Tag Archive for: Minoxidil

What You Need to Know about Smoking and Hair Loss

If you’re a smoker, you’re probably already well aware of why you should quit. Between your family using every scare tactic in the book and chilling public service announcements featuring people suffering from various types of cancers and lung diseases, you know the risks more than anyone. Beating the addiction is hard, though.  In fact, it’s so difficult that 80 percent of people who try to quit smoking on their own start again within a month. (01)

Just in case you need a little more incentive to kick the habit for good, consider this: according to several research studies, nicotine can induce hair loss.  Sure, you know how harmful cigarettes and vapes are to your body, but you probably didn’t expect to go bald from them.  What else do you need to know about the effects of smoking on your hair?  Keep reading, and we’ll fill you in on the latest.  

Nicotine Accelerates Hair Loss

Not only can continual use of nicotine lead to a heart attack, but it is also believed that smoking may be responsible for accelerating hair loss.  One study found that 85 percent of men who smoked had a form of androgenic alopecia, male pattern baldness.  Among the men in the non-smokers’ group, only 40 percent exhibited signs of male pattern hair loss.  The difference in hair loss was significant.  The study used the Hamilton-Norwood Scale, which categorizes hair loss on a scale of one to seven, with one being the least amount of hair loss.  In the smoker group, 71 percent had grade III or grade IV hair loss.  However, in the non-smoker group, only ten percent of the participants reached grade III or IV. (02)

Smoking Ages Your Scalp 

So the next question is, why do experts believe smoking leads to hair loss?  You know how smoking is known for giving people leathery alligator skin?  It has the same effect on your hair.  The reason why stems from a few different factors.  

  • Smoking reduces the blood flow to your hair follicles.

When you smoke, your blood vessels constrict, limiting how much blood flows to your organs.  Over time, the continual constriction stiffens the blood vessels and makes them less elastic.  When this happens, your cells don’t get the amount of oxygen and nutrients needed to thrive.  When your hair follicles are deprived of oxygen, miniaturization occurs, disrupting your hair’s growth cycle.  The hair follicle shrinks and eventually blocks the growth of new hair.   

  • Breathing in smoke can damage your hair’s DNA.

Smoke causes environmental effects that inhibit hair growth.  DNA contains genetic material that serves as our hair’s building blocks.  When carcinogens from cigarette smoke damage the DNA, keratin, a protein that makes-up 95 percent of your hair, cannot be produced. 

  • Smoking causes inflammation. 

Smoking stimulates follicular inflammation, a key feature in male and female pattern hair loss.  In a 2020 research study on androgenic alopecia, approximately 71 percent of biopsy samples of patients with male or female pattern baldness showed signs of inflammation. (03)

  • Smoking decreases estrogen levels.

It is well documented that smoking decreases estrogen levels in women, which can lead to earlier onset of menopause.  When estrogen levels drop, hair grows slower and thinner.  Lower estrogen levels also lead to an increase in androgens which cause female pattern baldness. (04)

  •  Smoking prematurely turns your hair gray.

In an observational research study, people who smoked were two and a half times more likely to have gray hair before age 30 than non-smokers. (05)  The study mentioned that the cause of premature graying is not yet known.  One hypothesis is that melanocytes, the cells responsible for producing color, are damaged in people who smoke.  

If You’re Thinking About Getting a Hair Transplant, Stop Smoking

Many reputable dermatologists and hair specialists refuse to perform hair transplants on patients who smoke.  The reason why is because oxygen is critical to the survival of transplanted follicles and helping the wounds heal.  Smoking causes poor blood circulation, which could result in the death of the skin tissue on the scalp and even post-operative infections. (06)  Another reason why is because nicotine in the blood vessels increases bleeding and inhibits clotting during the healing process. 

Vaping Can Cause More Damage Than Traditional Cigarettes 

What about vaping?  It’s safer than smoking cigarettes, right?  Not exactly.  Vaping has skyrocketed in popularity across all ages groups in the past few years due to the sweet taste and lack of stale smell. What many people don’t realize, however, is that JUUL, MarkTen Elite, PAX Era, and most other types of e-cigarettes contain more nicotine than traditional cigarettes.  

Although no studies are available, anecdotally, one can make the connection that nicotine from vape pens is equally harmful, if not worse, for your hair than traditional cigarettes.  Regardless of the source, nicotine has been proven to cause oxidative stress, which can impair your hair’s growth and cause hair loss. (07)

The Jury is Out on Marijuana

Recreational marijuana is currently legal in 19 states, Washington D.C., and Guam. (08)  Marijuana must not be harmful if it’s legal, right?  Well, the jury is out.  A study conducted in 2007 by the University of Debrecen indicates that the THC in marijuana can lead to hair loss. (09) 

Marijuana contains cannabinoid compounds.  Tetrahydrocannabinol (THC) and Cannabidiol (CBD) are the most well-known.  THC is the main psychoactive compound.  It’s the one that makes people feel high.  CBD is derived from hemp plants and does not cause a high or lead to addiction.  When it comes to your hair, THC is the troublemaker.  According to the study, the THC in marijuana can attach to receptors in your body, including your hair follicles, which causes hair loss.  Not much research has been conducted since to qualify or negate the study.  

We believe that the study is accurate because marijuana and other drugs can be detected in hair samples for up to 90 days prior to the test. (10)  It makes sense that if the THC attaches to the follicles and sticks around for a while, it could cause damage.  

Treatment is Available to Reverse Hair Loss Caused By Smoking

Treatment is available if you’re experiencing hair loss from cigarettes, vapes, or marijuana,.   The first step is to stop smoking to prevent further damage.  The next step is to consult with a dermatologist who is also a hair specialist.  Although many hair loss remedies are available over the counter, the most effective ones are only available by prescription.  A variety of medications can be prescribed to stimulate regrowth including:

Minoxidil

As mentioned previously, smoking can cause androgenic alopecia in people who are predisposed.  When people get male or female pattern hair loss, their hair follicles shrink.  Minoxidil enlarges miniaturized hair follicles to allow stronger, healthier hair to go to the surface of your scalp.  

Finasteride 

People who smoke and have male or female pattern baldness produce a chemical called Dihydrotestosterone (DHT) that is converted from testosterone. DHT attacks the hair follicles and causes the hair to fall out.  Finasteride is a DHT blocker that prevents testosterone from converting to DHT.  

Spironolactone

Sprionolactone is a DHT blocker.  The medication works similarly to Finasteride but is a bit stronger.  

Retinoids

Retinids are often used in conjunction with Minoxidil and Finasteride to increase absorption of medications that treat androgenic alopecia.

In many cases, combinations of these medications are most effective in promoting hair growth among former smokers.  For example, Minoxidil combined with Finasteride and Retinol for absorption has been proven more effective than Minoxidil alone.  

Quitting is the Best Way to Preserve Your Hair

 

If you’re really worried about losing your hair, the best route is to quit smoking.  Kicking the habit isn’t always easy, but it’s worth it. You’ll look better and your health will improve. 

 

According to the American Cancer Society, the best strategy is to quit one day at a time.  A day turns into a week, a week turns into a month, the months turn into years, and before you know it, you’ll have broken the habit.  Sure, it sounds simple, but we realistically know it’s not.  Here are some other helpful tips:  

  • Stay busy and spend time in public places where smoking is prohibited
  • Replace the feeling of holding a cigarette or joint with a paper clip, marble, or coin
  • Chew gum or eat lollipops as a substitute
  • Avoid places, activities, and people that you associate with smoking
  • Exercise
  • Create a support system of family members and friends who you can call when you have a craving

 

Many good resources and programs are available to help you as well.  Here are three that we recommend.  All of these organizations provide trusted information and support.

American Cancer Society 

If you’re considering quitting, you don’t have to do it alone.  During The Great American Smokeout annual event, thousands of people commit to a smoking cessation program on the third Thursday in November.

American Lung Association

The American Lung Association offers a Lung Helpline & Tobacco Quitline staffed by licensed registered nurses, respiratory therapists, and certified tobacco treatment specialists.  The staff is a wealth of knowledge and can help connect you with a support group, find a doctor, and even answer questions about health insurance.

National Cancer Institute

Smokefree.gov, sponsored by the National Cancer Institute, offers free tech programs to help you go smokefree.  One innovative program is a texting service that gives encouragement, advice, and tips to help you quit.  The organization also offers apps that allow you to tag locations and time of day you need support, as well as social media support.

If you are a current or former smoker and your hair is thinning or balding as a result, Happy Head is here to help.  Contact us so we can review your history and customize a prescription-grade hair loss solution for you.

 

Resources:

(01) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2928221/

(02) https://onlinelibrary.wiley.com/doi/10.1111/jocd.13727

(03) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7667670/

(04) https://www.karger.com/Article/Abstract/68894

(05) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3673399/

(06) https://pubmed.ncbi.nlm.nih.gov/7484781/

(07) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2758082/

(08) https://www.usnews.com/news/best-states/articles/where-is-marijuana-legal-a-guide-to-marijuana-legalization

(09) https://faseb.onlinelibrary.wiley.com/doi/epdf/10.1096/fj.06-7689com

(10) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5396143/

 

Dermaroller: The Most Helpful Hair Loss Tool You Didn’t Know You Needed

If you’re up-to-date on the latest skincare tools, you’ve probably heard about dermarollers designed to pump-up your skin’s collagen.  You may have even tried one.  But did you know that dermarollers can help rejuvenate your hair too?  Although relatively new to the hair care scene, dermarollers have quickly become a tool of choice, recommended by many dermatologists and hair specialists.  What makes dermarollers so popular for treating hair loss?  Will the trend last?  We’re here to fill you in.  

What is a Dermaroller and What Does it Do?

A dermaroller is a small hand-held roller with about 540 tiny needles on it.  When rolled over your skin or scalp, the dermaroller’s needles create microscopic wounds that stimulate collagen and elastin production.  Collagen keeps your skin firm, elastic, and hydrated.  It’s also needed to build keratin which keeps your hair strong, shiny, and thick.  In addition to building collagen, dermarollers increase blood supply to the hair follicles, enlarging the follicles to allow new growth to emerge.

Why Are We Just Now Learning About Scalp Dermarolling?  Is it New?

Although dermarolling, also known as microneedling, has been around since the 1900s to treat birthmarks, hyperpigmentation, and scars, we started hearing more about the treatment in the late 1990s.  Since then, dermarolling has been studied and found to be effective among patients with alopecia areata (01) and androgenic alopecia.  Patients with alopecia areata have seen positive results when applying triamcinolone after using a dermaroller.  Patients with androgenic alopecia have seen positive results when applying Minoxidil after using a dermaroller. (02)

Are Dermarollers Safe?

Dermarolling is quite safe and easy to do.  Simply wet your hair and then gently roll back and forth with the dermaroller, left and right, for just a few minutes.  Make sure that you keep the dermaroller moving.  Holding a dermaroller in one place in one area could cause scarring.

Can I Do Microneedling at Home?

The microneedling that’s referenced in this article can be done at home. All you need is a dermaroller. The number of times that you use your dermaroller each week will depend on the length of the needles you are using and whether you are using your dermaroller to apply medication. Patients should always consult with their dermatologists to develop a treatment protocol since alopecia type, medications, hair density and other factors vary from person to person.

Other types of microneedling are performed in a dermatologist’s office. You may have heard of Protein Rich Plasma (PRP) treatments which are often done in conjunction with microneedling. During a PRP treatment, a patient’s blood is drawn and placed into a centrifuge machine. The blood is spun at a high rate so the components are separated. The platelets are then extracted and injected into the scalp. When PRP is combined with microneedling, topical anesthetic is applied first, medical-grade dermarollers are used, and then PRP is applied last. PRP treatments can only be done in a doctor’s office.

Which Dermaroller Should I Buy?

According to Dr. Ben Behnam, board-certified dermatologist, hair specialist and co-owner of Los Angeles-based Dermatology and Hair Restoration, the key to selecting a dermaroller is to get the correct needle size. “When dermarolling, you don’t have to go very deep to get results,” said Behnam. “I recommend just 0.25, which is very shallow. Many people read online that a 1.5 depth is recommended, but in my opinion, that’s too deep. Nobody needs a roller that strong. Rollers with needles that are too long hurt, and they can damage the hair follicle. You certainly don’t want to damage areas where your hair is thinning or balding.”

Using a Dermaroller to Apply Minoxidil (Rogaine), Finasteride, and other Topical Medications Gives Better Results

A study conducted in 2013 compared patients with androgenic alopecia who used a dermaroller to apply Minoxidil to patients who did not use the roller. Not surprisingly, patients who used the roller achieved more growth. The dermaroller creates tiny holes in the scalp that allows the Minoxidil, Finasteride and other topical medications to penetrate deeper than they otherwise would. The medicine works more effectively.

If you’re using Minoxidil or any other topical hair loss treatment on your frontal hairline, Dr Behnam recommends using the topical about two inches behind the hairline to prevent getting the medicine on your face.

Can a Dermaroller be Used on Facial Hair?

Although no research studies have been conducted on patients using dermarollers on their mustaches or beards, there’s enough evidence to indicate it’s worth a try. We know that Minoxidil is effective for hair growth and that dermarolling increases absorption. In addition to boosting collagen and keratin production, dermarolling may help improve blood flow to the area.

Keep in mind that you may notice some redness after using the dermaroller on your mustache or beard area. This irritation should disappear after a few days. If you experience bleeding, you may be using too much pressure. See if using less pressure helps.

Here are some other tips for facial dermarolling:

  • Start with clean skin and facial hair
  • Wait until acne has cleared up before dermarolling to prevent irritation or infection
  • Use the least amount of pressure needed
  • FIll-in each cheek with air as you do when shaving to get a flatter surface for dermarolling
  • Get a consistent pattern by moving the dermaroller back and forth in horizontal, vertical and diagonal lines

How Much do Dermarollers Cost?

Microneedling sessions at a dermatologist’s office can be very expensive, costing anywhere from $200 – $700 per session or more. Using a dermaroller at home, however, saves time, money and gas. Dermarollers designed for home use are similar to the ones dermatologists use, but have smaller needles. As we’ve discussed though, smaller needles can still pack quite a punch. Dermarollers used at home are very budget-friendly. The average price of a good stationary unit ranges anywhere from $15 to $30. A good quality electric unit costs $100 – $200 depending upon the features included.

Should You Test out a Dermaroller on Your Scalp?

So, here’s the takeaway.  A dermaroller is an inexpensive hair growth tool that increases the effectiveness of topical treatments among patients with androgenic alopecia and alopecia areata.  As with any medical treatment, you should always check with your dermatologist before buying or using a dermaroller.  Although dermarolling is an easy, low-risk at-home treatment, it is not recommended for scarring alopecias.   

Always make sure that you buy your dermroller from a trusted source.  As with any other hair tool, make sure that you keep your dermaroller clean according to the package instructions.  Finally, use your dermaroller as recommended, and be careful not to overuse it.  More won’t give you better or faster results.

Resources:

(01) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3996798/

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

 

 

 

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/

 

Devastated About Your Hair Loss? Tips to Help You Cope.

 

“It seems to me that being “not okay” is a perfectly acceptable response to this unwanted, unannounced situation.  There’s nothing wrong with feeling “not okay” on some days or in some situations.  We are grieving the loss of our hair, the loss of our identity, the loss of our sense of self, and the loss of our confidence.”

– Sarah, Member of Alopecia Areata, Find a Cure (01)

In January of 2020, Massachusetts Representative Ayanna Pressley made an announcement with a video that she has alopecia.  Much like Jada Pinkett Smith, Pressley is in the public eye and tried to hide her condition as long as she could.  Pressley decided that she was done hiding.  She took off her wig and shared her story.  The video helped Pressley make peace with her condition.  Coming forward helped Pinkett Smith in a similar way.  “Me and this alopecia are going to be friends,” said Pinkett Smith.  

Alopecia may not be life-threatening, but it’s upsetting no matter what type you have.  Whether you have androgenic alopecia, alopecia areata, telogen effluvium, or any other kind of alopecia, men and women go through a similar grieving process when losing their hair. (02)   

Society’s expectations of what’s attractive don’t make it easy to accept your hair loss.  Somehow we can talk about sex, curse, and even be openly rude to each other, but revealing that you’re balding or completely bald is shocking and newsworthy.    

So how do you get to the point when you’re “okay” when it feels like you never will be?  We asked Rachel, one of our staff writers with lichen planopilaris, an autoimmune alopecia, how she got there. 

Q.  How did you find out that you had alopecia?

When my son was about one and a half, I noticed a lot of hair in the shower and sink. My hairline also started to recede on one side.  I had just had two babies back-to-back, and I figured that my hair was falling out from the hormonal changes.  I thought it would grow back.

Then, during a routine visit to the dermatologist, I had my doctor take a look.  He took a biopsy, which I thought was overkill for a slight hormonal imbalance, and I didn’t think about it again until I got a phone call.  The call wasn’t from a nurse or an assistant.  The dermatologist called me himself.  I knew right away that the news wasn’t going to be good. 

Q.  How did you react when you found out that you have alopecia?

I remember being really upset and desperately hoping that my dermatologist was wrong.  I was a ballet dancer all of my life and always had my hair back in a ponytail or a bun.  There wasn’t a way to hide the recession, and I wasn’t sure how to make my hair look presentable. 

Q.  How did your alopecia diagnosis affect you emotionally?

It was a tough time.  I hated the way my hair looked, and I kept imagining what I would look like as the rest of it fell out.  

On top of that, I felt guilty about being so vain.  People get all kinds of horrific diseases as they age, yet I was lucky enough only to get something cosmetic.  I didn’t think I had the right to be so upset about my hair.  Looking back, I wish I could tell my younger self that it’s okay to be upset.  It’s a natural part of the healing process.    

Q.  How did you treat your alopecia?  Did it help?

Shortly after I was diagnosed, I found a top dermatologist in my area who specializes in hair loss.  Initially, I was treated with steroid injections (yes, they hurt), topical Clobetesol, five percent Minoxidil, and Tacrolimus.  The goal was to prevent further hair loss and strengthen the surrounding hair.  

My alopecia went into remission for over ten years, but recently flared up again.  My treatment this time around is a bit different.   It’s amazing how much research has been conducted and how much has been learned since I first started on this journey.  My dermatologist added Finasteride to my treatment plan.   Much to my surprise, I’m seeing small areas where hair is growing back.  I didn’t expect that to happen.

Q.  What did you do to get to a better place emotionally when you were feeling down about your hair loss?

I set a time limit to allow myself to be upset.  I gave myself a week and decided that after the week was over, I would let my sadness go and focus on other things.  The time limit gave me power over my emotions and the situation when I didn’t have any control.   

When the lichen planopilaris flared up after being in remission for so long, I regressed a bit.  I wasn’t as upset as I was the first time because I had some experience, but I definitely got emotional.  I had to go through the same process of limiting my grief.  I think emotions tend to ebb and flow with alopecia.  Everyone has to find what works for them when managing those strong emotions.

Q.  A lot of people with alopecia are at a loss about how to style their hair.  What did you do?

I visited my hair salon and got a sassy, short haircut.  I wasn’t sure that I would like short hair, but it’s since become my style.  If my alopecia gets so bad at some point that I have to cut it shorter, I will.  

Ironically, this process has given me confidence and taught me to own my look, whatever that is at the time.  Although it’s not a choice that everyone would make, I found that cutting my hair was liberating. I followed the protocol that my doctor prescribed for me, but I stopped fretting about every hair that I saw in the sink.

Q.  What advice do you have for other men and women who are experiencing hair loss?

Most importantly, find a board-certified dermatologist who you like and respect.  You’re going to need a supportive partner.  If you don’t think you have the right professional on your side, get second opinions until you find the right person.   

Secondly, I’m in a few Facebook groups for people with alopecia and read about how many are apprehensive about testing.   If your dermatologist recommends getting blood work or a biopsy, do it.  The blood test isn’t a big deal, and the biopsy area is small.  Your dermatologist will numb the area.  You won’t feel anything, and the site heals quickly.  The small bit of aggravation is worth knowing if you have a form of alopecia.  You can then move quickly into treatment.  

Lastly, be kind to yourself.  It takes time to come to terms with your hair loss.  If you visit online or in-person support groups, you’ll see that you’re not the only one experiencing alopecia.  Millions of other people are in your boat.  It’s common for people with alopecia to suffer from anxiety or depression. (03) If this is the case for you, don’t hesitate to seek help from a professional therapist or psychologist.  

Healing from the sting of learning that you have a form of alopecia isn’t easy.  Now that we’ve heard Rachel’s story, we would love to hear yours.  What tricks have you used to make yourself feel better emotionally when dealing with alopecia?

Resources:

(01) Name has been changed for confidentiality

(02) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1261195/#ref11

(03) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1261195/#ref11

 

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/

Pump Up the Volume: 5 Tricks Men Can Use to Get Thicker Looking Hair

Is the comb-over really a good look?  Sure, Donald Trump made it part of his signature, but how many other guys do you know who can or want to make that style work?  If your hair is thinning due to male pattern baldness, also known as androgenic alopecia, or other reasons don’t stress. Whether you’re 25 or 75, there are ways to increase your hair’s volume, so your hair seems thicker and more attractive.

More Volume Equals Less Scalp

What does it mean to increase your hair’s volume?  Simply put, volume is the amount of hair that covers your  scalp.  Your hair’s thickness is determined by the number of follicles that grow per square inch and the density of those follicles.  If you can’t see your scalp through your hair, you’re in good shape.  If you can, your hair’s volume may be thinning due to genetic or lifestyle factors. 

Men Get Their Hair from their Moms

Not surprising, the main reason why most men start to lose volume is due to male pattern baldness.  Androgenic alopecia is so common it affects 30 to 50 percent of all men by the time they’re 50 years old. (01)  You can blame your Mom.  Male pattern baldness is a genetically inherited condition that stems from the X chromosome. 

Men’s Hair Typically Loses Volume Gradually

With male pattern baldness, you may not notice a loss in volume right away.  Instead, the condition tends to develop slowly starting with a slightly receding hairline or a very small bald spot on the crown of your head.  The progression is gradual because your hair follicles shrink over time, leaving shorter and finer hair.  Eventually, the miniaturization of the follicles prevents new hair from growing.  Fortunately, the follicles remain alive, suggesting that new hair growth is possible.

Your Hair’s Thickness is Also Affected by Your Lifestyle

Are you under a lot of pressure at work?  Are you trying to drop a few pounds, or have you recently started a new medication?  If so, remember that stress, changes in your diet, illnesses, and some medicines can affect your hair’s growth cycle.  If your hair is feeling thin or lacking body, changes in your lifestyle may be the culprit.  The good news is that thinning hair due to these factors can easily be reversed with minimal treatment.  Many cases will resolve on their own without any intervention. 

It’s Easier to Make Your Hair Look Thicker Than Most Men Realize

If dealing with your hair doesn’t top your list of ways you want to spend your time, don’t worry.  Improving your hair’s appearance and quality doesn’t have to take a lot of effort.  Here are five tricks that Dr. Ben Behnam, a leading dermatologist, hair specialist, and co-owner of Dermatology & Skin Restoration Specialists located in Los Angeles, California, recommends to his male patients:

Use the Right Hair Products, the Right Way

Strengthen with Collagen and Keratin Enriched Shampoo 

“When it comes to building volume, not just any shampoo will do,” said Dr. Behnam.  “Choose one that contains both collagen and keratin.”  Collagen, the most abundant protein in your body, helps make up your tendons, ligaments, and skin.  Collagen also contains amino acids that your body uses to make keratin, the protein that makes up your hair. 

Keratin goes deep into the hair follicle, making the hair follicle firmer to smooth frizzy hair and make dull hair shinier.  According to Behnam, “a combination of collagen and keratin will make your hair stronger and healthier to give it a more lustrous appearance.”  

Moisturize with Conditioner 

“If you’re like most men and don’t use a conditioner, it’s time to change your ways,” says Behnam.   He recommends that his male patients use high-quality conditioners to moisturize their hair and provide a protective coating to the outer layers of the hair shaft.  Conditioner gives your hair a nice sheen and a thicker appearance.  For the best result, select a conditioner that doesn’t contain sulfates.  Sulfates inhibit the conditioner’s ability to moisturize by stripping away essential oils that allow the conditioner to work.  Apply conditioner after each time you shampoo.  Remember only to use conditioner on the ends of your hair, and not your scalp.  Too much moisture at the root will weigh your hair down and leave it limp.  

Use Hair Gel Sparingly

Do you use gel or creams to style your hair?  If so, be careful not to overdo it.  Too much gel clumps your hair, making it easier to see your scalp and inadvertently making your hair look more sparse.  In the case of gel, lighter and less give you more.

Consider Using Hair Growth Treatments

Minoxidil 

Minoxodil, sold under the trade name Rogaine, was the first hair regrowth treatment to receive FDA  approval.  The medication is available over-the-counter for men in a five percent foam or liquid.  Prescription Minoxidil is available in higher concentrations as a pill or topical formula.

Minoxidil works by enlarging the size of your hair follicles and extending your hair’s growth cycle.  Numerous research studies have proven that Minoxodil increases growth among men with male pattern baldness. (02)   

Minoxidil is an easy way to add volume if your hair is thinning.  Rogaine is sold at many retail locations and is simple to use.  However, you’ll need to be patient because it takes about three or four months to see signs of growth.  Once you start using Minoxidil, you’ll need to keep using it.  If you stop using the product, you’ll lose any new growth. (03)

Finasteride

Finasteride, the other FDA approved medication for male pattern baldness, is a 5-alpha reductase inhibitor medication that is often used to treat an enlarged prostate.  Because Finasteride decreases production of dihydrotestosterone (DHT), it has been proven to stop hair loss and promote new growth.  

Men typically do not experience severe adverse effects from FInasteride, but some do have side effects from the oral medication.  If side effects are a concern, topical Finasteride is available and is a good substitute.  Many men actually prefer the topical solution since it works similarly to the pill without systemic effects.  

All-in-one Treatments for Men

New products that combine Minoxidil and Finasteride and other active ingredients into one formula have been proven to be more effective than Minoxidil alone. (04)  Many men prefer the simplicity, convenience, and potency of all-in-one formulas.

If you’re testing a treatment that includes both Minoxidil and Finasteride, make sure that the formula contains retonic acid.  Retonic acid, a compound derived from Vitamin A, significantly improved hair growth among 43 percent of people who did not respond to Minoxidil alone. (05)  It is believed that retinoids work synergistically with Minoxidil to prolong the hair cycle’s anagen phase, increasing the growth rate. (06)

Combination formulas including more than five percent of Minoxidil and Finasteride are often customized and are only available by prescription.  Be sure to work with a board-certified dermatologist to get the compounded formula that best meets your needs. (07)

Avoid Anything that Pulls on Your Hair

“Wearing a tight ponytail, or anything else that pulls on your hair, is a recipe for disaster,” says Dr. Behnam.  Tight hairstyles can cause traction alopecia which is often seen around the temple area.  Early on, traction alopecia will reverse itself if you stop pulling on your hair.  However, longer term pulling can bring scarring and bigger problems.  If you want to avoid traction alopecia, stay away from buns, hats, cornrows, dreadlocks, and braids.

Feed Your Hair

Dr. Behnam often reminds his patients that strong, healthy-looking hair requires a well-balanced diet that includes plenty of protein.  After all, your hair is made up of a fibrous protein called keratin.  The protein-rich foods we eat feed our hair.  

Good sources of protein include:

  • Nuts
  • Avocado
  • Organic, grass-fed chicken
  • Fatty fish (salmon, tuna)
  • Eggs

Adding collagen to your diet is also a good idea.  Collagen, the protein known for your skin’s elasticity, also plays a crucial role in growing strong, healthy hair.  Your body produces collagen, but over time, your production capability diminishes.  So, when your collagen levels begin to drop, your hair may get thinner.  Bone broth, gelatin, and chicken are all good sources of collagen that can help prevent a decrease in volume.

Get the Right Cut

Men with thinning hair often grow their hair long, thinking that the extra length will cover sparse areas.  Quite the opposite is true.  When your hair is shorter, it looks thicker. With short hair, layers camouflage the sparse areas.  Not having the dead ends weighing your hair down makes it look healthier too.

Find a barber or hairstylist who knows how to properly proportion your cut.  According to Parker Plotkin, Master Stylist and Artistic Director at Lotus Hair Studio located in Palm Beach, Florida, and season two Shear Genius stylist, the trick is to balance out thinning areas. “Many stylists tend to give round cuts that are short on top and longer on the sides,” said Plotkin.  “The problem is that the round cut makes the reduced volume on top more prominent.  Most men will look better with a square haircut with close cut sides.”

Consult with a Board-Certified Dermatologist and Hair Specialist

A trip to the dermatologist doesn’t top most guys’ lists of favorite things to do, but if you’re concerned about your thinning hair, you should consult with a professional.  A number of men who are concerned about their loss of volume are self-treating to avoid the embarrassment of a doctor’s visit. (08)  If that’s you, you may want to reconsider.  Board-certified dermatologists and hair specialists are highly experienced with treatments designed to prevent further hair loss and stimulate growth.  The sooner you begin treatment, the faster and better results you’ll get. 

Resources:

(01) https://www.ncbi.nlm.nih.gov/books/NBK278957/
(02) https://pubmed.ncbi.nlm.nih.gov/3900155/
(03) https://pubmed.ncbi.nlm.nih.gov/9777765/
(04) https://pubmed.ncbi.nlm.nih.gov/23193746/
(05) https://pubmed.ncbi.nlm.nih.gov/30974011/
(06) https://pubmed.ncbi.nlm.nih.gov/3063367/
(07) https://pubmed.ncbi.nlm.nih.gov/32166351/
(08) https://pubmed.ncbi.nlm.nih.gov/19514838/

Hair Loss Reversal 101: What You Need to Know

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

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

There are Different Types of Hair Loss

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

The Term Alopecia Encompasses More Conditions Than Most People Realize

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

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

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

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

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

What Type of Alopecia Do You Have?

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

Examples of Non-scarring Alopecia

Telogen Effluvium

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

Androgenic Alopecia

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

Alopecia Areata

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

Traction Alopecia  

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

Examples of Scarring Alopecia

Lichen Planopilaris

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

Central Centrifugal Cicatrical Alopecia (CCCA)

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

Effective Hair Loss Treatment Complements Your Diagnosis

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

Minoxidil (Rogaine)

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

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

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

Finasteride (Propecia, Proscar)

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

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

Finasteride is only available by prescription and is not recommended for women of childbearing age.  Check with a board-certified dermatologist to see if you are a good candidate for the topical or oral treatment.

Corticosteroids

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

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

Platelet-rich Plasma (PRP) Injections

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

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

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

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

Biotin

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

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

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

Hair Transplants

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

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

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

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

It’s Important to Set Realistic Expectations When Treating Alopecia

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

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

Resources:

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

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

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

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

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

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

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

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

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

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

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

(12) https://www.fda.gov/medical-devices/safety-communications/update-fda-warns-biotin-may-interfere-lab-tests-fda-safety-communication