Featured Dermatologists
Michael J. Crowe, M.D.
Robert C. Wright, M.D.
Jeffrey Dover, M.D.
Nelson Lee Novick, M.D.Female Hair Loss
The medical term for hair loss is alopecia. Hair loss is commonly considered a men's health issue, but women make up 40 percent of all hair loss sufferers. Instead of the receding hairline or male pattern baldness, in women, the hair becomes thinner over the whole scalp, and the frontal hairline is usually spared.
Although the vast majority of hair loss isn't life-threatening, the emotional effects of a changing appearance are enough to make most women seek treatment.
One option is a topical medication, minoxidil (Rogaine), which is available over the counter in formulations for men and women. Rogaine can stimulate hair growth and slow down hair loss, but it cannot “cure” baldness. It may take up to 6 months to see and results.
Hair transplants are also an option.
Male Hair Loss
Most men—and some women—experience some degree of hair loss as they grow older in the normal cycle of hair growth. It is natural to lose up to 100 hairs per day. If you are losing more than that, or if your hairline becomes more prominent, it could be a sign of excessive hair loss.
The medical term for hair loss is alopecia. The most common type of hair loss in men is male pattern baldness, or androgenic alopecia. This is an inherited tendency to stop producing new hairs. Many men are dismayed enough by a balding appearance to seek treatment.
The following treatments may slow hair loss or promote hair growth:
- • Rogaine (minoxidil). This topical, over-the-counter medication has been shown to regrow hair and prevent further hair loss in some people with alopecia areata and male pattern baldness. It is rubbed into the scalp twice per day. Rogaine only works while you are taking it, so any new hair will stop growing if you discontinue use of the medication. Results may not be seen until after 6 months of use.
- • Propecia (finasteride). This prescription medication is taken by mouth once a day and is designed to treat male pattern baldness. It works by decreasing the growth of DHT, a hormone that shrinks hair follicles and inhibits hair growth. As with Rogaine, the benefits of Propecia stop if you stop using it. Results may not be seen until after 6 months of use.
The effectiveness of these medication depends on the cause and extent of hair loss and each person's individual response. Usually, the more recent the hair loss, the more effective the treatment will be. Extensive hair loss probably won't respond well to medications.
One other option for treating hair loss is hair transplantation, where tiny plugs of hair-growing skin are removed from one part of the scalp and re-implanted on the bald area.
Hair Transplantation
For patients who want predictable, permanent hair restoration, surgical micro- and mini-grafting is a notable advance that gives transplanted hair a completely natural look. This technique uses strips of hair from the back of the scalp for trasplantation to balding areas. Genetically programmed to withstand hair loss, hair taken from the back of the scalp will retain this characteristic and not fall out after it is transplanted to other areas. Hundred of grafts can be transplanted in one session. The pluggy "doll's hair" is a thing of the past with modern hair transplant surgery. Most patients attain the look they desire, complete with new hairline, in about either to twelve months.
Because the grafts are made from your own hair, they are perfectly matched to your hair color and texture, giving you the most natural appearance possible. This new technique has revolutionized hair transplant surgery, allowing us to create beautiful natural scalp hair contours that will be your own, permanently.
Learn more about Hair Transplantation from Jeffrey Dover, M.D. of Skin Care Physicians of Chestnut Hill.
Stress-Induced Hair Loss
Stress-induced hair loss is so named because a variety of physical and emotional stresses have been known to precipitate it. These include a whole laundry list of medical and psychiatric conditions. Among the more common triggers are high fever, severe infections (even severe influenza) metabolic diseases (eg. thyroid disease, crash dieting, anemia), autoimmune diseases (like. systemic lupus erythematosis, ulcerative colitis, rheumatoid arthritis), delivery-related, major surgery, acute blood loss, trauma, and emotional conditions, such as relationship breakups, loss of work, acute anxiety disorders, serious depression, and schizophrenia. Whatever the cause, stress-induced alopecia is characterized by sudden hair loss that occurs diffusely throughout the whole scalp, including an often prominent recession in the temporal areas.
Although the exact physiologic mechanisms involved in telogen effluvium are not known, some researchers believe the condition may in some way be related to shifting concentrations of androgens and estrogens (male and female hormones). Others maintain that inflammation of the hair follicles plays a role. Whatever the exact mechanism, we do know that the normal hair cycle is altered and that large numbers of actively growing hairs (known as anagen hairs) are shifted suddenly into the resting phase known as telogen. In an otherwise healthy individual, about 80 percent of hairs are actively growing and the remainder are in the resting stage poised to fall out gradually. However in stress-induced hair loss as many as 40 percent of hairs may be shifted suddenly into telogen, an event very similar to what occurs prior to the molting phase seen in lower animals.
Although most cases of telogen effluvium resolve spontaneously without therapy, some physicians have recommended the use of a short course of topical or oral steroids to reduce any inflammation and thereby speed hair regrowth. More commonly, topical minoxidil (Rogaine) is used to shorten the course of the disorder by accelerating the generation of new anagen (growing) hairs. In the final analysis, simple reassurance that the pelage will likely return to its former glory is probably the best of all remedies.
Learn more about stress-induced hair loss from Nelson Novick, M.D. of New York City.
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