Tag Archive for: Telogen Effluvium

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/

 

Is Your Hair Healthy?

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

How Do You Know When Your Hair is Healthy?

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

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

Healthy Hair From the Inside Out

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

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

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

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

What Damages Healthy Hair?

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

Does Healthy Hair Fall Out?

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

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

Other Reasons for Hair Loss

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

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

How to Keep Your Hair Healthy

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

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

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

 

Resources:

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

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

 

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

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

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

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

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

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

Three types of alopecia areata exist:

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

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

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

2) Alopecia Areata Has Some Common Symptoms

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

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

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

3) Other Types of Alopecia Can Cause Hair Loss Too

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

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

 

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

4) New Medications Are Showing Promise in Treating Alopecia Areata

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

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

Other treatments often used to treat alopecia areata include:

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

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

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

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

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

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

Resources:

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

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

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

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

 

Is There a Genetic Test that Can Predict Hair Loss?

Nowadays, there’s a genetic test for just about everything.  Even to determine our dog’s lineage.   Just one quick saliva sample or blood test and, within days, you can find out if you’re destined for cancer, diabetes, or heart disease.  There’s even a DNA test to determine whether you’re likely to experience anxiety.  

Suppose a genetic test can give you accurate information to guide your health care plan and prevent future disease.  Can it also accurately predict whether you’re predisposed to losing your hair?  If a genetic test shows that you are likely to inherit your Great Uncle Bernie or Aunt Bonnie’s hairline, is there a way to ensure that you don’t follow in their footsteps?  Are genetic hair tests reliable?  Do dermatologists use DNA tests to help make diagnoses? Before you click “Buy Now” to order a genetic test kit, keep reading.  We’re here to answer your questions about genetic testing for male and female pattern baldness.

Can Alopecia Really be Inherited?

When people hear the word “alopecia,” they often think of hair loss caused by a medical condition.  Types of alopecia such as alopecia areata and lichen planopilaris are caused by autoimmune conditions.  Androgenetic alopecia, however, is a type of alopecia that is inherited.  It’s the most common type of alopecia.  As many as 80 percent of all men will experience male pattern baldness in their lifetime. (01)  In addition, many women experience female pattern baldness, usually around menopause.  

What’s the Link Between Genetics and Pattern Baldness?

A study conducted on twins confirms what we’ve long suspected.  Male and female pattern baldness have a genetic component. (02)  About 79 percent of men who were balding in the study could attribute their hair loss to their genes.  But, there’s a catch.  Researchers are still working to fully understand which genes are affected.  We’re still learning.  Here’s what we do know.  There are 63 genes that could potentially cause baldness.  Six of those are associated with the X chromosome, where the Androgen Receptors (AR) are found.  It’s also possible that not one isolated gene is the culprit.  Several genes working together may be to blame.

Can You Take a DNA Test to Determine Whether You Will Go Bald?

Ads make genetic testing very tempting, especially if your Mom or Dad starts losing their hair in their 20s.  It would be nice to know whether you will lose your hair too.  But, unfortunately, we’re not quite there yet.  As mentioned previously, there are still too many unanswered questions about which genes are involved and how the genetic process affects your locks. Also, false positives are not unusual with genetic testing.  You don’t want a test to tell you that you’ll experience androgenetic alopecia if that isn’t really the case. (03)

How do you Know if the Type of Alopecia You Have is Genetic?

When men and women experience androgenetic alopecia, they see specific hair loss patterns.  The first sign for men is usually a receding hairline.  The hair loss then progresses to the top, creating a horseshoe pattern above your ears that circles around to the back of your head.  Female pattern hair loss typically presents differently.  Women usually notice thinning on the top and crown.  Often, women will notice a widening of the center part.  Many other conditions cause hair loss besides androgenetic alopecia.  If you think your hair loss is genetic, be sure to have your dermatologist confirm your findings.  Early diagnosis is key to preventing further hair loss and to stimulating new growth.  You also want to make sure you’re addressing the right condition with the right treatment.  

Do Dermatologists Use Genetic Testing to Diagnose Male and Female Pattern Baldness?

The truth is that dermatologists don’t need high-tech tests to determine whether or not patients have androgenetic alopecia.  Most of the time, they can tell from your hair’s appearance and your hair loss pattern.  If there is any doubt, he or she may use a densitometer to magnify your hair follicles to see if miniaturization is occurring.  Miniaturization is when the hair follicles shrink, causing existing hair to fall out and preventing new growth.  Your dermatologist may order a biopsy and blood test to rule out other causes. Patients often ask about the benefits of running a hair analysis based on what they hear about on social media.   Hair analysis is not used to diagnose male or female pattern baldness.  Instead, it’s used to determine whether there’s lead, arsenic, or another substance causing your hair loss.  

What Can You Do to Treat Hair Loss Caused by Genetics?

Treatment for male or female pattern baldness is designed to meet two goals.  The first is to stop the progression of your hair loss.  The second is to promote new hair growth.   The best way to accomplish those two goals is by using a combination of medications simultaneously.  Here are medications often included in treatment plans for androgenetic alopecia:

  • Minoxidil topical foam – A vasodilator that enlarges the hair follicles
  • Finasteride, Dutasteride, or Spironolactone  – Prevents testosterone from converting to DHT that attacks the hair follicles and causes hair loss
  • Topical or oral cortisone – Treats any redness or irritation (not needed for evey patient)

Some men are concerned about experiencing sexual side effects with oral Finasteride.  If this is the case, topcial Finasteride has been proven to be just as effective without the side effects. (04)  Even better, topical solutions which mix Finasteride with Minoxidil, Cortisone and Retinol offer an even more effective all-in-one solution.  The retinol improves absorption of the other three medications.  

Are There Other Causes of Hair Loss Besides Genetics?

Male and female pattern hair loss are the only types of genetically induced alopecia.  However, other types of alopecia exist and treatment plans are designed to treat the type of alopecia you are experiencing.  Examples of other types of alopecia include:

  • Temporary Alopecia (Telogen Effluvium) – Occurs due to sudden illness, stress, or shock and usually reverses itself without treatment
  • Autoimmune Alopecia (Alopecia Areata and Lichen Planopilaris) – People experience flares and periods of remission
  • Trauma-induced Alopecia (Traction Alopecia and Trichotillomania) – Alopecia results from hairstyles that pull on the hair follicles or when people pull out their hair as a stress response)

Can You Prevent Hereditary Hair Loss?

Let’s play pretend for a minute.  Let’s say that a genetic test does exist that will determine whether or not you will lose your hair.  The tests come back showing that you are genetically predisposed to androgenetic alopecia.   Is there a way to prevent hair loss before it begins?  Sure, eating right, exercising, and managing stress never hurt.  But, even with that, you can’t necessarily fight Mother Nature.  That would be nice, though.  If male or female pattern baldness does rear its head, then it’s time to take action.  

Can You Reverse Hereditary Hair Loss

If you’re experiencing male or female pattern baldness and want to learn more about products available, contact us.  Although there isn’t a way to prevent androgenetic alopecia from occuring in the first place, there are things you can do to reverse the condition.   Minoxidil, Finasteride and other medications have been found to be safe and effective. Our board-certified dermatologists and hair specialists are available to answer your questions and help you develop the ideal treatment plan for your needs and lifestyle. 

 

Resources:

(01) https://www.ncbi.nlm.nih.gov/books/NBK538178/

(02) https://academic.oup.com/biomedgerontology/article/60/8/1077/545174

(03) https://www.nature.com/articles/gim201838

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

 

What Causes Hair Loss at a Young Age?

Hair loss is never easy to accept, but most people know that it comes with getting older. Losing hair at a young age, however, is a different story. For teenagers and twenty-somethings, unexpected hair loss can be a distressing experience. Fortunately, there are ways to reduce the chances of further hair loss. Let’s take a deep dive into what causes hair loss at a young age and options for addressing the issue. 

Typical Daily Hair Loss

The body loses hair each day as a natural part of each hair’s growth cycle. The American Academy of Dermatologists estimates that a person loses about 50 to 100 strands daily. With approximately 100,000 hair follicles on an average human head, 100 strands a day doesn’t create a noticeable change. Hair loss that’s caused by hair’s natural growth cycle is called “shedding.” (01)

Furthermore, most people will experience some level of hair loss with age. Roughly 40% of women lose more hair each day than men, probably due to heated hair styling tools, regular hair coloring, and hormonal changes. (02) For both men and women, as people age, the rate of normal hair growth slows. 

Hair Loss as a Teen or Young Adult

Losing hair at a young age is not typical. The teen years and young adulthood are a crucial time for building identity and self-confidence; hair loss at this stage can lead to low self-confidence and increased self-consciousness. (03) The following are a few potential causes of hair loss at a young age. 

Alopecia areata

Alopecia areata is an autoimmune condition that results in balding patches throughout the head. In an autoimmune disorder, the body’s immune system mistakenly attacks healthy cells. Unfortunately, in the case of alopecia areata, it’s cells within hair follicles that are damaged by the immune system. As a result, the hair follicles weaken, which leads to hair loss.

About 2% of all people will develop alopecia areata sometime in life. Along with balding patches, the condition can also lead to hair loss on the body, eyebrows, or eyelashes. A majority of people who develop alopecia areata do so before the age of 30. In some cases, however, the condition may begin as early as adolescence or childhood. (04)

Malnutrition

A lack of appropriate nutrients can lead to malnutrition. It’s essential to understand the difference between calorie intake and nutrition. An individual may consume sufficient calories but remain malnourished. A diet consisting of high-calorie foods without an adequate amount of vital nutrients can lead to a state of malnutrition. Malnutrition may also result from not eating enough food or being unable to process foods appropriately.

To maintain a healthy head of hair, hair follicles need the proper nutrients from a well-rounded diet. The following are some of the most vital nutrients necessary for hair growth: (05)

  • Vitamin A
  • Vitamin C
  • Vitamin D
  • Vitamin E
  • Niacin
  • Zinc
  • Biotin
  • Iron
  • Selenium 

A few potential causes of malnutrition in adolescents and young adults are inadequate access to food, eating disorders, restrictive dieting, or health problems. Additionally, a teen diet full of junk food and low on nutrients can lead to hair loss!

A Family History of Hair Loss

People who have close relatives with hair loss are at a higher risk for androgenetic alopecia. Androgenetic alopecia, a genetic condition leading to hair loss, usually begins in adulthood. Although in some cases, this condition may start as early as adolescence. Both men and women can experience androgenetic alopecia, and other names for the condition are male-pattern baldness or female-pattern baldness. 

In males, androgenetic alopecia is usually a gradual balding at the crown or hairline. For women, the condition begins as a slow thinning of hair throughout the head. Both teenage boys and girls can develop androgenetic alopecia, particularly if there’s a family history of the condition. (06)

Polycystic Ovary Syndrome

Polycystic ovary syndrome, also known as PCOS, causes an excess of androgens (male sex hormones) in women and girls of reproductive age. This hormone imbalance can result in female hair loss, even in teenage girls. 

Women typically produce low levels of male hormones, but PCOS causes an overproduction of them.  Due to these extra androgen levels, a woman with PCOS might develop masculine features and hair loss, especially throughout the head. Thinning hair due to hormonal imbalance such as PCOS is called androgenic alopecia or female pattern hair loss. (07)

Thyroid Conditions

The thyroid is a small — but powerful — gland. This gland at the neck produces hormones that control metabolism, heart rate, and mood. The thyroid also manages how the body uses oxygen and controls growth, which is why a low-functioning thyroid (hypothyroidism) can lead to hair loss at any age. 

Thyroid hormones keep hair growing consistently. Without enough thyroid hormones in the system, the hair’s shedding phase lengthens. More hair is shed, and less hair grows, leading to hair loss. Symptoms of an under-functioning thyroid include: (08)

  • Depression 
  • Tiredness
  • Unexplained weight gain 
  • Constipation
  • Dry skin
  • Puffy or swollen face 
  • Joint pain
  • Irregular menstrual cycle

People of all ages can experience thyroid issues. In children and adolescents, untreated thyroid disorders can lead to developmental delays. Thyroid conditions require medical treatment and should not be overlooked. 

Lupus

Like alopecia areata, lupus is an autoimmune condition. Though lupus is typically known for its hallmark symptom of a “butterfly-shaped” rash on the face, another symptom people with lupus experience is hair loss. Unlike alopecia areata, however, two types of hair loss are associated with lupus: scarring and non-scarring. 

Non-scarring hair loss stems from the inflammation caused by lupus. Widespread inflammation can affect the scalp and hair follicles, resulting in non-scarring hair loss. With lupus, hair loss may occur all over the body, including the eyebrows and external limbs. 

Lupus also causes discoid sores that may result in permanent scars. These sores, lesions, and scars can damage hair follicles, resulting in “scarring” hair loss. The hair loss doesn’t cause scarring. Instead, the scarring from lupus can prevent hair from growing, possibly making hair loss in most areas permanent. (08)

Telogen Effluvium

Does stress cause hair loss? Sometimes. Telogen effluvium is a temporary hair loss caused by physical or psychological stress. Events like severe illness, psychological trauma, childbirth, or significant weight loss can result in telogen effluvium.

Telogen effluvium is a temporary form of hair loss that causes excessive hair shedding. Stress, illness, childbirth, or weight loss are some of the many potential causes. Fortunately, this condition typically resolves itself after the stress lifts. 

Traction Alopecia

A tight bun or high ponytail may look chic, but it can pull hair and cause hair loss. Tight hats or headgear may also cause loss of hair over time. This type of hair loss is called traction alopecia and occurs in both men and women. 

In traction alopecia, repeated pulling may cause small pimple-like bumps on the scalp. As traction alopecia worsens, hair begins to fall out. Other symptoms of traction alopecia are: (09)

  • Scalp Redness
  • Folliculitis
  • Scalp tenderness 
  • Itching
  • Scaling 

Identifying and addressing traction alopecia in its early stages is essential because if follicles become too damaged, they will no longer produce and hold new hair.

Hair Styling and Treatments 

Experimenting with hair color is part of adolescence for many teens, and a bottle or two of Manic Panic purple dye will (most likely) not result in hair loss. Bleaching hair, however, can dry hair out and make strands brittle, resulting in breakage. Furthermore, heated styling tools and chemical straighteners also damage hair and lead to broken strands. 

The good news is that these processes don’t usually affect the scalp or hair follicles. However, this can make the hair appear thinner and unhealthy. To prevent breakage, try to keep the use of heated tools to a minimum and use them at a low setting. 

Hair Loss in Teen and Young Adults: Should You Worry?

Thinning hair and balding can occur at any age for various reasons. Obtaining an assessment and treatment as soon as possible, especially for adolescents and young adults, can help prevent issues with self-esteem and improve the chances of successful hair growth. 

Happy Head includes an assessment from a licensed dermatologist with every subscription, ensuring that each person gets to the root of their problem! Every treatment is individualized, and ongoing support is there to help you every step of the way. Take advantage of Happy Head’s six-month money-back guarantee and see what Happy Head can do for you. 

Resources:

(01) https://www.aad.org/public/skin-hair-nails/hair-care/hair-loss-vs-hair-shedding

(02) https://www.ncbi.nlm.nih.gov/pubmed/29193553

(03) https://pubmed.ncbi.nlm.nih.gov/34984078/

(04) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC55

(05) https://www.hairscientists.org/hair-and-scalp-con

(06) https://pubmed.ncbi.nlm.nih.gov/22106721/

(07) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8291365/

(08) https://www.webmd.com/connect-to-care/hair-loss/how-your-thyroid-may-be-causing-hair-loss

(09) https://www.medicalnewstoday.com/articles/320648

The Real Story Behind Vitamins that Prevent Hair Loss

I hate to start with a spoiler, but I’m going to start with a spoiler.  Neither vitamins nor supplements are FDA-approved or regulated for any type of hair loss.  Or, for any other health condition for that matter.  This means that information required to establish safety and effectiveness has not been submitted to or approved by the FDA.  Yet, do an Amazon search using the terms “vitamins for hair loss,” and pages and pages of products appear with assurances that the vitamins will help you regrow your hair.  Biotin, keratin, saw palmetto, and proprietary collagen blends are just a few that pop up on the first page, with prices varying from $11 to over $176.  Trying to figure out which ones are effective and worth the investment can make your head spin.   

If your hair is thinning or balding, it’s smart to question whether vitamins will help or if manufacturer promises are too good to be true.  So which ones do dermatologists and hair specialists recommend?  We’re here to answer your questions and set the story straight.  

Get Diagnosed Before You Buy Vitamins to Treat Your Hair Loss

Before you even think about trying any vitamins, you need to start with a diagnosis.  After all, you need to know what condition you’re treating.  Here are the three most common types of alopecia that cause either temporary or permanent hair loss:

  • Telogen Effluvium

Telogen effluvium is a type of temporary hair loss that can occur up to several months after a traumatic or stressful incident.  The condition can be triggered by various events, including high fevers, surgery, certain medications, nutritional deficiencies, and autoimmune diseases.  When physiologic stress occurs, hairs that would normally be in a growing phase are abruptly pushed into a resting phase, resulting in shedding.  The shedding can occur in either small or large amounts.  While hair loss from telogen effluvium can be upsetting in the short term, the long-term prognosis for regrowth is good.  No medication is typically needed.  Hair usually grows back within six months to a year.  

  • Androgenetic Alopecia

Androgenetic alopecia is also known as male or female pattern baldness.  The hair loss condition occurs when too much testosterone converts to an androgen called dihydrotestosterone (DHT).  The condition is genetic and can come from either the maternal or paternal sides of your family.  The hair loss pattern among men with androgenetic alopecia differs from that of women.  Men tend to lose their hair on the front and top of their heads.  Women usually notice their hair loss first along their widening center parts.  Oral and topical medications have been proven to help prevent further hair loss and facilitate growth.  

  • Alopecia Areata

Alopecia areata is an autoimmune hair loss condition that can affect women, men, and children.  Hair loss is usually noticed first in small round or oval patches.  In some cases, hair spontaneously regrows, and in others, the hair loss becomes permanent.  Treatment usually focuses on treating any underlying conditions and using topical and oral medications.

Determining whether you have one of these forms of alopecia is a multi-step process.  Your dermatologist will likely order blood work as part of the diagnostic process.  The lab results will indicate whether vitamin deficiencies could be contributing to your alopecia.  If so, you may benefit from supplementation.  

Vitamins are Helpful When People with Alopecia Have Deficiencies

Much conflicting information exists about the role that vitamins and supplements play when it comes to hair loss.  More research is clearly needed.  The general rule of thumb when it comes to vitamins is to supplement if there’s a deficiency.  Particular deficiencies can be associated with the three types of alopecia we discussed.  Here are the three most common:

Vitamin D

Research has demonstrated that people with telogen effluvium, androgenetic alopecia, and alopecia areata are likely to have vitamin D deficiencies. (01)  The greater the deficiency, the greater the hair loss.  Vitamin D is absorbed into the skin by keratinocyte cells.  The cells process keratin which is found in your hair, nails, and skin.  When your body has a vitamin D deficiency, the keratinocytes in your hair follicles have difficulty regulating the growth and resting phases of the hair cycle.  

Iron

In addition to checking for Vitamin D3 deficiencies, dermatologoists typically check their patients’ iron levels. Iron deficiency inhibits hemoglobin production which produces the oxygen responsible for hair cell growth and repair.  Low iron is a common cause of alopecia and can easily be remedied with a supplement.  

Biotin

People don’t typically have Biotin, Vitamin B7, deficiencies in industrialized countries.  A regular diet typically provides enough nutrients to ensure adequate levels.  However, some research studies have demonstrated that biotin deficiencies often exist in people with hair loss. (02)(03)  Experts have conflicting views on whether biotin supplements are necessary, even when there’s a deficiency.  It’s best to consult with your dermatologist on this one.  

Should You Take Vitamins if You Don’t Have a Deficiency?

Even if you don’t have a deficiency, it’s tempting to take vitamins to see if they will help regrow or thicken your hair.  More isn’t always better though, especially in this case.  Taking too many supplements or the wrong type of supplements can create issues.  For example, extra vitamin A or vitamin E can cause hair loss, which is what you are trying to prevent in the first place.  

Prescription Medications Are Often Used With Vitamins to Get Better Results

If your dermatologist doesn’t think that you are a good candidate for vitamin supplementation, prescription medications may be a good alternative.  This is especially true if you have been diagnosed with male or female pattern baldness.  Medications commonly prescribed include:

Minoxidil (FDA Approved)

A vasodilator designed to enlarge the hair follicles so you can start to regrow your hair.  

Finasteride, Proscar, Propecia (FDA Approved)

A medication that blocks the conversion of testosterone into DHT that attacks your hair follicles.

Dutasteride, Avodart (Not FDA Approved)

A DHT blocker prescribed as a second-line medication if Finasteride does not give the desired results.

Spironolactone (Not FDA Approved)

A DHT blocker prescribed only to women as a second-line medication if Finasteride does not give the desired results.

Minoxidil and Finasteride are both available in oral and topical formulas.  Topicals are often preferred, especially among men, because they do not cause sexual side effects such as lower libido.  Topical medications have been proven to be just as effective as oral medications.

The most effective hair loss plans often combine vitamins and other over-the-counter treatments with prescription medications. Vitamin D, Minoxidil, and Finasteride would be a logical combination if a person with androgenetic alopecia has a vitamin D deficiency.  Prescriptions that effectively combine multiple topical medications into one are available and are convenient and easy to use.  

Some Supplements Have Shown Moderate Improvement in Hair Loss

Although they are supplements rather than vitamins, there has been a lot in the news lately about pumpkin seed oil, saw palmetto, and rosemary oil.  While not quite as effective as Finasteride, these supplements have demonstrated a significant increase in hair growth. (04)  These supplements may be a good adjunct therapy when combined with prescription hair loss medication.

Curcumin, the active ingredient derived from turmeric, is known as a natural anti-inflammatory.  Interestingly, curcumin did not improve hair growth on its own, but it did give positive results when combined with Minoxidil.  The hypothesis is that the curcumin helped the Minoxidil better penetrate the scalp.  However, more research still needs to be conducted.  

Garlic gel, derived from onions, scallions, shallots, leeks, and chives, doesn’t live up to the hype.  Users did not see a significant difference in hair growth.  

As with any product you try as a hair loss solution, make sure to consult with your dermatologist first.  Even products that seem innocuous can have side effects or contradict other medications.  Your dermatologist is the best person to evaluate your treatment plan and determine the best mix of prescription and over-the-counter options.  

What To Do If Vitamins Aren’t the Answer to Your Hair Loss

Vitamins can be helpful if your bloodwork indicates that you have certain deficiencies.  If not, proceed with caution.  Even the most effective supplements aren’t typically as strong as prescription medications to slow hair loss and stimulate growth.  If you need an alternative solution for your thinning or balding hair, Finasteride, Minoxidil, and other medications are effective and are available by prescription.  For more information about your options, contact us.  Our board-certified dermatologists and hair specialists are available to answer your questions and make recommendations based on the type of alopecia you have.  We can even customize a formula to meet your specific needs.

Resources:

(01) https://pubmed.ncbi.nlm.nih.gov/34553483/

(02) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4989391/#:~:text=Biotin%20deficiency%20was%20found%20in,risk%20factors%20for%20biotin%20deficiency.

(03) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6388561/

(04) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6388561/

(05) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6388561/

 

Why Self-diagnosing Your Hair Loss is a Bad Idea

“When did you graduate from medical school?” my husband asks me on a regular basis.  I didn’t, but I am a self-proclaimed expert in the medical field anyway.  Why wouldn’t my Google education make me highly qualified to diagnose the whole family’s symptoms and illnesses?  Evidently, I’m not the only one self-diagnosing.  A survey conducted in March 2020  indicated that nearly one-third of all Americans do their own medical research. (01)

Being your own doctor can work against you though.  In fact, when I first started losing my hair, I didn’t even think to have it checked.  Based on what I read, postpartum hair loss is normal, and I had two babies in two years.  I would never in a million years have guessed that I had alopecia.  However, knowing what I know now, I do not recommend waiting to consult with a medical professional if you’re noticing an unusual amount of hair loss.  Treating hair loss early helps you prevent further shedding and even regrow your hair.  Here are seven more reasons why you should schedule an appointment with a board-certified dermatologist and hair specialist if you’re concerned about the amount of hair you’re losing. 

Reason #1:  Dermatologists are familiar with hair loss patterns associated with specific hair loss conditions.  

Your dermatologist has spent countless hours studying and memorizing the different types of hair loss.  Many times, just looking at patients’ hair loss patterns gives your dermatologist clues as to where to start with a work-up to get a diagnosis.  Common hair loss conditions and associated patterns are:

  • Androgenic alopecia (men) – Receding hairline and gradual thinning on top
  • Androgenic alopecia (women) – Widening of the part 
  • Alopecia areata – Patchy or circular bald spots on the head, eyebrows, or beard
  • Telogen effluvium – Overall thinning due to sudden hair loss
  • Fungal infection – Scaly patches that spread over the scalp
  • Alopecia totalis – Full-body hair loss

If your dermatologist suspects that you have androgenic alopecia, known as male or female pattern baldness, he or she may use the Norwood scale, a scale of 1 to 7, to track the progression of your hair loss.  The scale helps your dermatologist recommend the best possible treatment options to prevent further hair loss and stimulate growth based on the amount of recession or thinning you have.  

Reason #2:  Your doctor can determine the severity of your hair loss

Losing a certain amount of hair is normal and is part of the hair growth cycle.  How do you know if the amount you’re seeing in the sink or shower is too much?  You don’t.  However, once your dermatologist has an idea of your hair loss pattern, he or she has a number of tools and tests he or she can use to determine the extent of your hair loss.  The most common are:

Pull Test

A pull test is pretty much as the name indicates.  During the test, your doctor will gently tug on small sections of hair from parts of your scalp.  Usually, the litmus test is six or more strands.  If you lose that much, your hair loss is active.  

Scalp Biopsy

A scalp biopsy, also known as a punch biopsy, is often used to determine what type of alopecia you have. It allows pathologists to see inflammation and can distinguish whether the alopecia is scarring or non-scarring.  To take the biopsy, your dermatologist numbs the area and uses a pencil-sized device to remove a small amount of tissue that is sent to a lab for analysis. The incision is closed with a couple of small stitches.   

Trichometric Analysis

If your dermatologist wants to analyze your scalp and hair, he or she may do a trichometric analysis using a small handheld device with a high-definition camera.  The device magnifies images by up to 100 times so your hair, hair follicles, and scalp can be seen in great detail.  The tool shows how much hair is covering your scalp, and the diameter of each hair strand.  Dermatologists often use this camera to monitor progress after you begin treatment.  

Fungal Culture

If your dermatologist suspects that your hair loss is due to a fungus in your hair or scalp, he or she may run this test.  Fungal cultures determine if a condition called tinea capitis, scalp ringworm, is causing your hair loss.  During the test, a small sample of skin or hair is sent to a lab for incubation.   

Reason #3:  Your vitamin levels may need to be checked

Often one of the first questions dermatologists often ask new patients is whether they have recently had a routine blood test.  The reason why is because simple vitamin deficiencies can cause hair loss.  Fortunately, if this is the case, supplements will usually solve the problem quickly and easily.  The two most common vitamin deficiencies that cause hair loss are vitamin D and iron.  

Studies have shown that vitamin D has anti-inflammatory properties and affects the hair cycle. (02)  When your body has a vitamin D deficiency, regulation of the hair follicles is challenging.  Growth and shedding cycles are disrupted causing your hair to suddenly fall out.

Iron deficiency stunts the production of hemoglobin which transports oxygen to the cells in your body, including the cells that make your hair grow.  The hair follicles lack the nutrients they need to thrive.  With an iron deficiency, hair sheds and thins, giving the appearance similar to androgenic alopecia.

 

Reason #4:  Your hormones may be out of whack

 

Your dermatologist may also run blood tests to check for hormonal imbalances.  Hormone imbalances can cause hair to get dry, brittle, thin, or fall out altogether.  The only way to know if this is the case is to have your levels checked.  

Contrary to popular belief, high or low testosterone is not an indicator of hair loss.  Research has continually demonstrated that there is not a link between serum androgen levels and androgenic alopecia. (03)  Instead, male pattern baldness could be linked to an androgen sensitivity or high androgen density. 

Factors that can affect your hormone levels include:   

Menopause

Estrogen levels fall before, during, and after menopause while testosterone levels inversely increase.  During the process, the testosterone converts to dihydrotestosterone (DHT) which attacks your hair follicles, and makes your hair fall out.  

Stress

Stress is a bigger contributor to hair loss than most people realize.  When you are stressed out, your body creates cortisol which disrupts the function and regulation of your hair follicles as well as your hair growth cycle.  

Pregnancy

During pregnancy, estrogen levels rise, causing your hair to get fuller and thicker. After the baby is born, however, those levels drop rapidly, making the excess hair shed.  It can take a while for your estrogen levels and hair loss to balance out.  

Thyroid

Both hypothyroidism and hyperthyroidism have been linked to alopecia.  In a 2013 study, patients aged 21-40 with thyroid disfunction were likely to have diffuse alopecia and alopecia areata.  Patients older than 40 were more likely to have alopecia areata and androgenic alopecia. (04)  The findings confirm the importance of checking thyroid levels when there is a hair loss issue.  

Reason #5:  You could have a scalp infection 

A number of scalp infections can cause hair loss.  These infections can easily be confused with various types of alopecia, but once treated, hair typically regrows.  Examples include:

Ringworm

Ringworm is a fungal infection that forms scaly, raised, red patches.  Itching is a common complaint among patients with scalp ringworm and is typically treated with anti-fungal medications.  

Scalp Psoriasis

Psoriasis is an autoimmune condition that causes thick red patches, and sometimes scaling.  There isn’t a cure, but proper management can help prevent hair loss.

Seborrheic Dermatitis

Seborrheic dermatitis causes dandruff in adults, characterized by dry, flaky skin, and typically does not cause hair loss.  Shampoos and topical medications are often recommended. 

Lichen Planus

Lichen planus causes inflammation and can leave tiny red bumps on your scalp.  The cause is not known for certain, although autoimmune dysfunction is one of the possible causes.  Topical creams are often used to treat symptoms, but in many cases, lichen planus will disappear without treatment.  

Your dermatologist has been trained to address and treat all of these infections.

Reason #6:  Sometimes you need an outside perspective

When your dermatologist takes your medical history, he or she may be able to identify bad habits that are affecting your hair and contributing to your hair loss.  Some of these habits may include:

  • Smoking
  • Poor diet filled with processed foods
  • Stress
  • Tight buns, ponytails, braids, or other hairstyles that can pull on your hair and cause traction alopecia
  • Compulsively pulling on your hair (trichotillomania)

Reason #7:  The most effective medications are only available by prescription

Hair loss products are similar to skincare products in that very few over-the-counter (OTC) products are truly effective.  If you have a graveyard of barely or partially used tubes and containers under your bathroom sink, you get the picture.  The reality is that besides Minoxidil which is sold OTC as Rogaine in a 5 percent formula, you’re wasting your money on OTC hair loss products.  You’ll need a doctor to write a prescription.  Some of the most effective and widely used prescription hair loss medications that your doctor may prescribe are:

Minoxidil

Designed to enlarge the hair follicles and prevent miniaturization.  Used to treat a broad spectrum of hair loss conditions.  

  • Sold OTC in foam and liquid formulas
  • Available by prescription in higher dose pills and topical formulas

Finasteride

Prevents testosterone from converting to DHT, which attacks the hair follicles and causes hair loss.  Often used to treat male and female pattern hair loss.  

  • Available only by prescription
  • Reported sexual side effects such as lower libido by some users
  • Used by both men and women, but not recommended for women of childbearing age
  • Topical formula is proven to be equally as effective as the pill without the undesirable side effects since it is not systemic.  

Retinol

A derivative of Vitamin A that improves the absorption of Minoxidil, Finasteride, and other medications that stimulate hair growth.

  • Typically not used as a stand-alone hair loss solution
  • Low OTC doses not as potent as prescription doses

Spironolactone

A DHT blocker used to treat female pattern hair loss.

  • Available only by prescription
  • Safe for women who have not been through menopause

When to see a doctor

In a 2015 study conducted by the National Library of Medicine, nearly one-third of people surveyed reported avoiding the doctor, even those with major health problems. (05)  The result was later detection, reduced survival rates, and more suffering than necessary.  You won’t die if your hair falls out, but why lose your hair if you don’t have to?  If you are experiencing hair loss, be sure to seek medical treatment from a licensed dermatologist.   Early medical intervention not only prevents further hair loss but in many cases, can help you regrow your hair.  

If you have hair loss concerns and if accessibility and/or affordability is an issue, visit us at happyhead.com.  You will have the opportunity to consult with one of our board-certified dermatologists and hair specialists.  No insurance or co-pay is required.  You only pay for the product if deemed necessary and appropriate.

Resources:

(01) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7084283/#:~:text=Surveys%20suggest%20that%20a%20large,self%2Ddiagnose%20using%20online%20information.

(02) https://pubmed.ncbi.nlm.nih.gov/34553483/

(03) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7432488/

(04) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3746235/

(05) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4351276/#:~:text=People%20often%20avoid%20seeking%20medical,survey%20reported%20avoiding%20the%20doctor.&text=Even%20individuals%20with%20major%20health,12%20avoid%20seeking%20medical%20care.

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