Tag Archive for: male pattern baldness

Your Comprehensive Guide to Oral Minoxidil

 

If you are dealing with male or female pattern baldness, you’ve probably spent hours researching regrowth options for your hair. And, you probably learned about Minoxidil topical foams and liquid solutions. At Happy Head, we’ve created your comprehensive guide to Oral Minoxidil to answer all of your questions on your search.  Two and five percent Minoxidil is sold at pharmacies and other retailers under the name Rogaine and by prescription in higher doses. You may have even given it a try.  

But, you may not be aware that Minoxidil is also available as a pill.  It’s only available by prescription, and it’s not advertised. A lot of people don’t know about it. But, they should. Some people who don’t respond to topical Minoxidil may have success with oral Minoxidil.  Here’s everything you need to know about oral Minoxidil and how it works.  

Oral Minoxidil Was the First Hair Regrowth Treatment

Back in the ‘70s, Minoxidil was only available in a pill format.  Neither topical foam nor liquid existed.  Here’s the background.  

Minoxidil tablets were initially designed to treat high blood pressure. The medicine is a vasodilator that opens up the blood vessels and relaxes artery walls.  During testing for hypertension, researchers discovered that one of the (not so) adverse effects was hypertrichosis, excessive hair growth. More testing ensued, word spread, and dermatologists began prescribing Minoxidil pills to treat their patients with male and female pattern hair loss.  

In 1987, topical Minoxidil was developed and quickly became the go-to treatment for androgenetic alopecia and other types of hair loss. As topicals took off, the pills fell by the wayside. After all, topicals didn’t require a prescription. Everyone seemed to forget that pills were even an option to treat hair loss.  

Oral Minoxidil Works, But Don’t Ask Anyone to Explain Why

Even today, doctors have yet to learn exactly why Minoxidil works.  One hypothesis is that the medication increases oxygen and blood flow to the hair follicles.  When that happens, the hair growth cycle’s anagen (growth) phase is prolonged and the telogen (resting) phase when your hair falls out is reduced. (01) 

If you take the oral Minoxidil route, the odds of it working are favorable.  In a study of over 19,000 people taking low doses of Minoxidil from .25 to 5 milligrams once or twice per day, 61 to 100 percent of participants saw significant improvement after taking oral Minoxidil. (02)

What’s also interesting is that oral Minoxidil may work when topical Minoxidil doesn’t.  Here’s why.  Many people have an enzyme called sulfotransferase.  Sulfotransferase wakes up your hair follicles and activates Minoxidil.  When people don’t have that enzyme in their hair follicles, they don’t respond to topical Minoxidil.  However, those same people do have sulfotransferase in their livers, which means that people may respond to oral Minoxidil when they don’t respond to topical Minoxidil. (03)

Oral Minoxidil is Used to Treat Many Hair Loss Conditions

Dermatologists prescribe oral Minoxidil to treat various hair loss conditions, most commonly male and female pattern hair loss (androgenetic alopecia).  Oral Minoxidil is also used for other types of non-scarring alopecia, including alopecia areata, traction alopecia, anagen effluvium, and severe telogen effluvium.  

Happy Head's Oral Minoxidil pill that you can take at the highest strength for the best hair growth results.

Here are the Reasons Why You May Want to Consider Oral Minoxidil

Why do people choose the oral route if topical Minoxidil is also an option?  There are a few reasons. Topical Rogaine can sometimes contain propylene glycol, which can be irritating. Removing the ingredient can help, but people still sometimes develop a rash or an allergy.  In this case, oral Minoxidil may be a better option. Pills are also an option if you’ve already tried topical Minoxidil for at least six months and the growth isn’t meeting expectations. Lastly, some people find that topical Minoxidil dries their hair changing the texture and causing breakage. Oral Minoxidil alleviates the issue.  

1. Minimal Side Effects

Taking an oral medication designed for hypertension can seem scary. You don’t want to trade off one problem for another, especially when the issue you are trying to address is cosmetic.  Not to worry. Minoxidil doses prescribed for hair loss are so low side effects are rare.  Here’s what people have experienced:

Hypertrichosis – When oral Minoxidil makes your hair grow, it doesn’t distinguish between the hair on your head, body, or face.  It can make all of your hair grow.  Yes, it’s an annoying side effect, but it can easily be managed.  Men usually aren’t as bothered as women, but hair removal (ironic, right?) and dosage adjustments are quick fixes if necessary.  

Shedding – Yes, it’s true that just like topical Minoxidil, oral Minoxidil can also cause temporary shedding when first using the medicine.  The reason why is that Minoxidil adjusts your hair’s growth cycle.  If shedding occurs, it’s best to continue taking your oral Minoxidil as prescribed.  Shedding usually happens within the first six weeks and resolves after four weeks.   

Low Blood Pressure – Minoxidil is prescribed at much higher doses (10-40 milligrams) to control high blood pressure.  Even though much lower doses are used to treat male and female pattern baldness,  it is possible, yet not typical, for people to experience dizziness due to low blood pressure.  If that happens, contact your dermatologist, who can adjust your dosage.  

Other side effects may include swollen ankles, fluid retention, headaches, and a fast heart rate.  Keep in mind that less than two percent of people using oral Minoxidil experience side effects, so the likelihood that you will have these or other symptoms are low. (04) 

2. Keep Track of Your Blood Pressure and Heart Rate

Although it’s not likely that you will experience side effects from taking oral Minoxidil, some people do experience fluctuations in blood pressure, even at low doses. As a precaution, purchasing and using a home blood pressure monitor is a good idea.  Take readings before you begin the medication and check again once each week. It’s a good idea to track the readings, keep a chart, and bring the results to appointments.

3. It’s Inexpensive

If you have health insurance with a prescription plan, oral Minoxidil is usually covered. If not, the retail cost is low. Depending upon where you fill your prescriptions, a 30-day supply of oral Minoxidil can cost less than seventy-five cents per pill.  

4. It’s Easy to Take

Topical Minoxidil works well for many people without any issues. However, some people find that topical Minoxidil can cause irritation or be difficult to apply. Minoxidil works on the scalp, but the foam sometimes gets stuck in the hair.  Liquids can be runny.  Oral Minoxidil only requires one or two daily low-dose pills without any hassle or mess.  

5. Low Doses are Available

As mentioned, the amount of Minoxidil necessary to treat male or female pattern baldness is significantly less than what’s required to treat high blood pressure. Whereas 20 to 40 milligrams are prescribed to treat hypertension, a range of .25 to 1.25 milligrams is often prescribed for androgenetic alopecia.   If necessary, a 2.5-milligram tablet can easily be cut into quarters or halves with a pill cutter.  Men sometimes take higher doses than women.  

6. Can Be Combined with Other Hair Loss Medications

Always check with your doctor before combining medications, especially if you use other medicines that affect your blood pressure. That said, it’s generally safe to take oral Minoxidil with DHT blockers such Finasteride or Dutasteride like in our SuperCapsule™. Oral and topical medications can be combined as well. Research indicates that using Minoxidil and DHT blockers simultaneously leads to effective results. (05)

7. Take it Under a Doctor’s Care

You may not be aware of situations when it’s not safe to take oral Minoxidil. That’s why it’s important to have a doctor supervising your treatment protocol.  You want to avoid aggravating drug allergies, liver conditions, adrenaline dysfunction, heart conditions, and other health issues.

8. It Isn’t a Quick Fix or a Hair Loss Cure

Like topical Minoxidil, oral Minoxidil is a long-term commitment. Once you stop taking Minoxidil pills, you can lose new hair growth.  That’s why it’s important to use the medication under the supervision of a licensed dermatologist and be consistent. 

9. Be Sure to Keep Your Follow-up Appointments

If you begin an oral Minoxidil protocol, it’s important that you follow up with your provider as he or she recommends.  Initially, you may need to schedule appointments every three months.  Once your dose is established and stable, you may only need to see your doctor every six months to a year.  

Now that you know the benefits of oral Minoxidil, you may wonder if it’s right for you.  That’s where we come in.  Thanks to telemedicine, you can consult with one of our board-certified dermatologists without ever visiting an office or pharmacy. We’ll review your medical history and get a better understanding of the type of hair loss you’re experiencing. If oral Minoxidil is the way to go, we’ll ship your prescription in discreet packaging directly to your door.  

Resources:

(01) https://www.aad.org/dw/dw-insights-and-inquiries/archive/2022/low-dose-oral-minoxidil-alopecia

(02) https://www.aad.org/dw/dw-insights-and-inquiries/archive/2022/low-dose-oral-minoxidil-alopecia

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

(04) https://pubmed.ncbi.nlm.nih.gov/33639244/

(05) https://cosmoderma.org/combination-therapy-with-oral-minoxidil-and-dutasteride-in-the-treatment-of-male-patterned-baldness-a-case-report/

 

How to Talk to Your Partner About Hair Loss

Talking to your partner about hair loss can be tricky.  What are you supposed to say?  “Have you noticed that your hairline is receding?” After all, your significant other may be embarrassed, or be ignoring the issue.  They may also fall into the category of people who genuinely don’t care about their appearances. Not to mention that you don’t accidentally want your partner to question whether or not you find them attractive.  Aargh.  Maybe you’re better off not saying anything?

Well, that depends on your approach.  If you are supportive, raising the topic can be helpful.  You can help your partner feel better, and you can also help give him or her the confidence needed to get treatment.  Remember, it’s not what you say, but how you say it.  Let’s talk about the best way to start the discussion.  

Remember that Timing is Everything

Has your partner said anything about their hair loss?  Made any jokes?  If so, he or she is opening the floor to a conversation.  Be careful not to raise the topic out of the blue or force the conversation.  Doing so may make your partner feel awkward.  You want to calm any insecurities rather than fuel them.  What if they don’t give you an in?  They just may not be ready to talk about it.  Leave the topic alone for now and see if it comes up later.  

Show Empathy

If you and your partner do discuss their hair loss, keep in mind that your partner may be feeling a whole array of emotions.  Getting older, no longer being desirable, and fear of losing control over one’s body can go hand-in-hand with male pattern baldness, female pattern baldness, or other types of alopecia.  Yes, these emotions are real and can be challenging to overcome.  After all, hair is a big part of our physical identity.  It’s not uncommon to refer to a person as the “guy with the blonde spiky hair” or the “woman with the long, dark, wavy hair.”  

How can you approach the topic in a way that won’t diminish these feelings?  Remember that compassion goes a long way.  One way to do that is to acknowledge your partner’s grief.  Let them know that you understand hair loss is upsetting and that you care.  Avoid statements such as “maybe it will grow back” that invalidate their feelings.  You may also want to ask whether your partner wants you to just listen or if he or she wants your input.  Unsolicited advice may not be welcome.  

Do Your Homework

If your partner does want advice, you’ll want to be prepared.  Here are a few points that will be helpful to know.  First of all, the most common reason why people lose their hair is typically due to androgenetic alopecia (male or female pattern baldness).  It’s a genetic condition that occurs when a person’s body converts testosterone to a substance called dihydrotestosterone or DHT.  DHT attacks the hair follicles, causing them to shrink and eventually close up.  Existing hair sheds and new hair fails to grow.  Many people don’t realize that androgenetic alopecia can be treated.  

Minoxidil, known as Rogaine, is often used to keep hair follicles open.  Finasteride or Dutasteride, DHT blockers, can be prescribed and used simultaneously.   If your significant other is a guy and is concerned about sexual side effects, you can tell him not to worry.  Pills are what can cause side effects. Topical formulas, which are just as effective, don’t carry the same risk profile. (01) Women don’t carry the same risk profile, although Finasteride and Dutasteride should only be used by women who aren’t pregnant or thinking about becoming pregnant.  

Although male and female pattern baldness is the predominant type of alopecia that men and women experience, it’s not the only type.  They can also experience temporary hair loss from illnesses or stressful events, alopecia areata, lichen planopilaris, and other types of alopecia.  A trip to the dermatologist is the best way to find out for sure what kind of alopecia your partner has.  

Offer Reassurance

Your partner may or may not decide to seek treatment for their hair loss.  No matter where they stand on the topic, it’s important to let them know that their decision is okay with you.  Self-confidence is what matters.  

Build a Healthy Lifestyle

Does your partner eat right, exercise, or take any necessary supplements?  If not, now is the time to make lifestyle changes that can promote healthier hair.  Smoking, too much alcohol, poor diet, and stress all contribute to hair loss.  As a couple, you have an automatic built-in support system to improve any bad habits.  As a matter of fact, couples who quit smoking together are 5.83 times more likely to succeed than when only one partner quits. (02)

Lifestyle enhancements are more fun and longer-lasting when you make them together.  Cooking, going for walks, and taking bike rides not only improve hair health but are also nice bonding opportunities.  And, what’s more romantic than reading the back of protein powder labels together?  Well. maybe that one doesn’t top your list of date night activities, but it is a good learning opp for both of you.  (If you aren’t familiar with the benefits of protein powder for hair loss, check out Dr. Ben Behnam’s segment on Gillian Lockitch’s Growing Older Living Younger podcast.)           

Help Step Up Their Style Game

Some people are into fashion, and some aren’t.  If your significant other is open to some subtle (or not so subtle) changes, this may be the time for a new hairstyle or a shopping trip.  A good barber or hair stylist will know what styles best camouflage bald spots or make thinning hair look thicker.  The right clothes can strategically direct attention away from hair.  Not to mention that a fresh cut, jeans that fit just right, or a new dress can do wonders for a person’s confidence.  

Be There When They’re Ready

It’s no secret that many people would rather be anywhere other than a doctor’s office.  If your partner falls into this category, that’s okay.  See if they would like you to accompany them to their appointment.  If not, don’t feel slighted. It’s not you, they may just prefer to go solo.  If he or she is really skittish, telemedicine may be a better option.  They can consult with a board-certified dermatologist and hair specialist from the comfort of their own home.  Prescription medications can now be prescribed through telemedicine, and orders can be delivered in discrete packages directly to their front door.       

Hopefully, by now, you’ve learned that you don’t have to be a psychologist to help your partner deal with his or her hair loss.  You just need to be a good listener and offer helpful advice when wanted.  You have the opportunity to be the voice of reason.  The initial shock will wear off over time and your partner will either accept their fate or fight it.  Remember, Happy Head is here to help.  Contact us if you’d like more information about male pattern hair loss or how to get the strongest FDA-approved prescription medications delivered directly to your door.  

 

Resources:

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

(02) https://cardiovascularbusiness.com/topics/clinical/vascular-endovascular/quitting-smoking-easier-couples-try-together#:~:text=At%20the%20end%20of%20the,partner%20was%20attempting%20to%20quit.

 

What Every Man Should Know About Male Pattern Baldness

 

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

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

Why Do Men Go Bald?

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

Most Guys Are Genetically Predisposed to Hair Loss

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

Male Pattern Baldness is a Type of Alopecia

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

What About Genetic Testing?

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

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

Treatment Options for Male Pattern Baldness

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

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

Do Finasteride and Dutasteride Have Undesirable Side Effects?

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

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

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

How do Topical Brands Compare?

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

Although Not as Common, Men Experience Alopecia for Other Reasons

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

Thinning or Balding Can Be Temporary

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

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

 

Resources:

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

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

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

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

 

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

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

What Causes Men to Experience Dry Hair?

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

How Does Men’s Hair Get Damaged?

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

How Guys Treat Dry or Damaged Hair

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

  • Use the Right Shampoo 

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

  • Remember the Conditioner

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

  • Hair Masks Aren’t Just for Women

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

  • Visit Your Barber Regularly

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

  • Eat a Protein-rich Diet

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

  • Ask Your Dermatologist About Vitamins or Supplements

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

  • Stop Using Harsh Coloring Products

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

  • Don’t Wait to Get a Professional Opinion

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

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

 

Resources:

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

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

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

 

Does Stress Cause Hair Loss?

“I was so stressed I was losing my hair.” 

“All these bills have me pulling out my hair.” 

“This new job has my hair falling out.”

People often joke around about how stress causes hair loss, but for many people, it’s no laughing matter. Stress can cause you to lose hair. And when you’re trying to keep as much hair on your head as possible, managing stress becomes a top priority. 

Stress: The Good and the Bad

When you feel your heart rate rise because you’re running late or you start to sweat during a work presentation, what you’re feeling is stress. This emotional and physical tension is part of the body’s natural response to potentially dangerous or new situations. 

Known as the body’s stress response or the “fight-or-flight” response, stress can be positive. This emotion keeps you alert and driven, pushing the body to work harder and think faster. Stress works well for short periods, giving you enough energy to power through a challenging event. Long-term (chronic) stress, however, compromises your well-being – and may cause you to lose your hair. (01)

The Physiological and Psychological Effects of Chronic Stress

The stress response comes from your body’s autonomic nervous system, the same system responsible for your heart rate, vision changes, blood pressure, and breathing. 

During a stressful situation, you may experience the following: 

  • Increased heart rate
  • High blood pressure
  • Faster breathing
  • Sweating
  • Tremors

With chronic stress, you can see these additional symptoms: 

  • Headache
  • Muscle tension or pain
  • Chest pain
  • Restlessness
  • Insomnia
  • Fatigue
  • Stomach upset

Chronic stress can lead to health problems like high blood pressure, skin conditions, obesity, and heart disease. (01)

Why Stress Causes Hair Loss

To understand why stress causes hair loss, you first need to know the basics of hair growth. Hair grows in a cyclical pattern, with new hair growth to replace older hair once it falls out. Every healthy strand of hair typically grows in three primary stages: 

  • Anagen Phase
  • Catagen Phase
  • Telogen Phase

Anagen Phase 

The anagen phase is also known as the “Growth Phase.” During this phase, a strand of hair grows from the hair follicle. As it grows, sebaceous glands condition and lubricates the hair. Hair grows at an average rate of six inches a year for most people. At any given time, about 80% of hair is in the anagen phase. This phase of rapid growth usually lasts about 2 to 8 years. 

Catagen Phase 

Unlike the anagen phase, the catagen phase lasts only briefly. The catagen phase lasts about ten days, though some people may have hair that remains in the catagen phase for up to 4 weeks. This phase accounts for about 1 to 2 percent of a person’s hair. It is at this point that growth stops, and the hair follicle shuts down to rest. (02) 

Telogen Phase

Hair falls out of the follicle during the telogen phase. The telogen phase is aptly named the “resting phase” because the hair follicle shuts down for a short rest. During this phase, the follicles no longer supply nutrients, which causes the air to fall out. 

The hair that’s lost is usually hairs that are at the very tail end of the telogen phase, called the exogen phase. Approximately 15% of hair is in the telogen phase at any given time. The scalp sheds an average of 100 hairs a day. With about 100,000 hair follicles on the scalp, the daily loss of 100 hairs is negligible. (03)

Hair Loss and Stress 

Hair growth is determined by the stem cells within the follicles. Chronic stress affects the adrenal glands. A recent study published in the journal Nature– with support from the NIH’s National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), showed how the hormone corticosterone is impacted by the adrenal glands, which respond to stress. (04) 

Stress increases corticosterone levels. Corticosterone prevents the stem cells within hair follicles from activating hair growth. Instead, hair follicles remain in an extended resting phase – in the telogen phase. 

Telogen Effluvium

Telogen effluvium is the primary condition responsible for hair loss during stress. Stress can cause a greater than usual amount of hair to suddenly shift to the telogen phase all at once. During telogen effluvium, many strands stop growing, and hair follicles become dormant. Fortunately, hair typically regrows within 6 to 9 months. (05)

Signs of Telogen Effluvium 

With telogen effluvium, hair loss is often abrupt. However, hair loss may begin only a few months after experiencing significant stress. Hair follicles prematurely enter the telogen phase, and the follicles may take up to 3 months to start regrowing hair. 

Unlike other hair conditions, like alopecia areata, the hair loss pattern typically experienced by individuals with telogen effluvium is diffuse hair loss. In other diagnoses like female pattern hair loss or alopecia areata, hair falls off in a patchy pattern, or they may experience a widening of the hair part. In telogen effluvium, hair loss occurs throughout the head resulting in an overall thinning rather than bald spots. (05)

Other Hair Loss Conditions Caused by Stress

Telogen effluvium is the second most common type of hair loss for men and women, but it’s not the only hair loss condition due to stress. Chronic stress may also indirectly cause the following conditions:

Alopecia Areata

Although alopecia areata (AA) is an autoimmune disease, It results in hair loss. In alopecia areata, the immune system mistakenly targets hair follicles, causing patchy hair loss throughout the scalp. Stress may be a trigger for the immune sustain, resulting in further hair loss. There’s no cure for AA, but some prescription hair medications can help manage hair loss. (06)

Trichotillomania

During a bout of trichotillomania, known as “hair pulling disorder,” an individual may feel compelled to pull or tug at their hair. People with trichotillomania have episodes of the disorder during times of significant stress. Trichotillomania causes patches of bald areas where the hair pulling occurred. (07)

Does stress cause male pattern baldness? 

Male pattern baldness, also known as androgenic alopecia, is not caused by stress. The condition is caused by genetics. Unlike telogen effluvium, androgenic alopecia is not temporary. With early treatment, however, individuals with androgenic alopecia can slow hair loss or regrow hair. 

In general, hair loss can be caused by a variety of factors. Finding the reason for your hair loss is an important step in addressing the issue. Our hair specialists at Happy Head are licensed dermatologists who can help you determine the best approach to your hair loss. Contact us to learn what Happy Head can do for you.

Resources: 

(01) https://medlineplus.gov/ency/article/003211.htm

(02) https://www.ncbi.nlm.nih.gov/books/NBK499948/

(03) https://www.nejm.org/doi/full/10.1056/nejm199908123410706

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

(05) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4606321/

(06) https://www.niams.nih.gov/health-topics/alopecia-areata

(07) https://www.sciencedirect.com/topics/medicine-and-dentistry/trichotillomania

5 Facts All Men Should Know About Hair Loss

A few weeks ago, my husband pointed out a Facebook meme that made us laugh.  It showed two photos of hair and body care products.  One photo included products that women use in the shower, and another photo showed the products that men use.   The women’s photo was loaded with products, including body wash, face wash, two different types of shampoos, and a couple of different types of conditioner.  The men’s photo only had one product, a lone all-in-one bottle of body wash, shampoo, conditioner, shaving cream, and toothpaste.  Not only was it funny, but it also depicted the scene in our shower pretty accurately. 

The truth is, though, although some men don’t give their hair a lot of thought, I don’t know of any who are thrilled about the idea of going bald.  It’s a super sensitive topic.  As nonchalant as my husband is about his hair, even a hint that his hairline is receding results in a very alarmed “What?” and a close scalp examination in the mirror that night.   

Hair loss in men is common, but that doesn’t mean you’re okay with it.  Nor does that mean that you have to accept your fate.  So, if you’re a guy with some recession, thinning, or balding, this one’s for you.  We’re here to fill you in on what you need to know about losing your hair and what you can do about it.  

1) Hair Loss in Men is More Common Than You Realize

According to the American Hair Loss Association, by age 50, 85 percent of all men will have significantly thinning hair. (01)  Yes, you read that correctly.  The majority of men will deal with some type of hair loss in their lifetime.  

Men lose their hair for a lot of different reasons.  Balding or thinning hair can be due to autoimmune conditions, Covid, or even stress.  The most common reason, though, is genetics. The vast majority of men with thinning or balding hair have androgenetic alopecia, male pattern baldness.  Yup, that’s right.  Your parents or grandparents may have passed along a baldness gene.  

Male pattern baldness, also known as androgenetic alopecia, occurs when your testosterone is converted to an androgen (a sex hormone) known as Dihydrotestoterone (DHT).  The DHT attacks your hair follicles and causes a reaction called miniaturization which shrinks the follicles.  When that happens, the hair that is already there falls out.  New hair has trouble emerging through the shrunken follicles, and eventually, the hair stops growing.  

Although Male pattern baldness is the leading cause of hair loss among men; it’s not the only reason men lose their hair.  Other forms of alopecia can cause hair loss among men as well.  For example, Covid or other illnesses can cause a temporary hair loss called telogen effluvium.  In this case, your hair will grow back within six to twelve months.  Alopecia areata is an autoimmune condition that causes sporadic bald patches.  Some men’s hair spontaneously regrows, but flares can occur at any time without notice.   Lichen planopilaris is another type of alopecia that causes inflammation, leading to scars over the hair follicles that prevent new hair growth.         

2) Timing is Everything When it Comes to Hair Loss Treatments

Many men avoid doctors like the plague. (02)  However taking a “let’s wait and see what happens” attitude isn’t recommended when it comes to hair loss.  If you don’t get treatment when you first notice that your hair is thinning, then your hair loss will most likely progress, leaving you with a higher number on the Hamilton-Norwood Scale.  In case you don’t know what that is, the Hamilton-Norwood Scale is a classification system developed to measure the extent of baldness.  You don’t want to get high scores on that test.  

If you visit a board-certified dermatologist as soon as you see signs of thinning or balding, your doctor will identify the cause of your hair loss.  Once you are diagnosed, your dermatologist can recommend treatments to stop your hair loss and to promote new growth.  

3) Hair Loss Consultations Are Not a Big Deal (Really!)

If the idea of any medical procedure secretly has you a bit nervous, don’t let that prevent you from seeing a dermatologist.  The exam is much easier than you would expect, and trust me, your dermatologist will not think you are vain for seeking treatment.  Dermatologists evaluate men for hair loss conditions all the time.  So, while you may be out of your comfort zone, your dermatologist certainly isn’t.   

Your dermatologist will ask questions about your health, medications, family history, and lifestyle during your exam.  The more detailed information you provide, the better.  Your dermatologist will examine your scalp to evaluate your hair loss pattern and possibly do a pull test.  A pull test measures the severity of your hair loss.  During the test, your dermatologist will gently tug on small sections of your hair to see if any strands fall out.  If six or more do, you have active hair loss.  Dermatologists usually diagnose androgenetic alopecia based on visual exam.  A blood test or a small biopsy may be ordered if he or she suspects another type of alopecia.  Don’t stress if you need a biopsy.  You’ll be numb, the biopsy area is small, and it heals within a week.

4) Today’s Hair Loss Treatments are Effective and Natural Looking 

After you get a diagnosis, you’ll have many treatment options.  The good news is more data than ever is available on hair loss treatments.  Research indicates that many are not only safe, they’re highly effective.  Here are some examples of the most popular prescription hair loss treatments used:

Minoxidil 

  • FDA approved to treat hair loss
  • Available in oral or topical formulas
  • Brings oxygen to the hair follicles, enlarging them so existing hair does not fall out and new hair can emerge

Finasteride

  • FDA approved to treat hair loss
  • Available in oral and topical formulas
  • Prevents testosterone from converting to DHT and attacking your hair follicles
  • First-line treatment for androgenetic alopecia

Dutasteride

  • Used off label to treat hair loss
  • Only available as a pill
  • Prevents testosterone from converting to DHT and attacking your hair follicles
  • Prescribed if patient does not respond to Finasteride
  • Lower dosage prescribed for Dutasteride than Finasteride

Cortisone

  • Available in pill and topical formulas
  • Reduces irritation and inflammation

Retinol

  • Available in topical formula
  • Proven to improve absorption of topical Minoxidil and Finasteride

Compounded Topical Formulas

Research has shown that combinations of topical formulas are more effective than monotherapy.  For example, topical Finasteride combined with topical Minoxidil works better than one of the medications alone. (03)  Finasteride and Minodixil combined with Retinol is more effective because the retinol helps the scalp better absorb the other two medications. (04)

Alternative Hair Loss Treatments for Men

You may also be a candidate for treatments such as Protein Rich Plasma (PRP), laser light treatments, and hair transplant surgery.  Let’s talk about what these are and how they work.

Protein Rich Plasma

PRP acts similarly to Minoxidil by bringing oxygen to the hair follicles to enlarge them.  During a PRP procedure, your dermatologist draws your blood.  The blood is then separated.  The plasma is then injected into sites where your hair is thinning or balding. 

Laser Light Treatment

You may have seen ads for laser light caps.  Do they work?  Well, the jury is out.  The philosophy behind them is that the light increases blood flow to the areas on your scalp that are thinning.  More oxygen and nutrients are able to reach the hair follicles, allowing the hair to grow thicker and longer.  Although research indicates that laser lights show promise for treating hair loss, the most effective intensity and frequency is still to be determined. (05, 06)  

Hair Transplant Surgery

In the 70s and 80s, you could always tell when a man had hair restoration surgery.  You could actually see little circular holes where the plugs were implanted.  It looked like a doll’s head.  Over time, dermatologists have been perfecting the surgery and today’s techniques give a natural appearance.  Dermatologists now move individual hairs from a place where the hair is dense to an area where the hair is thinning. (07)  You can’t even tell that the hair has been transplanted.  

5) Perceptions of Bald or Balding Men Have Changed for the Better

Men with thin or thinning hair tend to have lower self-esteem and lack confidence, which could explain negative perceptions of their appearance. (08)  The key is to work with what you do have so you feel as confident as possible.  

Yes, there was a time when bald or balding men were deemed less attractive.  That’s no longer the case, though.  Today, men who embrace their look are seen as intelligent, successful, and confident. (09)  Jeff Bezos, Samuel L. Jackson, Ed Harris, and The Rock are prime examples.  So if your hair is thinning or balding, work with your barber or hair stylist to find and own a fresh new look.  That look can evolve as you undergo hair loss treatment.  

If you notice some recession, thinning, or balding, and are concerned, contact us for a discrete consultation from the comfort of your home, on your schedule.  Our board-certified dermatologists and hair specialists are available to evaluate how much hair you’ve lost and your scalp’s condition.  Most importantly, they can offer a customized prescription solution to give you the desired results.  

 

Resources:

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

(02) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6560804/#:~:text=At%20the%20societal%20level%20masculine,not%20go%20see%20the%20doctor.

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

(04) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2693596/

(05) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8906269/

(06) https://www.karger.com/article/fulltext/509001

(07) https://www.aad.org/public/diseases/hair-loss/treatment/transplant

(08) https://pubmed.ncbi.nlm.nih.gov/16307704/

(09) https://journals.sagepub.com/doi/abs/10.1177/1948550612449490

 

Dealing with Bald Spots and Male Pattern Baldness



Whether it’s a slow realization or a sudden awareness, discovering that you’re losing your hair is a difficult event. Every hair on the pillow or on the floor of the shower comes back to haunt you, and you’re at a loss for what to do. Fortunately, there’s steps you can take to slow – or sometimes even stop – your hair loss.

What Causes Bald Spots?

Men don’t have the monopoly on bald spots; women can have them, too! Everyone is at risk for developing a bald spot at some time in their lives, for a variety of reasons. However, some people are at a higher risk than others. 

The most common cause of bald spots in both men and women is the hormone dihydrotestosterone, or DHT.  Both men and women produce DHT, but some people have higher levels of DHT than others. Male pattern baldness (MPB), also called androgenic alopecia, results from a combination of DHT and variation in the androgen receptor (AR) genes. Androgen receptors allow hormones like DHT to bind to them, and men with AR genes tend towards male pattern baldness. (01)

High levels of DHT can damage or shrink hair follicles, preventing hair from growing normally. The hair follicles most sensitive to DHT are located at the hairline and at the crown, which is why these areas are often the first to experience hair loss. And although DHT can also cause hair loss in women, 

But it’s not just DHT that can cause bald spots. Other factors that trigger hair loss are: (02)

  • Severe emotional stress
  • Physical stress or illness
  • Hormonal Shifts
  • Medications
  • Nutritional deficiencies
  • Age
  • Hairstyling 
  • Hairstyling products
  • Repeated physical trauma (tight hats or headbands)

The First Signs of Balding

If bald spots or male pattern baldness runs in your family, you’ve probably been on the lookout for hair loss for awhile now. Sometimes it’s difficult to tell if it’s really a bald spot or just a bad hair day. Here are a few signs that you may be experiencing bald spots or male pattern baldness:

A Receding Hairline

Hair loss typically starts at the hairline. A receding hairline may occur so slowly that you might not notice it until you have something to compare it against. For example, you might spot your receding hairline when you start looking at old photos and see that your hairline looks  different today. Your hair loss may occur incrementally, making it tougher to see.

Reduction in hair thickness

Do you notice less hair on top? Does your hair feel different when you run your fingers through it? If your hair feels finer and more airy, then it might be due to male pattern baldness or hair loss.

Loss of hair at the crown

A growing crown area is one of the first signs of hair loss, especially male pattern baldness. Most people don’t look at the back of their head, so seeing differences in your crown can be challenging. Check your crown every so often using two mirrors to check for bald spots.

How Can I Manage Hair Loss?

Experiencing balding or male pattern baldness is tough, but you do have options. The following are steps you can take to slow down hair loss.

Surgical Treatments

Surgical treatments are typically reserved for advanced cases of balding or male pattern baldness. A hair transplant, for example, is an outpatient surgery that utilizes donor hair follicles. These donor follicles are implanted into sparse or bald areas, allowing new hair to grow. These implants, called follicular unit transplantation (FUT) or follicular unit extraction (FUE), leave little to no scarring. The donor follicles typically come from your own head, but the process still requires recovery time and post-surgical care. (03)

Because surgical options are invasive, there are contraindications that may keep some people from obtaining FUT or FUE treatments, like blood disorders or the tendency toward heavy scarring (keloids). Furthermore, surgery may result in adverse side-effects like swelling, folliculitis, numbness, and infection.  (04)

Scalp Reduction 

A scalp reduction is exactly as the name implies. To perform scalp reduction, areas of the scalp without hair are surgically removed, and the areas with hair are stretched to fill over the bald portions. If you’re wondering how much of the scalp can be removed, you might be surprised to find that scalp reduction can remove up to half of the scalp. 
The skin that’s meant to be stretched is prepared and loosened, prior to stretching gently. Scalp reduction may be combined with other treatments such as FUT or FUE treatments. Some people find the recovery period from scalp reduction surgery highly uncomfortable, due to a scalp tightness that lasts for a few months as skin adjusts. Hairline lowering surgery, for example, is a kind of scalp reduction surgery. To lower the hairline, the receding portion is removed and the portion with hair is pulled forward. (05)

Platelet-Rich Plasma

A procedure called platelet-rich plasma (PRP) uses an individual’s blood and separates out the plasma using a centrifuge. This platelet-rich plasma (hence the name) is then injected into bald patches and areas of thinning hair. The plasma stimulates growth and repairs damaged blood vessels, helping hair to regrow. Although effective, the PRP process is very involved, costly, and is the newest hair loss treatment option, therefore more research is still necessary to evaluate the ideal therapeutic levels. (06)

Non-surgical Procedures

Scalp micro-pigmentation creates the look of thicker hair through the application of pigmentation that appears like hair follicles. The process includes stippling a tattoo in small dots to mimic hair follicles. Men who have thinning hair or shave their head short are the ideal candidates for scalp micro-pigmentation. However, micro-pigmentation does not grow new hair, nor is it recommended for people with large bald spots or who have major hair loss and wish to regrow hair. (07)

Least Intrusive Procedures

Once you see the signs of male pattern baldness or bald spots, it might warrant considering the least intrusive method for managing hair loss. Medicinal treatments like minoxidil and finasteride are two FDA approved medications for hair loss. When used together, minoxidil and finasteride can slow – or even stop – hair loss and regrow hair. Better yet, when minoxidil and finasteride are customized for each individual, common side-effects can be avoided. 

Dealing with Bald Spots or Male Pattern Baldness: What to Choose?

How you manage your hair loss depends entirely on what’s best for your situation. Bald spots and male pattern baldness can be a distressing event, and making a choice isn’t easy. Talk to people you know who have opted for hair loss treatments and get some perspective. Determine what’s financially feasible and speak to professionals to evaluate with options that will work with your health and lifestyle. At Happy Head, we’re ready to answer any questions you may have about our hair loss products. Let’s talk!

Resources:

(01) https://www.webmd.com/connect-to-care/hair-loss/symptoms-of-high-dht

(02) https://www.aad.org/public/diseases/hair-loss/causes/18-causes

(03) https://www.ncbi.nlm.nih.gov/books/NBK547740/

(04) https://www.ncbi.nlm.nih.gov/books/NBK547740/

(05) https://pubmed.ncbi.nlm.nih.gov/24017989/

(06) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4622412/

(07) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4382144/

When Women Get Male Pattern Hair Loss


Female pattern hair loss can progress from a widening part to overall thinning.

I met my friend Barbara (01) twelve years ago when our boys were toddlers.  Barbara is a tiny woman with lots of spunk.  I always thought of her as strong, smart, and confident.  She called one day and confided in me that it bothered her that her hair was thinning.  She had been losing hair on the crown of her head since she was in her late 20s, and she never did anything about it.   She knew that I had lichen planopilaris and wanted to get the name of the dermatologist I used to treat my hair loss.  

Anyone knew just from looking at Barbara that her hair was sparse, and it took me by surprise that she hadn’t already had it checked out by a dermatologist or a hair specialist.   But then again, Barbara isn’t exactly a fashionista.  She’s an elder care nurse who spends most of her weekdays in scrubs and her weekends in sweats.  But still, I was surprised.  Barbara visited my dermatologist, and it turns out that she has androgenic alopecia, also known as male pattern baldness.  Who knew that women can get male pattern baldness?  And who knew that it could start so young?

How do Women Get Male Pattern Baldness?

Women get male pattern baldness for the same reasons men do.  Also known as androgenic alopecia, female pattern hair loss is usually inherited.  The condition occurs when a woman has a shorter than normal period of hair growth and a longer than normal period between when her hair sheds and grows.  In some cases, women have the misfortune of inheriting smaller hair follicles and thinner strands of hair.  

Almost every woman experiences female pattern hair loss at some point in her life.  Most first notice androgenic alopecia around menopause, but it can start any time after puberty begins.  If anyone on either side of your family has lost his or her hair, it’s more likely that you will too. 

What Does Female Pattern Baldness Look Like?

There’s some good news if you have female pattern baldness.  Women’s hairlines usually don’t recede and you won’t end up with a donut.  The other good news is that women typically don’t go completely bald.  Usually women with androgenic alopecia have one of three different patterns of hair loss.  A bald spot can form at the crown of your head, you could lose hair along your center part, or your hair could thin all over.  In some cases, hair gets so thin that the scalp can be seen.

If you’re a Woman, How do you Know if you Have Male Pattern Baldness?

Although it’s tempting, don’t try to self-diagnose or treat yourself if you think you have androgenic alopecia. Get an appointment with a board-certified dermatologist and hair specialist.  Your dermatologist may do one or several of the following:

  • Evaluate your hair loss pattern
  • Review your medical history
  • Rule out other possible causes for your hair loss, such as iron or vitamin D deficiency, thyroid disease, or another type of scarring alopecia
  • Determine whether you are producing too much androgen (male hormone)
  • Use a dermoscope or a microscope to look at the structure of your hair shaft
  • Take a small biopsy of your scalp and send it to a pathologist

Androgenic Alopecia Often Goes Undiagnosed in African American Women

Women of every race are affected by androgenic alopecia and other types of hair loss.  African American women are no exception.  In a 2016 survey conducted at Boston University’s Sloane Epidemiology Center, 47.6 percent of African-American women surveyed reported hair loss. (02)   

However, like my friend Barbara who noticed that her hair was thinning and didn’t do anything about it, many African-American women are not seeking treatment for androgenic alopecia.  Out of the group surveyed, 81.4 percent reported that they had never consulted with a physician about their thinning hair or bald spots.

The moral of this story?  If you think that your hair is thinning and have a history of hair loss on either your Mother’s or Father’s side of the family, don’t ignore it.  Make an appointment with your dermatologist to get evaluated and treated. 

Do Asian Women get Alopecia?

Asian women do get alopecia, but traditionally rates have been lower than those of Caucasian or African-American women. (03)  That number seems to be on the rise, though.  Diet is believed to be a contributing factor.   

Early research indicates that diets rich in vegetables, herbs, and soy may contribute to hair growth and health thanks to their anti-inflammatory nutrients. (04)  The traditional Asian diet, loaded with fish and vegetables, meets that criteria.  

Today’s modern Asian diet looks more like a typical American diet though, filled with processed foods.  The fat, salt, and empty calories lead to higher BMI and blood sugar levels that have been linked to female pattern hair loss. (05)

What Treatments are Available to Women with Female Pattern Baldness?

Treatments for androgenic alopecia are designed with two goals in mind:

  1. Prevent further hair loss
  2. Stimulate hair growth

Sounds logical, right?  Well, it is.  Here are medications that dermatologists typically prescribe:

Retinol (Tretinoin)

Retinol is derived from Vitamin A and has been found to be effective for treating female pattern hair loss when used either alone or in combination with Minoxidil. (06)  Retinol has been proven to stimulate growth and improve the absorption of other ingredients that promote hair growth.

Minoxidil (Rogaine)

Minoxidil, sold over-the-counter under the name Rogaine, is a hair regrowth treatment.  It works by enlarging the hair follicles and elongating your hair’s growth phase.  Minoxidil is available in both a topical foam and a pill.  Although the foam is available in a two percent formula for women and a five percent formula for men, dermatologists often recommend the five percent for women to use for androgenic alopecia.  Any hair growth realized while using Minodixil can be lost if you stop using the product, so it is highly recommended to use it under the care of a licensed dermatologist.

Finasteride (Propecia)

Finasteride is a prescription medication that was initially designed to treat enlarged prostates.  Because it prevents testosterone from converting into dihydrotestosterone (DHT), the medicine is helpful for women with female pattern hair loss. (07)  Finasteride is available as an oral medication and as a topical solution.  Many women prefer topical to avoid potential side effects.

Dutasteride (Avodart)

Dutasteride is similar to Finasteride.  Both medications prevent your body from converting testosterone into DHT, which causes female pattern baldness.  Dutasteride is newer to the market and is used off-label for androgenic alopecia in women. Finasteride is highly effective for most women, but when stronger medications are required, Dutasteride is a good option. (08)  Like Finasteride, Dutasteride is best for women who are not pregnant or thinking about becoming pregnant.   

Spironolactone (Aldactone)

Spironolactone is an effective treatment for hormone-induced hair loss that is only prescribed to women.  The medication blocks DHT production by simultaneously decreasing testosterone and increasing estrogen.

Data indicates that Spironolactone is highly effective for treating female pattern baldness.  In a research study conducted, 74.3 percent of patients who were treated with Spironolactone reported stabilization or improvement in their hair loss. (09)  

Oral Spironolactone can cause low blood pressure, drowsiness, and other side effects.  Topical Spironolactone, which does not go through the digestive system and is less likely to induce side effects, is often prescribed and preferred.  Topical Spironolactone is often compounded with Minoxidil to help your hair grow even faster and thicker.   

Compounded Topical Treatments

If you’re not thrilled about using multiple products, all-in-one topical treatments that combine multiple medications into one are now available and can be more effective than using just one medication alone. (10)   Popular combinations are:

  • Retinol, Minoxidil, and Finasteride 
  • Minoxidil and Spironolactone

Many women appreciate the convenience and ease of applying just one formula twice a day.  

With so Many Medications Available to Women with Androgenic Alopecia, How do you Choose?

Are you confused about all of the different options?  If so, that’s understandable since some of the DHT blocking medications work similarly.  Thankfully, dermatologists have experience selecting the right medications for patients with female pattern hair loss.  Your dermatologist will help you choose the right medication, dosage, and combination of medication based on the severity of your hair loss and your medical history.  

Remember that treatment for female pattern hair loss isn’t one-size-fits-all.  Different medications work for different women.  It’s common to go through a trial process to see what works best for you.  

Also, keep in mind that patience is key when treating androgenic alopecia.  Medications work over time, so it may be a few months before you see a noticeable improvement, no matter which treatment you and your dermatologist choose.

Women with Androgenic Alopecia Often Need a Support System

Every woman deals with androgenic alopecia differently.  My friend Barbara took her diagnosis in stride, but many women are devastated.  Hair is a huge part of a woman’s identity, and losing it can take a toll on a woman’s confidence.  

If you’re having trouble coping with your hair loss, resources are available to you.  Best of all, some of the resources are free.  Facebook has a closed group dedicated to females with androgenic alopecia.  Members share information about their diagnosis and treatment plans. Sometimes, they’re just there to tell each other that it’s okay to be sad about their hair loss.  Whether it’s on Facebook, another social media outlet, or in person, support groups are a good way to connect with others who are feeling the same way as you about your hair loss situation.  

If you’re not in a good place mentally, make sure you contact a qualified psychologist or a psychiatrist.  Depression and anxiety are common among women with female pattern hair loss.  It’s important to seek help so you can regain your sense of self.

Resources:

(01) Name has been changed to protect confidentiality

(02) https://www.sciencedaily.com/releases/2016/03/160304093239.htm

(03) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4560543/

(04) https://www.karger.com/Article/Fulltext/504786

(05) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4560543/

(06) https://pubmed.ncbi.nlm.nih.gov/3771854/

(07) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7060023/

(08) https://pubmed.ncbi.nlm.nih.gov/25382509/

(09) https://www.jaad.org/article/S0190-9622(15)01878-2/fulltext

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

 

What Is Topical Finasteride?

If you’re searching for hair loss treatments, finasteride is a name you’ll need to familiarize yourself with. Why? Only two hair loss products have received the FDA’s seal of approval — minoxidil is one of them. The other product is finasteride. 

What is finasteride?

Although there are many different types of hair loss, the most common type is androgenetic or androgenic alopecia, also known as male pattern baldness or MPB. As part of a class of medications called 5-alpha reductase inhibitors, finasteride treats male pattern baldness by blocking testosterone’s ability to develop into dihydrotestosterone (DHT). DHT is a hormone that causes hair loss in adults, especially men. By blocking the production of DHT, finasteride reduces the amount of DHT within the scalp. (01)

Isn’t finasteride used for prostate issues?

Yes, finasteride is also prescribed for symptoms of benign prostatic hypertrophy (BPH) — an enlargement of the prostate gland. When used for BPH, finasteride reduces urinary frequency and urinary retention. However, the doses used in the treatment of BPH are much higher than the doses used to treat hair loss. As a treatment for BPH, finasteride is sold under the name Proscar.

What is finasteride’s history?

During finasteride’s use as an FDA-approved treatment for BPH under the name Proscar, researchers noticed its effectiveness against hair loss. Several years afterward, lower-dose finasteride was approved for hair loss under the name Propecia.

How does finasteride work against hair loss?

Finasteride works by inhibiting the action of the 5 alpha-reductase enzymes. Concentrated in the oil glands of hair follicles, 5 alpha-reductase, which helps convert testosterone into DHT, another hormone. For people who have the genes for hair loss, DHT binds to hair follicle receptors and diminishes the follicle’s size. If the follicle becomes too small, gradual hair loss occurs. 

Finasteride inhibits 5 alpha-reductase, thus reducing serum DHT (the DHT in the blood). Without DHT to constrict hair follicles, hair loss slows and — for many people — hair regrows. With less DHT in the blood, some people see their hair loss stop completely. In short, finasteride protects hair follicles from DHT damage and stops hair loss.

Which Types of Hair Loss Does Finasteride Treat?

The average person loses 100 hairs each day, even with no hair loss issues. Hair falls away as part of each strand’s natural growth cycle, and the loss is negligible. Each strand of hair grows until its fullest length, then rests and eventually falls away. Afterwards, another strand grows to take its place. (02)

Excessive hair loss is more than a normal part of a hair’s growth cycle. Hair loss can become a problem when more than the average amount of hair is lost over time or if hair fails to regrow. For many people — about an estimated 80 million US adults — a balding scalp or thinning hair is the result of hereditary factors. (02)

If a person’s hair loss stems from DHT’s damage to hair follicles, then finasteride can help.

Is oral finasteride better than topical finasteride?

Finasteride requires a physician’s prescription. A physician can determine the cause of hair loss and prescribe the most appropriate treatment. Getting to the root of the problem determines what works and what doesn’t — like oral finasteride versus topical finasteride. 

Oral finasteride, though effective, comes with a myriad of side effects. Many of the side effects of oral finasteride are life-altering, for example:

  • Decreased sex drive 
  • Pain or tenderness in the testicles 
  • Numbness in the testicles
  • A reduction in sperm count
  • Difficulty obtaining or maintaining an erection (erectile dysfunction)
  • Reduced ejaculatory volume
  • Severe mood changes
  • Breast enlargement 

In rare cases, oral finasteride may cause permanent side effects. 

Fortunately, taking finasteride topically reduces many of the more problematic side effects caused by taking finasteride orally. However, topical finasteride isn’t without precautions and still necessitates professional oversight to monitor and prevent side effects. Though not as severe as oral finasteride, some topical finasteride side-effects include:

  • Decreased sex drive 
  • Inability to urinate 
  • Swelling of hands and feet
  • Increased liver enzymes
  • Headaches
  • Testicular tenderness
  • Scalp irritation
  • Contact dermatitis 
  • Depression or anxiety
  • Dizziness or weakness

Can you buy finasteride over the counter?

Because finasteride works best for people with an inherited tendency for hair loss, it’s safest to have a physician determine its use. Therefore, finasteride is not a product that anyone can purchase at a pharmacy without a prescription. Finasteride is not an over-the-counter medication and requires a physician’s approval.

Is topical finasteride effective for hair loss?

Topical finasteride works excellently against hair loss. What’s more, topical finasteride avoids many of the adverse side effects that may deter others from completing treatment. The following are studies highlighting the effectiveness of oral finasteride.

  • A 2016 article published in the journal Dermatology Clinics and Research of 107 people found that:
    • Both topical and oral finasteride are equally effective.
    • However, participants on topical finasteride were more likely to complete treatment because there were less side effects. (03)
  • A 2019 literature review published in the Journal of Drugs and Dermatology found that topical finasteride delivered: (04)
    • A significant decrease in the rate of hair loss.
    • An increase in hair counts.
    • A reduction in DHT levels within the scalp and plasma.
  • A 2021 study published in the Journal of European Academy of Dermatology and Venereology utilized 458 study participants found: (05)
    • No serious adverse side effects in participants.
    • Fewer complaints of sexual side effects when using topical finasteride.
    • Topical finasteride improves overall hair count while producing fewer adverse side effects. 

To summarize, the topical application of finasteride is as effective as taking the drug orally. However, adverse side effects are less common with the topical application of finasteride when compared to oral treatment. 

When taken orally, finasteride goes through the digestive system and into the bloodstream. Applied as a topical, it bypasses the digestive tract and goes straight to its target with little to no side effects. This aspect makes topical use much more desirable, making users more likely to stick with the treatment! 

How do you balance the effectiveness of finasteride versus the side effects?

Getting the most benefits from finasteride with minimal side effects is achieved through:

  • Combining both finasteride and minoxidil, the two only FDA-approved medications for hair loss.
  • Customizing hair loss treatment to the needs of each individual, making every formula unique to each person’s needs.

Because each person is different, it’s essential to make every finasteride treatment as specific to the person as possible. By catering the therapy to each person, adverse side effects are less likely to occur. And because side effects like the loss of libido and a reduction in sperm count can lead to non-adherence with treatment, catering each treatment to the patient makes it more likely that customers finish their treatment and see successful results.

Making That First Step Towards Finasteride Hair Treatments

Happy Head requires a physician assessment to begin treatment. Happy Head, in collaboration with the physician and the customer, determines the most effective hair loss treatment with the least amount of side effects. The involvement of a licensed professional helps to improve safety, provides valuable feedback, and determines the most successful path toward stopping hair loss. 
With the help of board-certified dermatologists, you can find the right balance of finasteride treatments to suit your hair loss needs. Happy Head understands that hair loss can hurt. Losing your hair can be a traumatic event, even if it occurs slowly over time. Add the fact that hair loss treatments often come with side effects, and it can make anyone feel overwhelmed when searching for treatments. With Happy Head, help is just around the corner!

Resources:

(01) https://medlineplus.gov/druginfo/meds/a698016.html

(02) https://www.aad.org/media/stats-numbers

(03) https://www.scitcentral.com/article.php?journal=19&article=60&article_title=Randomized%20Comparative%20Research%20Study%20of%20Topical%20and%20Oral%20Finasteride%20with%20Minoxidil%20for%20Male%20Pattern%20Androgenetic%20Alopecia%20in%20Indian%20Patients

(04) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6609098/(05) https://pubmed.ncbi.nlm.nih.gov/34634163/

Why using Sunscreen on your Scalp is Crucial for Thinning Hair

Everyone knows sunscreen is an essential part of a healthy skincare regimen. You’re probably diligent about applying sunscreen on your arms and face, probably even the tops of your ears! As awesome as you are at applying sunscreen, you might be missing one crucial area – your scalp.

Sun Protection for Your Scalp

There are three ways you can shield your scalp from the sun. 

  1. Have thick hair. 
  2. Wear a hat. 
  3. Use sunscreen. 

An article published in the journal Photochemistry and Photobiology found that your hair acts like natural sun protection, called hair ultraviolet protection factor (HUPF). (01) HUPF works as a sun barrier and helps to prevent skin cancers caused by ultraviolet (UV) radiation. 

So, if you have lots of hair or intend to wear a fedora whenever you’re in the sun, then you’ve got it all covered. If your hair is thinning, cut very short, or if you’re without any hair, however, then your scalp is vulnerable. Unlike the skin on your face, your scalp lacks the same barrier strength, which makes your scalp sensitive to UV radiation and environmental toxins. Because your scalp’s skin barrier is thinner than the barrier on your body, safeguarding your scalp should be an important part of your skincare routine. (01)

Do people with hair loss conditions need sunscreen?

Hair loss affects a larger portion of the population than most people realize. According to the Cleveland Clinic, about 25% of men experience their first signs of hair loss by the age of 21. And roughly 50% of all the men undergo some level of hair loss by age 50. 

However, it’s not just men who are affected by hair loss. About 30 million women have a condition called female pattern hair loss (FPHL). It could happen to anyone. In many cases, people may have hair loss only in very specific areas on their scalp, while other parts remain flush with hair. Hair loss varies from person to person, and it’s the exposed scalp areas that need sun protection the most. (02, 03) 

Sunscreen for the scalp is a relevant consideration for all people, but especially for people with hair loss conditions. The following are few examples of hair conditions that may benefit from sunscreen use.

  • Androgenetic alopecia
  • Alopecia areata
  • Cicatricial alopecia
  • Folliculitis Decalvans
  • Frontal fibrosing alopecia 
  • Central centrifugal cicatricial alopecia
  • Discoid Lupus erythematosus
  • Male pattern baldness 
  • Loose anagen syndrome
  • Hypotrichosis
  • Lichen planopilaris
  • Anagen effluvium
  • Telogen effluvium

Even people who don’t have a hair loss condition may need to use sunscreen on their scalp. Most people are unaware that they have sections of their scalp showing. For example, people have a whorl of hair at the crown, often showing a bit of exposed scalp. Spend enough time outdoors without sun protection, and this small patch of unshielded scalp can become sunburnt. 

Can your scalp get a sunburn?

Just like the rest of the skin on your body, your scalp can burn from too much sunlight. For this reason, protecting your scalp from the sun is crucial to reducing skin damage, lowering your risk of developing skin cancer, and preventing painful sunburns.

Sunburns and Your Hair Follicles

In general, if you’re already dealing with hair loss, injury from the sun can create more challenges. Third and fourth-degree sunburns, for instance, may damage and physically stress hair follicles, causing a temporary condition of hair loss called telogen effluvium. Maintaining your scalp health means potentially keeping more of your hair, which makes sun protection paramount. (03)

Sunburns and Skin Cancer

Sun damage may cause further hair loss, but it can also lead to something life threatening — skin cancer. The American Academy of Dermatology Association (AADA) reports that about one in five people will develop some form of skin cancer in their lifetime. (04) Out of that population, about 2% to 18% affect the scalp. (05) Furthermore, cases of skin cancer continue to rise each year. Keeping this information in mind, your scalp should receive the same – if not more – sun protection as the rest of the skin on your body. 

What is a Sunburn?

Environmental pollutants and UV radiation accelerate the signs of aging, injure cells, and damage DNA within the skin barrier and deeper tissues. Sunburns are an inflammatory response to excessive UV radiation, which destroys the upper layers of skin. (06) Melanin, which darkens skin with exposure to sunlight, helps to protect your skin cells from the sun’s damage. Contrary to popular belief, a glowing tan doesn’t indicate healthy skin. A tan means that your skin cells have reacted to the sun’s radiation!

How your skin reacts to UV radiation is primarily based on your genetic makeup. Some people undergo gradual skin darkening, while others immediately experience a sunburn. While both are signs of skin damage, people with sunburns experience more pain and visible skin cell injury. Repeated sunburns or exposure to UV radiation can place individuals at a higher risk of skin cancers like squamous cell carcinoma, basal cell carcinoma, and melanomas. (07)

What does a scalp sunburn feel like?

Whether or not a person feels pain with a scalp sunburn depends on the severity of the burn. Most sunburns are first or second-degree burns, but they can still cause some discomfort. With a first or second-degree sunburn, you might experience signs and symptoms like: 

  • Redness
  • Swelling
  • Irritation
  • Flaking
  • Itching
  • Burning 

Pain from a sunburn is typically at its worst 6 to 48 hours after exposure to the sun. (07) Severe cases of scalp sunburn may result in significant pain and blistering, which may take longer to heal. Fortunately, most sunburn symptoms are temporary and go away after three days to a week. The damage to cells and DNA, however, can remain for decades.

Treating a Scalp Sunburn

Caring for sunburn on the scalp takes a little TLC. To encourage healing, moisturize the area while the scalp is damp. Keeping the scalp moisturized cuts down on unsightly peeling and flaking. If you’re searching for sunburn medication, products that contain aloe vera may help to reduce inflammation and soothe irritation. 

  • Avoid oil or petroleum-based products because their ingredients can aggravate the scalp and cause more pain. 
  • Use shampoos that are sulfate-free and gentle on the scalp. 
  • Instead of hot water, run cool water over your scalp to cleanse the area. 
  • Stay hydrated and well-nourished to prevent further water loss and promote wound healing. 

Choosing the Right Sun Protection for Your Scalp

Fortunately, you have a variety of options when it comes to shielding your scalp from the sun. It may take some trial and error to find what suits your needs and lifestyle the best, but the effort is worthwhile.

Hats and Hair Loss

If you’re using headwear to protect your scalp, then you’ve got an array of style choices. From beanies to cowboy hats, your options are endless. However, wearing hats do come with a few drawbacks. 

Here are a few things to consider before you start your hat collection.

  • Remember that hats with openings in them, like snapback and trucker caps, allow sunlight to penetrate through parts of the hat.
  • Hats retain heat, and your head is one of the primary ways your body regulates its temperature. Wearing a hat in the sun may make you feel excessively warm. 
  • Hats that are hot or are too tight may reduce blood to hair follicles, depriving them of nutrients and causing stress — which can encourage further hair loss! (08)
  • Be wary of developing traction alopecia when choosing a hat. Constant pulling or tension of hair can lead to traction alopecia hair loss, so choose a loose-fitting hat. (08)

Don’t like hats? Don’t want to risk any more hair loss? Then you’ll need sunscreen. 

Helpful Hints for Choosing a Sunscreen for Your Scalp

Keep in mind that finding the right sunscreen for your scalp can be tricky. If you have thinning hair, you’ll want a formula that’s thick enough to protect your delicate scalp but won’t cake into your strands of hair. Finding the right sunscreen for your scalp is a bit like Goldilocks looking for the happy medium – you want something “just right.” 

Here are a few factors to think about when you’re on the lookout for a good scalp sunscreen: (09)

  • Sunscreens for the skin on the body tend to be oily. You may not want an oily sheen covering your scalp and hair. 
  • Stick sunscreen is excellent for small areas (like your crown or part) but not ideal for use over large areas with thinning hair. 
  • Powder sunscreen options for the hair are convenient and can make hair appear thicker. However, powder sunscreen can be twice the price of other types of sunscreen. 
  • Sunscreen sprays or mist are practical and are reasonably priced, though they can sometimes weigh hair down. 
  • Chemical sunscreens absorb the sun’s rays and prevent radiation from reaching your scalp and skin. These kinds of sunscreen don’t typically leave that white cast on the skin that sunscreen is known for.  

A few ingredients found in chemical sunscreens are: 

  • Avobenzone
  • Octisalate
  • Oxybenzone
  • Octocrylene
  • Octinoxate
  • Homosalate
  • Mineral sunscreen physically blocks or shields UV radiation. This sunscreen blocks the rays of the sun and deflects them back out. People with sensitive scalps or chemical sensitivities may find mineral sunscreen less irritating. 

A few ingredients found in mineral sunscreens are: 

  • Titanium dioxide
  • Zinc oxide

What is the best sunscreen?

According to the AADA, the sunscreen that’s best for you is the one you will use consistently. Whatever sunscreen you choose, make sure it meets the following criteria: (09)

  • Broad-spectrum for both UVA and UVB rays
  • Consists of an SPF of 30 or higher
  • Water-resistant

In short, if you have thinning hair, you need sun protection for your scalp. Whether you’re looking for some fun in the summer sun or you’re working outdoors, remember that you – quite literally – have skin in the game. Protect it! 

Resources: 

(01) https://pubmed.ncbi.nlm.nih.gov/25682789/

(02) https://pubmed.ncbi.nlm.nih.gov/25682789/

(03) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7320655/

(04) https://www.aad.org/media/stats-skin-cancer

(05) https://onlinelibrary.wiley.com/doi/full/10.1111/ddg.13546

(06) http://skincancer.org/risk-factors/uv-radiation/

(07) https://jamanetwork.com/journals/jama/fullarticle/2383280

(08) https://health.clevelandclinic.org/can-wearing-a-hat-make-you-go-bald/

(09) https://www.aad.org/public/everyday-care/sun-protection/sunscreen-patients/sunscreen-faqs