Tag Archive for: Corticosteroids

Why You Shouldn’t Ignore Beard Hair Loss

Woo hoo! You got an enthusiastic “yes,” and your date is tonight. It’s time to get spiffy. So you pull out your razor, glance in the mirror, and just as you begin to lather up, you notice something strange. A tiny little circle where your beard hair is missing. Is that a bald spot? Was that there yesterday? Will my date notice? Will the hair grow back? Whoa, stop for a minute. Here’s the deal. Beard hair loss can often be treated, but the process takes time and requires a dermatologist’s supervision. Although you shouldn’t panic, you should seek treatment as soon as possible to prevent further beard loss. Here’s what else you should know and why you shouldn’t ignore beard hair loss.  

Why is My Beard Hair Falling Out?

Let’s start with the basics. It’s important to understand why your facial hair is falling out. Most of the time, facial hair loss is due to an autoimmune condition called Alopecia Barbae.  The condition occurs when your body attacks your hair follicles, causing small, circular patches of hair loss. Alopecia Barbae is usually seen along your jawline, but it can affect any part of your beard. Hair loss can be isolated to one patchy area, or it can be widespread. 

If you’ve heard that having one autoimmune disease predisposes you to more, that’s true in this case. The same autoimmune disease that causes Alopecia Areata, which causes patchy round circles of hair loss on your head, causes Alopecia Barbae. People who have Alopecia Areata are more likely to experience Alopecia Barbae. That doesn’t necessarily mean that you will see hair loss on both your head and beard. You can get one without the other. The condition is unpredictable, which can make management extremely frustrating. Having thyroid disease, diabetes, lupus, or psoriasis can also make you more susceptible to beard hair loss.  

Did I Miss the Symptoms of Alopecia Barbae?

How is it possible that you had a full beard yesterday and today you’re finding bald spots? Did you miss something? Could you have prevented the beard loss? Unfortunately, there isn’t a way to predict Alopecia Barbae. As a non-scarring form of Alopecia, there isn’t any redness, itching, or inflammation waving a red flag. There isn’t a way to know what’s to come until your bald patches appear.

Will My Beard Grow Back?

Yes, the hair on your beard may grow back. Alopecia Barbae is non-scarring, meaning that your hair follicles aren’t permanently damaged. Hair can regrow, sometimes spontaneously. Other times, treatment is required. To help boost hair growth all around, you can try to incorporate a hair supplement into your hair care routine. 

How Do Dermatologists Diagnose Alopecia Barbae?

Diagnosing Alopecia Barbae takes experience and skill. You definitely shouldn’t ignore beard hair loss. The condition’s distinguishing traits require a dermatoscope or biopsy to see. The first are small hairs that look like exclamation marks. They are wider on top than on the bottom near the hair follicle. Your dermatologist will also look carefully around the bald patch for signs of short vellus hairs. Vellus hairs tend to have a grayish-whitish color and a fluffy texture. Your dermatologist may also see small hairs that break off just underneath the skin. The hairs may look like small black, white, or yellow dots. 

Happy Head custom hair loss treatments are made for you and your unique hair loss condition and pattern. We base this formula off of your unique responses to our questionnaire and your consultation with your dedicated board-certified dermatologist. You shouldn't ignore beard hair loss when you have solutions to keep it.

What Treatment Options are Available?

If your beard doesn’t regrow on its own, your dermatologist can offer treatment options to help jump-start the process. No treatments are FDA approved, however, dermatologists commonly prescribe medications off-label. Treatment typically focuses on simultaneously calming the immune system and stimulating growth, so you may find yourself using multiple medications at the same time. Because everyone’s body chemistry differs, it may take some experimenting to determine the right mix of medications for you. 

Topical or Injected Corticosteroids

Corticosteroids are often used as a first-line approach to suppress your body’s immune system. It may take time for your body to calm down, so be prepared for treatments to be spread over a few months.

Topical or Oral Minoxidil

You may be familiar with Minoxidil for regrowing the hair on your head. Minoxidil can also be safely used to stimulate beard growth. The treatment is often combined with corticosteroids and is a fast, easy, and accessible option for many men.

Platelet-rich Plasma

Platelet-rich plasma treatments have been in the spotlight for many different applications ranging from sports treatments to hair loss therapy. During a PRP treatment, platelets are extracted from your blood, concentrated, and reinjected to stimulate growth. While PRP gets mixed results for other applications, research indicates that PRP therapy produces promising results for treating beard loss. (01)

JAK Inhibitors

Exciting breakthroughs have been made in the past few years using JAK inhibitors to stimulate hair growth among people with severe cases of Alopecia Areata. JAK inhibitors are immune-modulating medications that inhibit the enzymes responsible for causing your body to attack itself. Topical treatments or oral pills are prescribed based on a patient’s needs. At Happy Head, we create custom topical hair loss treatments that are made just for you and your particular hair loss needs. 

Anthralin

Anthralin, a topical medication prescribed to treat psoriasis is being used off-label to treat Alopecia Barbae. Although not much research has been conducted on the effectiveness of facial hair, findings indicate that the medication shows promise in treating Alopecia Areata. (02)

Diphencyprone

Diphencyprone has been used since the 70s to treat Alopecia Areata. Like Antralin, there’s limited research on the medication’s use for Alopecia Barbae, but it has demonstrated efficacy in treating Alopecia Areata. It is not unusual for dermatologists to prescribe the medication off-label to patients experiencing severe beard hair loss. 

What Else Can Cause Beard Hair Loss?

Keep in mind that neither Alopecia Areata nor Alopecia Barbae is common. A very small percentage of the population is affected. Some men are never able to grow a full beard. For them, sparse facial hair is normal. Stress, medications, poor diet, hormonal imbalances, and other factors can cause beard hair loss. So, before you assume the worst, check in with your dermatologist. There may be an easy fix to get your beard back into shape. 

What You Can Do About Beard Hair Loss (Besides Panic)

Beard hair loss is aesthetic, and fortunately, it doesn’t affect your overall health. That said, any alopecia can affect your self-esteem and confidence. While you wait for your hair to grow back, temporary fixes to camouflage the bald spots in your beard can make you feel better. While a close shave may not be your ultimate goal, it can bridge the gap until your hair grows back. Depending upon the size of the bald spot(s) you may also be able to use a little hair cover-up powder. Some creative guys have also found success experimenting with a fine point liquid eyeliner pen in a color that matches their hair. 

Stressed about patches in your beard? Don’t have a dermatologist? Can’t get an appointment for months? Happy Head has board-certified dermatologists licensed in every state who can advise you on your beard hair loss as well as scalp hair loss. Simply complete a brief questionnaire to learn whether you are a candidate for our topical Minoxidil or other hair loss treatments that can help regrow facial hair. We can even customize a formula just for you. You shouldn’t ignore beard hair loss when you can find a solution that’s easy to add to your daily routine. 

Resources:

(01) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7193229/

(02) https://pubmed.ncbi.nlm.nih.gov/3314718/

 

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

Hair Loss Reversal 101: What You Need to Know

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

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

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

There are Different Types of Hair Loss

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

The Term Alopecia Encompasses More Conditions Than Most People Realize

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

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

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

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

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

What Type of Alopecia Do You Have?

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

Examples of Non-scarring Alopecia

Telogen Effluvium

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

Androgenic Alopecia

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

Alopecia Areata

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

Traction Alopecia  

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

Examples of Scarring Alopecia

Lichen Planopilaris

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

Central Centrifugal Cicatrical Alopecia (CCCA)

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

Effective Hair Loss Treatment Complements Your Diagnosis

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

Minoxidil (Rogaine)

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

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

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

Finasteride (Propecia, Proscar)

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

Clinical studies have found Finasteride to be highly effective in reversing hair loss in both men and women with scarring and non-scarring alopecias. (0708) Topical Finasteride is often used to treat androgenic alopecia, while oral is typically recommended for scarring alopecias.

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

Corticosteroids

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

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

Platelet-rich Plasma (PRP) Injections

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

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

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

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

Biotin

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

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

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

Hair Transplants

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

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

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

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

It’s Important to Set Realistic Expectations When Treating Alopecia

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

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

Resources:

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

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

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

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

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

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

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

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

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

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

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

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