Tag Archive for: Hair Transplant Surgery

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.

 

Everything You Need To Know About Finasteride Interactions

If you have aging parents or grandparents and have seen their overflowing pill boxes, you know that it’s important to track their medications. One prescription can easily interact with another, and boom, you’re at the doctor’s office figuring out which drug is the culprit.  

Dermatologists and hair specialists often recommend prescription hair loss medications because they are safe and effective.  However, if you are taking other drugs or supplements at the same time, you should be aware of potential unintended interactions.  Since Finasteride, also sold under the brand names Propecia and Proscar, is FDA-approved to treat hair loss, it’s the one most often prescribed.  So, for that reason, we’ll tell you everything you need to know about what mixes well with Finasteride and what might not be the best combination.

Finasteride is a Leading Treatment for Male and Female Pattern Baldness

Research continually demonstrates that Finasteride, a medication originally developed to treat Benign Prostatic Hyperplasia (BPH), is one of the most effective ways to treat androgenetic alopecia.  The statistics tell the story.  After two years on Finasteride, 83 percent of men included in Merck’s research study did not experience further hair loss.  More than 70 percent showed increased hair growth. (01)  Finasteride works just as effectively for women. (02)  That’s why Finasteride is often dermatologists’ drug of choice when it comes to stopping further hair loss and stimulating new growth.  

Finasteride Increases the Testosterone Levels in Your Body

So, how does Finasteride help stop your hair from shedding?  It blocks an enzyme called 5-alpha-reductase (5-AR).  When 5-AR isn’t produced, testosterone can no longer be converted to an androgen called Dihydrotestosterone (DHT), which is what causes your hair follicles to miniaturize.  Finasteride also increases testosterone levels in your body.  More testosterone shrinks prostate size and helps your hair grow.  The only catch is that when you stop taking Finasteride, any new growth will be lost.   

Finasteride Interactions are Uncommon

Complications stemming from Finasteride use are rare.  That’s not to say that it doesn’t or can’t happen.  Certain medications can either increase or reduce the amount of Finasteride in your bloodstream.  Carbamezepine, Rifampin, and St. John’s Wart may reduce Finasteride’s efficacy by metabolizing the Finasteride faster in your liver.  Other medications such as Itraconazole and erythromycin may actually increase the levels of Finasteride in your blood.  Checking with your doctor is the best way to know if other medications you are already taking will contradict Finasteride.  

Avoid Interactions with Other Medications by Using Topical Finasteride Versus Oral 

If you have androgenetic alopecia and are worried about Finasteride interacting with the other medications you are taking, ask your doctor about using topical Finasteride.  Research indicates that topical Finasteride is equally as effective as oral. (03)   Think of topical Finasteride as a spot treatment.  It works directly on the areas where your hair is thinning to prevent further hair loss and stimulate growth.  Oral Finasteride, on the other hand, is systemic since it is metabolized in your stomach.  Topical Finasteride is the ideal solution for men and women who want the benefits of the medication without any potential drug interactions.  

Some Medications Make Finasteride Work More Effectively

Some medications have been found to increase the efficacy of Finasteride.  Because some medicines work synergistically, dermatologists and hair specialists often recommend that patients use multiple hair loss treatments simultaneously to maximize results.  

Minoxidil, also marketed under the brand Rogaine, is a topical hair loss solution that has proven to complement Finasteride. (04)  While Finasteride blocks the testosterone from converting to DHT, Minoxidil enlarges the hair follicles, preventing hair loss, and allowing new growth to break through.  Minoxidil is available in both oral and topical formulas.

Retinol is also a medication that is often prescribed with Finasteride.  Retinol, a derivative of Vitamin A, is often prescribed to reduce wrinkles and improve skin texture.  The medication increases collagen production and stimulates the production of new blood vessels bringing oxygen to the skin.  In addition, retinol has been proven to improve the absorption of topical Finasteride. (05)

When patients with hair loss experience inflammation, topical or injected cortisone is often prescribed in conjunction with Finasteride as well.

Taking Finasteride, Minoxidil, Retinol, and Cortisone all at the same time can seem like a lot of medications to remember.  Fortunately, topical formulas are now available that combine all into one convenient bottle.    

Alternatives to Finasteride

Other options exist if you are experiencing male or female pattern baldness and oral or topical Finasteride aren’t suitable for you.

Dutasteride

Finasteride is effective for most people.  However, an alternative medication is Dutasteride. Dutasteride works similarly to Finasteride by blocking the conversion of testosterone into DHT.  The difference between the two medications is that Finasteride inhibits the Type 2 5AR isoenzyme,while Dutasteride inhibits both Type 1 and Type 2.  In addition, Dutasteride’s prescribed dosages are typically lower than Finasteride’s because the medication is a bit stronger.  

Spironolactone

Spironolactone, also known as Aldactone, is used off-label to treat female pattern hair loss.  It was originally marketed to treat fluid retention caused by liver and kidney disease. The medication is only prescribed for women because it can cause feminizing features when used over time.  Research has not yet been conducted on a large sample size, but four women included in a study, saw reduced hair loss and experienced some growth. (06)

PRP

PRP, an abbreviation for Platelet Rich Plasma, is a three-step process designed to trigger hair growth by increasing the amount of oxygen available to the hair follicles.  First, blood is drawn. Then, blood is then separated into three groups using a centrifuge.  Lastly, the platelet rich plasma is injected into the scalp. PRP is often used in conjunction with other treatments to maximize results.  

Hair Transplant Surgery

If you are concerned about drug interactions, hair transplant surgery may be an option and a long-term hair loss solution.  During the past few years, many advances have been made in how the procedure is performed.  Rather than taking strips of hair to transplant, surgeons are now able to move individual hairs giving a more natural look.  

Low-light Laser Therapy (LLLT)

You may have seen ads recently for laser caps marketed for hair growth.  Most use light in the red or infrared range to penetrate the scalp and target the hair follicles.  Early studies show promise for the technology, but more research needs to be conducted on the efficacy.  One study found that LLT works better when used with Minoxidil or Finasteride.  The study also indicated that more data is needed to determine the optical laser power and wavelength. (07) 

Be Honest About Your Medical History

If your dermatologist recommends Finasteride or any other prescription hair loss treatment, the best thing you can do is be honest about your medical history.  In addition to telling your doctor about any other hormone, heart, or other medications you’re taking, remember to list any supplements. Also, although sharing information about smoking, drinking, or recreational marijuana use may seem embarrassing, remember that your dermatologist has seen and heard it all.  He or she is more concerned with giving you the best hair regrowth options and keeping you safe than passing judgment on your behavior.  

Is Finasteride Right For You?

If you have questions about whether Finasteride is right for you or could potentially interact with other medications you’re taking, let us know.  Our board-certified dermatologists have full medical degrees from accredited universities.  They are available and happy to review your medical history and suggest solutions based on the type of hair loss you are experiencing.  

Resources:

(01) https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/020788s020s021s023lbl.pdf

(02) Note: Recommended doses differ for men and women

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

(04) https://onlinelibrary.wiley.com/doi/10.1111/dth.12246#:~:text=Efficacy%20assessment,combination%20therapy%20showed%20improvement%2C%20respectively.

(05) https://jamanetwork.com/journals/jamadermatology/article-abstract/557305

(06) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3769411/#:~:text=In%20a%20case%20study%20of,total%20number%20of%20anagen%20hairs.

(07) https://pubmed.ncbi.nlm.nih.gov/29270707/