drying effect as you get when swimming in the ocean.  Salt strips the moisture out of your hair.  

Stressed Out?  Here’s An Excuse to Treat Yourself to a Massage.

It’s not surprising that stress takes a toll on our minds and our bodies.  Headaches, digestive issues, heart disease, and more have all been linked.  This one may surprise you, though.  Hair loss can be directly related to stress.  Think about it.  When you get stressed, your body reacts involuntarily by getting tense.  Your blood vessels constrict, and there isn’t as much oxygen flowing to your scalp and hair follicles as usual.  And when your hair follicles don’t feel the love, they can’t sustain or produce healthy hair.  The technical term is called telogen effluvium.  Fortunately, stress-induced hair loss can resolve itself over time.  Meanwhile, a good massage, 30 minutes a day with a meditation app, or a brisk walk may be just what the doctor ordered.

Avoiding Your Barber or Stylist

Growing your hair out?  Too busy to get in for a haircut?  You may want to squeeze in time for an appointment.  When you go too long between visits, you can end up with split ends.  Split ends mean that your hair is more likely to break higher up near the shafts.  The longer you wait between cuts, the higher the damage to your hair strands.  Trims every four to six weeks will help keep your hair healthier and stronger.  

It May Be Time to Change Your Pillowcases

This one may seem far fetched but stay with us.  Switching to silk pillowcases may help keep your hair healthier.  If your pillowcases are cotton, the fibers could be rough.  If that’s the case, your hair rubbing against the fibers could cause tangling and breakage.  You know what it takes to get a knot out of your hair.  Extra brushing and yanking leads to breakage.  The fibers themselves could also cause breakage.  Cotton is known for absorbing oils as well. Silk pillowcases do a better job of allowing your hair’s natural oils to stay on your head where they belong rather than on the pillowcase where they could cause acne.  

Yet Another Reason to Quit Smoking

If you’re a smoker, you probably don’t want another lecture on quitting.  You’ve heard it all, or so you thought.   Did you know that smoke from cigarettes can damage your hair follicles?   When you smoke, your body is exposed to toxic chemicals, including formaldehyde and arsenic.  These and additional toxins damage the structure of your blood vessels. Some of those blood vessels affect your heart.  Other vessels lead to your head and scalp.  When the blood vessels are exposed to the toxins and shrink, the blood flow to your hair follicles is reduced.  That means new, healthy hair can’t be produced.  Existing hair may fall out.  

Your Genetics May Be Working Against You

If you notice that your hair is thinning or balding, you may be experiencing androgenetic alopecia, male or female pattern hair loss.  It’s a genetic condition that affects a large percentage of the population.  Men who experience the condition see a receding hairline.  Women usually notice a widening part.  Hereditary hair loss can occur any time after puberty, so even people in their 20s may be affected.  The best way to know for sure is by checking with your dermatologist.  If it turns out that your hair loss is due to androgenetic alopecia, medications including Minoxidil, Finasteride, Dutasteride, and Spironolactone are available to stop the shedding and stimulate hair growth.  The medications help enlarge shrinking hair follicles and prevent your hormones from converting to androgens that cause hair loss. 

Can Damaged Hair be Repaired?

If damage is already done, is there anything you can do to repair your hair?  Take heart.  All is not lost.  First, stop using any offending products.  If the damage is stems from smoking, stress, or other behavior, lifestyle changes will help.  If your hair is thinning or balding, it’s always good to consult with your dermatologist.  As mentioned, you may be experiencing male or female pattern hair loss or another type of alopecia that can be managed with the right treatment.  

Not sure what’s damaging your hair?  Our hair growth experts are here to help.  All of our doctors are board-certified dermatologists experienced in diagnosing and treating conditions that affect your hair.  They’ll be able to help you figure out if your hair is damaged from something you might not be aware of or if you have a form of alopecia that can be treated. We also offer customized treatments ranging from thickening shampoos and conditioners to prescription hair regrowth formulas.  Best of all, you can order from your couch and receive your delivery at your front door.   Get started now!

 

Resources:

(01) https://pubmed.ncbi.nlm.nih.gov/30034190/

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

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

1. You Can’t Fight Genetics

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

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

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

2. You’re Having an Autoimmune Response 

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

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

3. You’ve Had Surgery or Been Sick

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

4. You’re Stressed Out

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

5. Your Hair Needs Some TLC

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

6. You’re Experiencing Side Effects From A Medication

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

7. Your Lifestyle Could Use Some Improvement

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

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

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

Early Hair Loss Treatment is the Best Hair Loss Treatment

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

We’re Here to Help

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

 

Resources:

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

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

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

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

 

Worried About Going Bald? Why Men Are More At Risk Than Women.

Unless you were lucky enough to be born with perfect genes, the odds are that you’ll experience hair loss at some point in your life if you’re a guy.   By age 35, about two-thirds of all men begin to notice that their hair isn’t quite as thick as it once was.  Or even more alarming, they start to see a bit of recession on their foreheads.  By the age of 50, that number shoots up to 85 percent. (01)  Yes, women lose their hair too.  But why does it seem like men have noticeable hair loss while women still have their standing weekly appointments to get their hair blown out?  

Androgenetic alopecia affects both men and women.  However, it affects each gender differently.  If you’re wondering why male pattern hair loss seems so much more prevalent, we’re here to fill you in.  We have the facts and tips on what you can do if thinning or recession are stressing you out.  

Why Do Men Go Bald?

There are several reasons why men lose their hair.  The most common is due to androgenetic alopecia, male pattern baldness.  The hair loss condition is genetic.  You can inherit it from either your mother’s or father’s side of the family.  Hair loss begins when testosterone converts to an androgen called dihydrotestosterone (DHT).  DHT attacks the hair follicles and shrinks them during a process called miniaturization.  When the hair follicles miniaturize, a couple of things happen.  First, the hair that is already there falls out.  Secondly, the smaller hair follicles make it more difficult for new hair to emerge.  Newer hair tends to be finer.  Eventually, the follicles close off, leading to thinning and baldness.  While most people think of balding happening to older men, the truth is that male pattern baldness can affect any male after puberty.  It’s not unusual for men in their 20s and 30s to lose their hair.

Does Too Much Testosterone Cause Male Pattern Baldness?

There’s a theory that bald men have more testosterone than men with a full head of hair.  Which would explain why more men than women go bald.  That’s just a myth, though.  The amount of testosterone isn’t what causes male pattern baldness.  The amount of testosterone that converts to DHT is what matters.  If a man has low testosterone levels, but a high percentage of the testosterone he does have converts to DHT, male pattern baldness can result.  

Can Women Go Bald Too?

Women experience androgenetic alopecia too.  It’s called female pattern baldness.  However, women’s and men’s hair loss patterns are different.  Men tend to lose hair in the front of their heads and on top.  Male pattern baldness often starts as an M shape.  If the condition progresses, it can result in a donut shape.  The pattern of women’s hair loss is different, however.  Women tend to lose their hair along the part line.  Although the hair loss can and does spread, women with female pattern baldness usually don’t go completely bald the way men do.  That’s one of the reasons why it seems like men are more affected by genetic hair loss.  

If a Man Loses His Hair Due to Male Pattern Baldness, Can it Grow Back?

Men with androgenetic alopecia can regrow their hair if the hair follicles have not fully miniaturized and are still intact.  It’s also possible to make thinner hair fuller and healthier looking.  Fortunately, there are two FDA-approved medications designed to help.  

Minoxidil Is Easily Accessible

The first is Minoxidil.  You can buy Minoxidil over-the-counter at drug stores and big box retailers that sell pharmaceutical products.  Minoxidil is sold in two and five percent liquid and foam formulas.  Higher percentages, up to ten percent, are available by prescription.  Not surprisingly, research indicates that five percent (02) is more effective in achieving regrowth. Researchers do not know the exact mechanism that makes Minoxidil work.  But, they do know that Minoxidil brings oxygen to the scalp, enlarging hair follicles, preventing miniaturization and hair loss.  

Finasteride Is a First-line Prescription Treatment for Male Pattern Hair Loss

Finasteride is a prescription DHT blocker that has been FDA-approved to treat male pattern baldness.  The medication, marketed initially to treat enlarged prostates, is effective in promoting hair growth and stopping hair loss in men. (03)  Finasteride prevents testosterone from converting into DHT, which can attack and shrink the hair follicles.  Some men, however, are reluctant to try or use Finasteride because it has a reputation for causing sexual side effects.  Using topical Finasteride is a good, often preferred, alternative that allows men to benefit from the medication without experiencing systemic effects.  

Treatment for Male Pattern Baldness Often Requires a Combination of Prescription Medications

If you’re starting to see thinning or bald spots and are worried about losing your hair, don’t wait to seek treatment.  As mentioned, you want to act while your hair follicles remain active.  A combination of medications are typically used at the same time.  Minoxidil and Finasteride are often prescribed together.  Minoxidil, a vasodilator, enlarges the follicles, while Finasteride stimulates growth. (04)  Depending on your particular case, your dermatologist may also recommend Retinol to help absorption, Cortisone to eliminate irritation or other medications.  Liquid formulas that combine multiple medications into one are available if you’re concerned about taking multiple medications and side effects. 

Customized Hair Loss Treatments Can Be Modified

Keep in mind that treatment for male pattern baldness isn’t one-size-fits-all.  It may take some trial to determine which combination of medications works best for your body’s chemistry.  Finasteride is typically the first-line treatment since it’s highly effective.  However, some men find that Dutasteride, a more broad-spectrum DHT blocker, works better for them.  The key is to remember that once you start treating your hair loss and find a solution that works, you’ll need to keep using it.  If you stop treatment, any growth will be lost.

No, you can’t change your genetic makeup, but you can treat your hair loss.  If you have questions about what medications are right for you, contact us.  Our board-certified dermatologist will review your case and recommend the best way to start regrowing your hair.

 

Resources:

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

(02) https://pubmed.ncbi.nlm.nih.gov/12196747/

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

(04) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4314881/

 

8 Facts That People with Hair Loss Should Know About Rogaine (aka Minoxidil)

Dermatologists often recommend Rogaine as the first line of treatment for many different types of hair loss.  It’s well-tested, relatively inexpensive, and easy to find on drugstore shelves.  However, if you skim through Facebook groups for people experiencing androgenetic alopecia (male and female pattern baldness) and other types of hair loss, you’ll see that people are often hesitant about using Rogaine for a wide variety of reasons.  Whether you’re on the fence, heard a rumor about Rogaine that you’re not sure is true, or just want a little more information before picking up a 3-month supply, you’re in the right place.   We’re here to give you the facts.  

1. Rogaine is FDA-approved to Treat Male and Female Pattern Baldness

In the 1970s, Rogaine, the brand name for the generic medication called Minoxidil, was tested in an oral pill form to treat hypertension.  During research studies, physicians noticed that the medication caused a side effect of regrowing hair that patients had lost.  The discovery led to the development of a topical hair loss formula designed to treat male and female pattern baldness.  In 1986, a two percent topical formula was marketed, and the five percent was made available in 1993.  Rogaine is only available in liquid and foam formulas.  Minoxidil is also available as a pill that is taken orally.  

Currently, Rogaine and Finasteride, a DHT blocker, are the only FDA-approved medications available to treat androgenetic alopecia.  However, Rogaine is often used off-label to treat other types of hair loss, including alopecia areata and scarring alopecias.  

2. Rogaine is Effective

Rogaine has been used for over 30 years and has been thoroughly tested over the years.  Although the exact reason why Rogaine works is still a bit of a mystery, research indicates that the hair loss medication is effective when patients use the medicine as prescribed.  What is known is that Rogaine is a vasodilator, which means that the medication brings oxygen to shrunken hair follicles and enlarges them, allowing new, healthy hair to emerge.  Rogaine may also prolong your hair’s growth phase.  When more follicles are in the growth phase, you’ll see more hair coverage on your scalp.  A study conducted in 2004 by the Journal of the American Academy of Dermatologists indicated that over 90 percent of patients in the study achieved growth or halted hair loss after using Rogaine for one year. (01)

Dermatologists can also combine Rogaine with other hair loss medications to maximize results.  Research indicates that Rogaine combined with Finasteride has better efficacy than Rogaine alone when treating male or female pattern baldness. (02)

3. You may shed hair before new hair begins to grow

You may have heard of the dred shed people get when they first use Rogaine.  Yes, it’s a real thing.  Not all people experience initial shedding, but some do during the first few months of using the medication.  When shedding occurs, it means that the Rogaine is doing its job.  Keeping it simple, Rogaine accelerates the last stages of hair growth when the old hair falls out so that your hair can go through the growth phase faster.  That means you may see more hair loss for a short period before seeing new growth.  Most people notice small changes in three or four months.  It can take up to a year to get complete results.  

4. Certain application techniques make Rogaine more effective

You may have heard about a derma roller before.  It’s a little roller that gently punctures the skin to allow topical products to penetrate the skin deeper than if you apply the products with your hands.  According to research, people with androgenetic alopecia who use a derma roller to apply Rogaine get significantly better results. (03)  If you have another type of alopecia that isn’t male or female pattern hair loss, check with your dermatologist before using a dermaroller.  Dermarollers aren’t recommended for people with scarring alopecias.  

5. Rogaine is available without propylene glycol

Fortunately, topical Rogaine doesn’t have a lot of side effects.  If you do experience irritation, it’s possibly due to propylene glycol in one of the liquid formulas.  Propylene glycol is an active ingredient that contains two different types of alcohol.  If you experience irritation, you can make a couple of easy changes.  The first is to use Rogaine foam rather than liquid.  The foam does not contain propylene glycol.  If you use a compounded liquid formula that includes other medications, such as Finasteride and retinol, you can request that the propylene glycol be omitted.  

6. Yes, it’s true that once you start using Rogaine, you have to continue

Once you begin using Rogaine, you’ll need to continue to maintain the hair you grow.  If you stop using the hair loss product within three to four months, you will most likely lose any newly grown hair.  Your hair will look the way it did before you started using Rogaine.  

7. Stronger formulas do give better results

Rogaine is sold over-the-counter in two and five-percent liquid and foam formulas.  As you might guess, the 5 percent formula is more effective than the two percent for both men and women.  According to a study conducted on men, the five percent formula worked faster and resulted in better scalp coverage than the two percent formula. (04)  Although Rogaine is not sold over the counter at a higher dose, the generic equivalent, Minoxidil, is available by prescription for up to 10 percent and can be prescribed off-label.  Higher doses can cause more irritation than lower doses.  Minoxidil combined with cortisone helps prevent irritation from occurring.  Combining retinol as well helps improve absorption.  

8. Rogaine is safe to use on facial hair too

Some people with forms of alopecia are disturbed when they realize that they have lost hair in their eyebrows, mustache, and beard areas.  Fortunately, Rogaine is effective for facial hair as well as hair on your head.  According to a research study, Rogaine was superior in enhancing beard growth.  Adverse effects were mild. (05)

If you have male or female pattern baldness or another type of alopecia, being able to take proactive steps toward halting your hair loss and stimulating new growth can be empowering.  If you are a bit nervous about giving Rogaine a try, remember that it is a trusted medication with few downsides and many potential benefits.  And our board-certified dermatologists and hair specialists are here to help.  Let us know if we can answer any further questions or be of assistance.

 

Resources:

(01) https://www.jaad.org/article/S0190-9622(03)03692-2/fulltext

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

(03) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3746236/

(04) https://pubmed.ncbi.nlm.nih.gov/12196747/

(05) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6691938/

Is Propecia (aka Finasteride) the Right Medication for You?

After months of stressing out about how much hair you’ve lost, you finally pay a visit to your dermatologist.  You talk to your doctor, have an examination, and finally get the news you’ve been dreading.  You have androgenetic alopecia, another name for male or female pattern baldness.  You were trying to process the diagnosis and heard the dermatologist mention the medication Propecia, but couldn’t fully concentrate on what he or she was saying.  You were too focused on the fact that you are losing your hair.  Now that you’ve calmed down, you have decisions to make. Should you try taking Propecia or not?  Will it work?  Is there a less expensive generic version?  Does it have any side effects?  If these or other questions are swirling around in your head, you’re in the right place.  We’re here to give you all of the information you need to help you decide whether Propecia is right for you. 

Why is Propecia Prescribed?

Propecia, the brand name for the generic medication Finasteride, is FDA-approved to treat male pattern baldness. Although the medication is not FDA-approved to treat women, it is often prescribed off-label for female pattern baldness.  Both Propecia and Finasteride work the same.  The difference between the two medications is the price.  Since Propecia is a brand name, it is more expensive due to associated marketing costs.

Is Propecia a New Hair Loss Medication?

Propecia has been available to treat hair loss for over 25 years.  The medication was first used in 5-milligram doses in 1992 by urologists to treat enlarged prostates among men aged 50 and older.  During trials, it was discovered that a side effect was hair growth.  In 1997, one milligram of Propecia was formally approved for hair loss in men who are 18 and up.

How Does Propecia Treat Androgenetic Alopecia?

Propecia inhibits type II and type III 5-alpha-reductase isoenzymes.  In simple terms, that means it prevents testosterone from converting into an androgen called dihydrotestosterone (DHT).  Blocking DHT is important because excess DHT shrinks your hair follicles and interrupts your hair’s growth cycle.  When your hair follicles shrink, hair becomes thinner and weaker.  Hair falls out easily and doesn’t grow back.  

How is Propecia Dosed to Treat Male or Female Pattern Hair Loss?

As mentioned previously, Propecia was originally marketed to treat benign prostatic hyperplasia at 5 milligrams.  The dosage typically prescribed to treat male pattern hair loss is significantly less.  Your doctor will determine the right dose for you; however, one milligram is the most common prescription for men.  Women usually need a higher dosage than men.  Doses prescribed for women can range anywhere from 1.25 to five milligrams.  

Does Propecia Effectively Treat Hair Loss?

If you’re wondering whether or not you should give Propecia a try, the data is favorable.  Propecia is effective in preventing further hair loss and growing new hair.  Research has demonstrated that Propecia reduces serum DHT by 70 percent. (01)  With the medication, testosterone cannot convert to DHT, which can damage the hair follicles. Furthermore, one study indicates that 48 percent of users achieved growth after one year.  After two years, that number increased to 66 percent.  The study also shows that Propecia halts hair loss.  After two years, 83 percent of users in the study had no further hair loss. (02)  It’s important to know that results are only seen while using Propecia.  If you stop using the medication, new growth will likely fall out and your hair will look like it did before taking it.  Further hair loss can also occur.

Can You Combine Propecia With Other Hair Loss Medications?

Dermatologists often find that combining Propecia with Minoxidil gives better results than using Propecia alone.  The two medications serve different purposes.  Propecia blocks the DHT from converting, while Minoxidil sends oxygen to the hair follicles, helping them open so healthy new hair can break through.  You may also hear about retinol.  When using topical Propecia, retinol has been proven to improve absorption of the medication, giving better results.  

How Long Does it Take Propecia to Work?

It’s normal to be anxious to see results after starting a hair loss medication.  When you take Propecia, you may see hints of new growth around the three or four-month mark.  However, it typically takes six months to notice significant improvement.  It generally takes a year to see full results.  

Does Propecia Have Any Side Effects?

Many men are apprehensive about taking Propecia because they have heard it can cause undesirable sexual side effects.  Some report erectile dysfunction, decreased libido, and ejaculation disorders.  The side effects are rare, only affecting approximately one percent of men who take oral Propecia. If side effects are a concern, topical Propecia is an alternative that has been proven equally as effective without the same risk of side effects.  Topical solutions work specifically at the site of the hair follicles without risking systemic exposure. (03)

Can Women Take Propecia?

Although Propecia is not FDA approved for women, many dermatologists prescribe the medication off-label for their patients with female pattern baldness.  Both oral and topical Propecia has been proven effective for treating women. (04)  Topical Propecia is absorbed into the skin of the scalp without systemic effects.  Oral Propecia can be prescribed for women who are post menapausal, but isn’t recommended for women of childbearing age unless oral contraceptives are also being taken.  

Are There Alternatives to Propecia to Treat Androgenetic Alopecia?

Other hair loss treatments exist, but keep in mind that prescription medications are most effective.  Minoxidil is often used in conjunction with Propecia for both men and women.  Propecia is effective for most, but in cases where stronger medications are needed, Dutasteride can be prescribed to men or women.  Dutasteride works similarly to Propecia; however, it blocks an additional enzyme.  Spironolactone can be prescribed to women but isn’t recommended for men because it can cause breast enlargement.  Combination topical treatments are often a good choice because they conveniently combine multiple medications into one formula.  

Propecia is a well-tested medication proven to help people with androgenetic alopecia.  The medicine helps stop further hair loss and stimulates new growth in many patients with male and female pattern baldness.  If you have additional questions about Propecia, let us know.  Our board-certified dermatologists are available to review your case and recommend dosages, formulas, and other medications that work well with Propecia.

 

Resources:

(01) https://www.ncbi.nlm.nih.gov/books/NBK513329/#:~:text=2%5D%5B3%5D-,Finasteride%20is%20an%20FDA%2Dapproved%20pharmacologic%20agent%20for%20treating%20benign,a%20dose%20of%205%20mg.

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

(03) https://onlinelibrary.wiley.com/doi/full/10.1111/jdv.17738

(04) https://pubmed.ncbi.nlm.nih.gov/29464847/

 

Is Your Hair Healthy?

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

How Do You Know When Your Hair is Healthy?

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

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

Healthy Hair From the Inside Out

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

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

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

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

What Damages Healthy Hair?

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

Does Healthy Hair Fall Out?

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

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

Other Reasons for Hair Loss

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

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

How to Keep Your Hair Healthy

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

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

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

 

Resources:

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

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

 

Do You Need a Hair Loss Doctor? – How to Know When It’s Time for a Professional Opinion.

 

Did you know that many types of hair loss can be reversed?  If you didn’t, you’re not alone.  According to a 2018 study that evaluated why people don’t seek treatment for their hair loss, a significant number of people with androgenetic alopecia aren’t aware that treatments are available to help them regrow their hair.  (01)  This is one reason why people don’t seek medical attention when their hair is thinning or balding.  However, if you are experiencing male or female pattern baldness, not only can treatment help you regrow your hair, but the earlier you begin treatment, the better your results.  

Nobody wants to leave work early or spend money on doctor’s appointments that aren’t necessary.  Life is way too busy for that.  So, how do you know whether your hair loss warrants a visit?  Here’s a guide to help you with everything you need to know, from when it’s time to get a professional opinion to what type of doctor you’ll need.  

How Much Hair Loss is Too Much?

Everyone sees a few strands of hair in the sink or on the shower floor from time to time.  That’s a normal part of the hair growth cycle and is expected.  Losing 50 to 100 hairs during the shedding phase is normal.  How do you know if you’re losing more than that, though?  Here are a few signs:

Gradual Hair Loss

  • Thinning on top of your head
  • Growing bald spot
  • Receding hairline
  • Widening center or side part
  • Thinning ponytail

Sudden Hair Loss

  • Seeing a bald spot or area appear within 1 or 2 days
  • Losing clumps of hair 
  • Watching all or most of your hair fall out all at once

Both Gradual and Sudden Hair Loss Requires Medical Attention

Whether you notice gradual or sudden hair loss, we recommend you seek medical attention.  In addition to losing hair on their heads, some people lose hair on their face and their bodies.  If you notice bald spots or missing hair in areas such as your eyebrows, eyelashes, beard, mustache, or other areas, that also warrants a doctor’s visit.  

Male and female pattern baldness is the most common type of hair loss, and usually does not have any accompanying symptoms besides hair loss.  However, people with other types of alopecia such as alopecia areata and lichen planopilaris may experience burning, stinging, itching, or tenderness resulting from inflammation.  If this is the case for you, treatment is needed as quickly as possible to limit the amount of hair lost and have the best possible chance of regrowth.

What Type of Doctor Treats Hair Loss?

Finding the right person to help diagnose and treat your hair loss can be tricky.  There are a lot of different types of practitioners who claim to help people with their thinning hair and bald spots.  Here’s a rundown of who’s who:

Trichologist

A trichologist is a specialist who focuses on treating hair and scalp diseases.  Although trichologists have specialized training, they are not medical doctors.  They can’t write prescriptions or perform medical or surgical procedures.  

Holistic Medicine Doctors (Naturopaths)

A holistic medicine doctor focuses on a whole-body approach to improving health and wellness.  Rather than just looking at symptoms, naturopaths evaluate a patient’s mind, body, and spirit.  Prevention comes first, and treatment comes second.  Although holistic medicine doctors can order lab tests and use botanical therapies, they cannot write prescriptions unless they also hold medical degrees.  

Dermatologist

A dermatologist is a medical doctor trained to treat skin, hair, and nails.  Dermatologists have the training and expertise necessary to conduct a full evaluation, run any necessary tests, and prescribe medications if needed.  Some dermatologists have more specialized training and experience working with hair loss than others.  When selecting a dermatologist, ask questions such as what hair loss conditions he or she typically treats and what treatments are most often used.  

Why Self Diagnosis is a Bad Idea

There are many good reasons why you should get a professional diagnosis.  Access to the wealth of online information may make you feel like an expert, but you’re not.  You may come to the wrong conclusion about why you’re losing your hair.  Another reason why is that using ineffective medication is expensive.  There is an abundance of nonmedical treatments on the market, such as vitamins, supplements, shampoos, and topical solutions, but research indicates that they have temporary or little effect on hair growth.  The cost of over-the-counter treatments is actually higher than the cost would be for proven, supervised medical treatments.  (02)

How a Hair Loss Doctor Makes a Diagnosis

Dermatologists use a staged approach to evaluating hair loss conditions.  Typically, he or she will review your medical history to determine if there’s a pre-existing or new condition that is causing your hair loss.  Whether your hair loss is gradual or sudden, your hair loss pattern will point your doctor in the right direction during your evaluation.  For example, androgenetic alopecia usually presents with thinning on top, a receding hairline in men, and a widening part in women.  Bald spots about the size of a quarter are often seen in patients with alopecia areata.  A microscope can see if there is any redness caused by inflammation from scarring alopecia or a possible fungal infection.

Other tests sometimes used include a pull test to see how much and easily hair falls out. Usually, just a visual exam is all that is needed to diagnose androgenetic alopecia.  However, if your doctor needs more information, biopsies are the gold standard for a diagnosis.  

Treatment Options Available Through Hair Loss Doctors

Hair loss treatment depends upon the condition that is diagnosed.  The most proven, commonly prescribed medications include:

Minoxidil 

Topical Minoxidil, a vasodilator that increases the amount of oxygen to the scalp, is often prescribed to treat male and female pattern baldness and various other types of alopecia.  Minoxidil is available over-the-counter in two and five-percent liquid and foam topical formulas.  Higher topical doses and oral pills are only available by prescription.  It’s best to use Minoxidil under a doctor’s supervision.  Once you start using the medication, any hair that has grown can be lost if you stop taking it.   

Finasteride

Finasteride is a topical and oral medication only available by prescription.  The medication is typically prescribed to treat androgenetic alopecia; however, it has been proven effective for generating hair growth among patients with lichen planopilaris and other types of alopecia.  (03)   Finasteride works by blocking the production of DHT, which causes hair loss.  Finasteride has a reputation for causing sexual side effects among men.  If this concerns you, talk to your doctor about using topical formulas instead.  Topicals work equally as effectively without side effects. (04)

Dutasteride

Finasteride is effective for most patients and is usually used as a first-line medication to treat hair loss.  If you do not respond to Finasteride, your doctor may recommend trying Dutasteride, which works similarly to Finasteride.  The difference between the two medications is that Finasteride inhibits one type of isoenzyme, while dutasteride inhibits two types.  

Spironolactone

If you are a woman, your doctor may recommend Spironolactone, which blocks aldotestosterone, a hormone produced in the adrenal glands.  Spironolactone is not usually prescribed to men since it can cause feminizing side effects.  

Combination Treatments

Some types of alopecia require a combination of medications.  For example, doctors often prescribe Minoxidil and Finasteride simultaneously.  Minoxidil enlarges the hair follicles, while Finasteride prevents testosterone from converting to DHT.  Retinol helps the absorption of other topical hair treatments, and cortisone can be added to prevent irritation.  

Protein Rich Plasma (PRP)

Protein Rich Plasma treatments are a three-step process that involves drawing and separating your blood and injecting the separated platelets.  Protein derived from the PRP process is believed to help your hair grow by encouraging cell growth.  Only licensed practitioners can perform this medical procedure.

Hair Transplant Surgery

Hair transplants are becoming more common thanks to improved techniques that have been developed throughout the years.  Because hair transplants are a type of surgery, doctors performing hair transplants must be licensed.  

Why Prescription Hair Loss Medications are Superior to Over-the-Counter Treatments

As you’re probably already aware, the number of products on the market to treat hair loss is pretty overwhelming.  Trying out a new shampoo that you find on Amazon may be harmless but could cost a lot of money without much hair gain.  The window to regrow your hair could also close while you’re experimenting.  The difference between the OTC products and what your dermatologist prescribes is research.  It may not sound like much, but it’s a big deal.  Clinical studies provide dermatologists with a scientific basis for providing advice and treatment.  Clinical studies are also FDA-regulated, ensuring safety and properly reported results.  

Need a Hair Loss Doctor?  We Can Help.

Finding a dermatologist who is also a hair specialist can be difficult.  If you have questions or are interested in treatment for your alopecia, contact us.  Our licensed dermatologists will consult with you to determine whether you would benefit from using Happy Head or any other type of medication that treats hair loss.  

Resources:

(01) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6029958/

(02) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6029958/

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

(04) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4314881/#:~:text=Studies%20show%20that%20topical%20finasteride,post%2D%20treatment%20with%20oral%20finasteride.

 

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

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

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

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

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

Three types of alopecia areata exist:

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

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

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

2) Alopecia Areata Has Some Common Symptoms

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

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

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

3) Other Types of Alopecia Can Cause Hair Loss Too

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

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

 

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

4) New Medications Are Showing Promise in Treating Alopecia Areata

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

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

Other treatments often used to treat alopecia areata include:

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

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

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

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

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

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

Resources:

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

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

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

Oral Minoxidil: Truth Behind Its Hair Growth Success

There has been some press and a lot of talk about the benefits of low-dose oral Minoxidil recently. Our phone lines have been flooded with questions in response. Is oral Minoxidil the cure for balding and thinning hair? Will it work for me? What’s the truth behind its growth success? That’s what everyone wants to know.  

In response, we thought it would be helpful to share answers to some of the frequently asked questions we’ve been getting.  If you’re thinking about asking for a prescription, make sure you read this first. We’ll explain what oral Minoxidil is, how it works, and some things you should consider if you decide to give it a try.

Oral Minoxidil by Happy Head, formulated by board certified dermatologists. What's the secret behind its success?

What’s the Big Deal About Oral Minoxidil?

In previous blog posts, we talked a little bit about the abundance of over-the-counter (OTC) products on the market that promise to help people who are experiencing hair loss regrow their hair.  Shampoos, conditioners, vitamins, and supplements are easy to buy and tempting to try.  If you’ve already tried one (or five), you know what we mean.  We’ve also discussed how with the exception of two and five percent Minoxidil liquid and foam, which are marketed under the brand name Rogaine, the products that are truly effective in treating hair loss are only available by prescription.  

Recent press has reiterated this point and has touted the benefits of low-dose oral Minoxidil.  Minoxidil is an inexpensive medication and has been proven to be effective in treating male and female pattern hair loss (androgenetic alopecia) and other types of alopecia.  

What is Minoxidil?

Minoxidil was originally developed and marketed to treat high blood pressure. The medication is a vasodilator.  It relaxes the blood vessels, allowing blood to pass through more easily.  When Minoxidil was initially tested for high blood pressure, doctors and researchers noticed that one of the side effects was hair growth.  Minoxidil brings more oxygen to the scalp’s surface, enlarging the hair follicles and offsetting the effects of miniaturization that results in hair thinning and balding.  Through the enlarged follicles, new hair can grow, and existing hair remains strong and healthy.  

Why is Oral Minoxidil Prescribed Off Label?

Liquid and foam Minoxidil are FDA approved for treating hair loss.  Oral Minoxidil is prescribed off-label for hair loss because it has been approved to treat high blood pressure but not for hair loss.  Prescribing medications off-label is common practice in dermatology. Many dermatological conditions ranging from skin pigment disorders to inflammatory conditions, do not have standard FDA-approved treatments, so dermatologists use research findings to prescribe off-label to treat their patients’ conditions.  

How is Oral Minoxidil Usually Prescribed to Treat Hair Loss?

Dosage may differ based on your body weight and other factors; however, the typical prescription of oral Minoxidil to treat alopecia is 2.5 milligrams.  Dr. Ben Behnam, dermatologist, hair specialist, and founder of Happy Head hair loss solutions, recommends building up slowly over a month to avoid side effects. “Use a pill cutter,” says Dr. Behnam. “Take one-quarter of a tablet for the first two weeks, one half of a tablet during the second two weeks, and a full tablet after that.”  As with any prescription medication, patients should only take oral Minoxidil under the supervision of a licensed physician.

What are the Side Effects of Oral Minoxidil?

According to Dr. Benham, oral Minoxidil is a relatively safe medication, and side effects are rare.  Oral Minoxidil does not cause weight gain or sexual side effects.  Although most people do not have any side effects, people who do may experience changes in blood pressure, heart palpitations, headaches, and ankle swelling.  If you have concerns about fluctuating blood pressure, Dr. Benham suggests buying an inexpensive blood pressure cuff and checking your blood pressure weekly.

If you’re of middle-eastern descent and are using oral Minoxidil at higher doses, there’s a risk that you could grow hair on your face or other parts of your body.  That usually doesn’t happen at the lower doses though.  There’s also a higher chance of hirsutism in women than men.  

Most side effects resolve on their own after a week of continuously taking the medication.  However, if your symptoms don’t resolve, Dr. Ben recommends contacting your dermatologist and discontinuing the medication.  

Can You Use Oral Minoxidil and Topical Hair Loss Treatments at the Same Time?

Using oral Minoxidil at the same time as topical hair loss treatments is often recommended for the best results.  The reason is that oral Minoxidil may work as a stand-alone treatment for some, but many people will also require an anti-antigen such as Finasteride.  Minoxidil will open the hair follicles, but it won’t block testosterone from converting to DHT.   Therefore, most people need a DHT blocker to complement the Minoxidil.  

What other Medications Exist to Treat Male or Female Pattern Baldness?

Both oral and topical medications are available to treat androgenetic alopecia.  Oral medications include:

Finasteride (Propecia)

A DHT blocker that’s typically prescribed as a first-line medication due to its high efficacy.  Although not common, some men taking oral Finasteride experience some sexual side effects.  Topical Finasteride, has been proven to work equally as well as oral Finasteride without the same risk of side effects.

Dutasteride (Avodart)

Dutasteride is also a DHT blocker.  The difference between Finasteride and Dutasteride is that Dutasteride inhibits two isoenzymes while Finasteride inhibits one.  That said, FDA-approved Finasteride is effective for most people with male or female pattern baldness.  When Finasteride isn’t quite strong enough, Dutasteride is prescribed off-label.  Knowing whether Finasteride or Dutasteride will work best in each case is usually unknown until a patient tries one of the medications.  Based on Dr. Behnam’s experience, Finasteride works better for some people than Dutasteride, even though Dutasteride is a stronger medication.  That’s why Finasteride is used as the first-line treatment. 

Spironolactone

Sprironolactone is a second-line DHT blocker prescribed to women when Finasteride isn’t effective.  Men typically aren’t candidates for the medication because it can cause feminizing side effects.  

Topical Medications

In addition to Minoxidil, topical Finasteride and combination medications are available.  Formulas that combine prescription medications such as Minoxidil and Finasteride are beneficial because they contain both a vasodilator and a DHT blocker into one.  Patients often prefer the convenience of using one medication rather than multiple medications.  Topicals are also often preferred because they work as effectively as oral medications without the same risk of side effects.  

Is it Okay to Take Oral Minoxidil if You’re Already on Other Blood Pressure Medications?

If you are currently on a blood pressure medication, check with your cardiologist before adding oral Minoxidil.  Knowing whether you can take oral Minoxidil with other blood pressure medications depends on what you’re taking and your current blood pressure.  Again, your cardiologist is the best one to advise you.  

How Do I Get a Prescription for Oral Minoxidil?

The best way to get a prescription for oral Minoxidil is by scheduling a meeting with your dermatologist or hair specialist.  If you aren’t currently under the care of a practitioner, Happy Head has licensed dermatologists who can review your case and determine whether you are a candidate for the medication.  Contact us if you would like more information.  

We covered a lot of ground, so let’s review.  Dermatologists do often recommend oral Minoxidil to their patients.  It’s a reliable medication with relatively low side effects.  However, oral Minoxidil often needs to be combined with a DHT blocker to get the results that most people want.  The right combination of medications varies and can take some trial and error.  Hair loss treatment isn’t one-size-fits-all and can be affected by factors such as weight and genetic make-up.  If you have further questions, Happy Head is here for you.  Reach out and we’re happy to help.

REJUVENAGING® with Dr. Ron Kaiser Podcast Featuring Dr. Ben Behnam

 

Dr. Ben Behnam was recently invited to participate in the inspirational podcast Rejuvenaging, hosted by Dr. Ron Kaiser.  Dr. Kaiser is a psychologist, keynote and TEDx speaker, and author of the triple award-winning book Rejuvenating the Art and Science of Getting Older with Enthusiasm.  He likes to think of his podcast as a mental gym, a place for information about wellness, positive psychology, and, what he likes to call, goal-achieving psychology.  During the podcast, Dr. Ben and Dr. Kaiser discussed healthy ways to cope with hair loss, from both a physical and psychological perspective.  If you didn’t get a chance to tune in, here are some highlights that you won’t want to miss.  

The First Step in Coping with Hair Loss is Realizing that You’re Not Alone

Whether you’re male or female, if you’re in life’s second half-century, there’s a pretty good chance that you’re experiencing some type of hair loss.  According to American Hair Loss Association, 85 percent of men and 50 percent of women lose a significant amount of hair by the age of 50.  So when you look at the numbers, you’ll find that most people are experiencing some sort of hair loss by age 50. 

Dr. Ben defines hair loss in two ways:  thinning and balding.  When someone’s hair is thinning, you can see their scalp through the remaining hair.  When people are balding, hair is completely missing, and you can see their heads.  

Female Hair Loss No Longer Carries a Stigma

A couple of years ago, no one talked much about female hair loss. It was taboo. But now, over 50 percent of Dr. Ben’s patients are women with hair loss issues. Hair loss is becoming much more accepted in society.  When women talk about their hair loss, it’s good because putting the conversation out there benefits both men and women.  

It’s Important to Identify the Underlying Reason for Your Hair Loss

There are different reasons why people lose their hair.  Three common reasons include nutritional deficiencies, anxiety, and genetics.  Treating hair loss means understanding the cause.  

Common nutritional deficiencies Dr. Ben often finds in his patients are low Vitamin D, iron, and biotin.  Those vitamins are necessary for hair growth.  Vegetarians who don’t get enough protein in their diets also tend to experience issues with hair loss.  When Dr. Ben finds that patients are lacking vitamins or protein, he supplements their diets with additional proteins and collagen. He also adds Vitamin D and iron.  

Many times, Dr. Ben’s patients have already seen another doctor and are on medication for hair loss, but their hair still isn’t growing.  By the time they go to him, he doesn’t need to add another medication.  He’s just helping with lifestyle changes, so the medication works better.  Without the proper foundation, hair loss medication can’t work.  What you eat affects how you look.    

Hair Loss and Mental Health are Closely Intertwined

Anxiety can lead to hair loss in a few different ways.   One, when people are anxious, they are more likely to pull on their hair.  Physical manipulation will lead to more hair loss. Unfortunately, patients can also experience a lot of different stressful situations that can lead to hair loss.   One example is an 18-year-old patient with alopecia who did not go on birth control and could not use condoms for religious reasons.  She got pregnant and had to make difficult choices.  She hid her pregnancy from her parents and experienced great stress from the ordeal.  In situations like this, where stress is a hair loss trigger, Dr. Ben offers support by giving referrals to a therapist.  

Diagnosing Hair Loss Requires a Specialist

When someone experiences alopecia, Dr. Ben uses a holistic approach to treatment.  He looks at mental status, home life, stress levels, metabolic, and other health issues.  He believes that he should look at everything when he’s making a diagnosis and developing a treatment plan.  

Seventy to 80 percent of men are relatively easy to diagnose.  They don’t have nutritional deficiencies, mental issues, or any factors that would cause alopecia. They have clear-cut cases of male pattern hair loss.  But then there’s that 20 percent that doesn’t fall into that category.  Women are also a bit more challenging to diagnose.  Every case is different, and he believes that you have to evaluate each case individually.

People with Androgenetic Alopecia Can Regrow Their Hair

Depending upon the cause of your hair loss, treatment is available to help regrow your hair. People who experience male and female pattern hair loss tend to get good results with available medications.  Medications used include Finasteride, which is Propecia, a prostate medication that’s used to block testosterone.  Dr. Ben has seen excellent results with patients who use Finasteride.  Rogaine, which is a topical product sold over the counter, is also called Minoxidil.  Minoxidil is an oral medication used to control high blood pressure.  Since Minoxidil dilates the blood vessels, more oxygen reaches the scalp and causes hair growth.  

Finasteride, Minoxidil, and other hair loss treatments take about 6 months to start seeing results.

You Don’t Have to Experience Side Effects Associated with Oral Hair Loss Medications

One of the side effects of Propecia is erectile dysfunction.  So, a couple of years ago, Dr. Ben and Dr. Sean developed a Finasteride alternative.  It’s a topical Finasteride, meaning that you’re not ingesting it.  Clinical studies have proven that topical Finasteride has a lower risk of sexual side effects, yet it is still effective.  The dermatologists were quite excited about the discovery, so they developed Happy Head, their own formula of topical Finasteride combined with prescription-grade Minoxidil.  They tested Happy Head with patients and found that patients who experienced sexual side effects with oral Finasteride did not have the same side effects with the topical.  The product was researched for two years before being launched nationwide.  

It’s Time to Get Rid of the One Size Fits All Mentality When it Comes to Hair Loss

Dr. Ben and Dr. Sean set out to change the hair loss field.  After two years of launching Happy Head, it’s still the only company in the U.S. with a customizable prescription hair loss solution that’s available nationwide.  Most products on the market are mass-produced.  With Happy Head, however, patients can change the concentrations of ingredients, remove ingredients, and replace ingredients.  For example, the change can easily be made if you need .25 percent Finasteride rather than one percent.  A month later, if the .25 percent isn’t strong enough, the dose can be increased.  Traditional corporate thinking is to produce in large volumes to reduce cost.  With Happy Head, the needs of individuals are unique, so the product is customized to meet those individual needs. 

Fast, Easy Access to Prescription Hair Loss Treatments is Available

Happy Head is a telemedicine website with licensed doctors and pharmacies in every state.  It works by going on the Happy Head website to submit photos and complete a medical questionnaire.  The process takes about five minutes.  Within 24 hours, a doctor reviews the information you provided and writes a prescription.  You receive a bottle in three days.  There isn’t a charge for the consultation.  If the doctor who reviews your case determines that you’re not a candidate, your money is refunded.  

If you’re over 50 and experiencing hair loss, you’re not alone.  Eating well, managing stress, and living as healthy of a lifestyle as possible all contribute to the quality of your hair.  If you are experiencing male or female pattern hair loss (androgenetic alopecia), medications are available to help regrow your hair.  Simply visit happyhead.com and complete a brief survey.  A licensed dermatologist will review your case and determine whether you are a candidate for prescription hair loss medication.