As mentioned above, an autoimmune response is commonly associated with hair loss related to alopecia areata. Patients who have this condition see their body’s immune system attack their hair follicles. The patient’s hair follicles become very small and hair growth begins to stop.  A major symptom of alopecia areata is patchy hair loss, according to the American Academy of Dermatology, which says patients often first notice the problem when they see clumps of hair on their pillow or in the shower. 

Topical immunotherapy (i.e., contact sensitizers) is the most effective treatment option for chronic severe alopecia areata (Table 5).6 Response ranges from 40 to 60 percent for severe alopecia areata, and reaches approximately 25 percent for alopecia totalis and alopecia universalis.6 Because of potentially severe side effects, only clinicians who have experience with these agents should prescribe them.
Medications are available that encourage regrowth of hair. These medications, such as topical minoxidil* and oral finasteride, are not appropriate for everyone with hair loss. Hair growth medications work to varying degrees in different people, and only trigger complete regrowth in a minority of individuals. They work best for people who have smaller amounts of hair loss. Hair loss returns if you stop taking the medication. Finasteride is not appropriate for women who may become pregnant, as it can cause severe birth defects. Spironolactone, although not approved by Health Canada for this purpose, is a medication that may help women who are losing hair due to excess testosterone. Biotin is a vitamin that makes hair and nails stronger and is often used as an adjuvant therapy.

*All medications have both common (generic) and brand names. The brand name is what a specific manufacturer calls the product (e.g., Tylenol®). The common name is the medical name for the medication (e.g., acetaminophen). A medication may have many brand names, but only one common name. This article lists medications by their common names. For information on a given medication, check our Drug Information database. For more information on brand names, speak with your doctor or pharmacist.
Furthermore, Penn dermatopathologists developed an even more advanced method called the HoVert technique for diagnosing hair loss and other disorders from a scalp biopsy. The technique uses a unique horizontal and vertical testing approach that provides a greater amount of information to the referring dermatologist than standard industry longitudinal scalp biopsies.
I too visited the infamous-overpriced Dr Redmond from NYC. I’m on spiro and all the meds for 7 months, going on 8. Forget regrowth, forget halting of shedding, the rate of hair shedding refuses to slow. (I’m also certain its PCOS and not lupus that causing my hairloss, thoroughly medically investigated my hairloss. ) At the start of my treatment, I cut my hair to bout 5 inch lenght, so I’d easily be able to tell thinning versus halt versus regrowth. And all I can say is, I have less hair than I started with. Unfortunately even a physicians intervention is incapable of helping me. To all those out there, atleast this approach before scratching it off your list, its the least you can do.
My scalp is pain-free but has on occasion flared again but 1/100 of the original pain. My scalp still needs frequent shampooing (I could go weeks without it before) to keep the dermatitis at bay. My hair and scalp are still fairly dry and brittle despite aloe for moisture, avocado oil to moisturize and seal in moisture and Behentrimonium Methosulfate to close cuticles, provide slip and halt hair snapping, BUT the breakage is 90% better. I’m still too afraid to go back to humectants though I know they’re amazing as moisture-retainers for dehydrated hair. I have spots of completely missing hair towards my hairline that hasn’t and will probably never regrow but I’m focusing on nursing everything else back to health.
Hi, I cannot afford to go to see Dr. Redmond even though I live in NY (he’s just too pricy, I have no insurance, etc…) but I’m going to see the ob/gyn towards then end of the month to get help because I’m convinced I have PCOS (literally all the symptoms) and I was wondering, what birth control is best for hair? I’ve read Dr. Redmond’s site before and I could have sworn that Yaz or Yasmin kept popping up in the faqs section or somewhere on that site as good bcp for hair loss. I realize some people experienced hair loss after going off those pills, but if you have hair loss prior to bcp, I could have sworn Dr. Redmond listed those as good at helping hair loss and I thought some women claimed (elsewhere, not on his site) that they’ve regrown some hair after going on Yasmin. Sorry if I’m rambling, but does anyone know? Thanks. If I have PCOS, which I’m sure I do, I’m pushing for Spironolactone because I’ve read of a bunch of women who’ve had great success at regrowing hair with it, and one story on this site about a woman named “Jen” had great results. I think it took her 2 years, and she allegedly grew back 90-95% of her hair (also taking Metformin, dieting and exercising, and using Nizoral shampoo) so I’m trying to remain optimistic. It’s not just being 27 & single that makes me horrified at losing hair, though it doesn’t help, I’d still be freaking out if I was 57. If I could regrow even 30% to 50% I’d be elated. Because ultimately, I’m holding out hope for stem cells to be all of our “saviors.” Lol. There are 3 companies working on adult stem cell therapies for hair loss (from what I’ve seen here and elsewhere, they are Histogen, Follica, and Aderans) not to mention a Cairo Dermatologist who has successfully helped children with alopecia areata/totalis regrow significant amounts of hair, though only in one study and the results are only preliminary. Who knows. But still, fingers crossed that I can get these stupid hormones under control and stop my daily horror at washing my hair and seeing my once beautiful hair fall away. I always took my hair for granted and often complained about it, but I’d give anything for my thick long hair back. I had fine hair always, but tons of it and I always wore it long. Now I wear it pulled back in a bun to hide as best I can all that scalp showing through. Thanks for this site, it’s keeping me from going off the deep end.
I was searching the internet and came across this wonderful site. I really appreciate you posting this article. I have always had a small bald patch on one side of my head. My mom told me it had always been there so I didn’t worry about it. Recently it has been getting larger and the hair around it is getting lighter. On the other side my hair is thinning and the color and texture is changing. It also seems to be falling out. I have excessive hair loss on a regular basis. I am only 24 years old and I can’t stand that my hair is falling out. I went to the dermatologist and he gave my injections but they didn’t work. He said I have alopecia areata and that the other side was a normal receding hairline. (He barely even looked at it) He then told me after the injections weren’t working to try Rogaine. I think it might be helpful to see an endrocrinologist as I have also been having problems with anemia. Again, thank you so much for the information you have provided.
Aside from the falling hair, I’m also experiencing bouts of arrhythmia. There are instances when my heart would beat slowly and it feels like it’s going to break my ribcage. It’s hard to breathe and I get dizzy. Do you think these are related? I don’t want to go to another doctor yet because I haven’t researched yet and because of my many disappointing experiences with them, I would never dare to consult with one without knowing anything.
"Others are taking hair follicles out of human scalp and growing them with dermal papilla cells," Cotsarelis says. "If they grow in culture, you might be able to recombine them with skin cells and form new follicles. This would let you expand the number of follicles you get for a hair transplant. This may not be that far off -- five to 10 years, maybe. There's very good evidence you will be able to do that."
If you’re a lady and can remember the one difference in directions (or just scope out the instructions online) we recommend saving the cash. Similarly, you could go generic with Equate Hair Regrowth Treatment for Men or Costco’s Kirkland Signature Hair Regrowth Treatment Minoxidil Foam for Men. These alternatives offer the same percentage of active minoxidil and near-identical inactive ingredients for as little as half the price — a great option for both genders.
It is expensive ($700) to see him. He does give you a bill which you can submit to your insurance company (max reimbursement $150-$200). He will send you a lab slip once you sign up for the appt so you don’t have to go through any other doctor to get the labs done. I have regular insurance through work and didn’t get charged at the lab. If you do go to see him, I highly recommend reading his book first so you know what to expect. He spends alot of time with you (initial consultation is 1 hour and 30 minutes) but you don’t want to waste any of that time on questions that he answered in his book). In my opinion, he is a very learned and specialized physician. he has had excellent training and has taken a personal self interest in this. He is the only physician I have seen. I have not yet tried a dermatologist.

I am so glad this site exsists. Thank you ladies for sharing your experiences and making this whole hair loss crisis feel less lonely. I’ve been having soo much hair loss over the past 8 months that now there’s a visibly bald spot at the top of my head and I have to wear a headband to hide it! Most days I contemplate shaving my head and walking around with a bandana so I don’t have to deal with the daily shedding (which literally causes me neck tension!). I’ve gone to my primary doctor twice and both times she’s drawn blood to test my thyroid levels. The first time the results showed my levels were normal but she still put me on levothyroxin to see if it would make a difference with the breakage. It didn’t. I just went back a second time and she took blood again to do a second test on my thyroid levels and also to see if I have lupus. I’m waiting for those results. I just want to know why this is happening now. I’m only in my early 30’s. I am so grateful that there are others of you out there dealing with this too, atleast we’re not by ourselves in this process.
i’ve come across this site before, but today has been an already 5 hour session reading everything that has been posted and researching things on the side. first and foremost, i want to thank you all for your words, rants, and honesty. i stayed home from work today after breaking down in the bathroom, already dressed for work, because of my hair. a few posts made me cry, a few made me smile and all remind me that i am not alone. i, like a few of you, hate that i focus on my hair, but even though i try my damndest to not do so, it really does depress me. i know i will bounce out of it, but it’s only a matter of time before it comes back. today is the first day that i have ever not gone in to work because of the hair situation. here’s my story:
i am a mother of a 10 yr old beautiful daughter who at this moment has started to lose some hair on her eyebrows.. at first i thought it was just skin disorder because it started out as an round and whitish spot on her left eyebrow…and only applied ointment on it. but then i statrted to notice that her eyebrows are have seen to not look normal and both end of her eyebrows are gone … and so i immediately took her to a dermatologist and with just one look at her through a lighted mirror ( i think) she told me – its alopecia.. due to stress, – that really shocked me…she’s a happy ten year old girl.. attending grade school.. she’s my only child … day and night we are together..so i am very secured in knowing that if she has any problem in school or with her friends – she would tell me as she always does.. and then the doctor showed me pictures od bald older men and told me that sometimes _ alopecia showed itself in men’ s mustaches.. sideburns… etc. then she gave us a prescription for an ointment to use on her brows 2 x a day and get back at her after two weeks.

Telogen effluvium occurs when the normal balance of hairs in growth and rest phases is disrupted, and the telogen phase predominates. The disproportionate shedding leads to a decrease in the total number of hairs. Axillary and pubic areas often are involved, as well as the scalp.2 The hair-pluck test usually shows that up to 50 percent of hairs are in the telogen phase (in contrast to the normal 10 to 15 percent), although these results can vary in persons with advanced disease.4  The patient often is found to have had inciting events in the three to four months before the hair loss (Table 4).1,4 If 70 to 80 percent of hairs are in the telogen phase, the physician should look for causes of severe metabolic derangements, toxic exposures, or chemotherapy.1,4 No specific treatment for hair loss is required because normal hair regrowth usually occurs with time and resolution of underlying causes. Lack of significant historical events and a delay in regrowth should raise suspicion for syphilitic alopecia.1

Women also may experience AGA, often with thinning in the central and frontal scalp area but usually without frontal–temporal recession (Figure 3). A history and physical examination aimed at detecting conditions of hyperandrogenism, such as hirsutism, ovarian abnormalities, menstrual irregularities, acne, and infertility are indicated. Laboratory tests are of little value in women with AGA who do not have characteristics of hyperandrogenism.5
Hi, I’m 25 years old, and started having hair loss at 15. It started and has continued to thin around my hairline only on one side, to the point that one side is receded and extremely thin. About a year and a half ago, my overall scalp started thinning as well. It’s been about a year since I’ve dyed my hair and I rarely ever put hairspray or any other chemical in my hair. I try to just wash it and let it air dry in fear that anything I do will make more hair fall out. I haven’t been to a doctor at all so far because I’ve never had health insurance. I’m about to have insurance next month and will be looking for a doctor to go to ASAP. I’ve been trying to look online and see what information I can find about what’s happening with me, but I dont’ see anything about a similar case to mine. I used to have long, thick hair and could do anything with it, and now it’s short and thin, and I can never style it at all, and my receding hairline on my right side has me so self conscious. I live in Baton Rouge, Louisiana, does anyone have any suggestions to my situation or a reputable doctor in this area?

The best fix by far for replacing lost hair is a transplant. Back in the day, docs used plugs that resembled cornrows (definitely not natural looking). Today, guys have more options. You can go for “the strip method” where a doctor surgically removes a strip of hair from the back of your head, dissects every hair graft under a microscope, and then plants the individual grafts onto hair-thin areas of your scalp with tiny incisions.
I don’t know in which proportion including diet, all of these things occurred but I believe A-Ret abuse was a large part of it as evidenced by blood tests taken by my PCP which I was never able to get re-evaluated due to doctor apathy. My sister is experiencing an unrelated bout of hair loss concentrated at her crown and feels hopeless. I’m sending her to this board and to all of your suggestions right away. My problem seems to have subsided but I’m remaining only optimistically cautious and still very vigilant about monitoring hair loss. Thank you everyone again for contributing to this board.
The general medical consensus around laser treatments — caps and combs alike — is that low-level laser light therapy stimulates the cells within the hair follicle. These devices may also increase cell metabolism to promote thicker and more durable hair shafts, something that neither minoxidil or finasteride can do. To use the HairMax Ultima, all you have to do is glide the device over your scalp slowly. Treatments should take about eight minutes, and you should do it three days per week for the best results.
Re-growing hair: It is likely that the hair will grow back even without treatment. It may fall out again, though. Most patients lose their hair more than once before the disease goes away for good. Even people who lose all the hair on their scalp and body can have their hair grow back. When hair loss is widespread (lots of hair loss on the scalp and/or body), there is a greater chance that the hair will not re-grow.
Hair is made up of the hair follicle (a pocket in the skin that anchors each hair) and the shaft (the visible fiber above the scalp). In the hair bulb, located at the base of the follicle, cells divide and grow to produce the hair shaft, which is made from a protein called keratin. Papilla that surround the bulb contain tiny blood vessels that nourish the hair follicles and deliver hormones to regulate the growth and structure of the hair.
I am 45 years-old and started noticing a thinning of my hair about 2 years ago. I did see a dermatologist specialized in hair loss and was only prescribed a testosterone lab test which came back normal. My scalp is vey itchy but I do not have dandruff or any signs of dry skin. It sometimes hurts so bad I wake up at night. I was prescribed a steroid shampoo and a steroid lotion which have helped calm down the itchiness and pain if used regularly. I was diagnosed with Female baldness (mostly on the top which is really thin now) and dermatitis. not further explanations. I was also prescribed Rogaine 5% and a mixture of Rogaine and RA to use every 3 days. once a day. should I start using them twice a day? its only been 3 months and I have not noticed a change. I accepted a job to work from home because I was getting too self conscious to go to work at the office. I am very concerned by my appearance usually but this hair loss is a constant worry.
The general medical consensus around laser treatments — caps and combs alike — is that low-level laser light therapy stimulates the cells within the hair follicle. These devices may also increase cell metabolism to promote thicker and more durable hair shafts, something that neither minoxidil or finasteride can do. To use the HairMax Ultima, all you have to do is glide the device over your scalp slowly. Treatments should take about eight minutes, and you should do it three days per week for the best results.
Alopecia areata is an autoimmune disease, where a person's immune system attacks the body, in this case, the hair follicles. When this happens, the person's hair begins to fall out, often in clumps the size and shape of a quarter. The extent of the hair loss varies; in some cases, it is only in a few spots. In others, the hair loss can be greater. On rare occasions, the person loses all of the hair on his or her head (alopecia areata totalis) or entire body (alopecia areata universalis). 

I recently noticed I was loosing hair on the front of my head, I started using the rogain Foam and after a month my hair started falling out even more. It’s gotten really bad, I can see my entire scalp now and my hair is falling out in chunks. Rogain advised you loose hair making room for new ones to grow, has anyone had any experience using rogain? Is This normal?
Medications are available that encourage regrowth of hair. These medications, such as topical minoxidil* and oral finasteride, are not appropriate for everyone with hair loss. Hair growth medications work to varying degrees in different people, and only trigger complete regrowth in a minority of individuals. They work best for people who have smaller amounts of hair loss. Hair loss returns if you stop taking the medication. Finasteride is not appropriate for women who may become pregnant, as it can cause severe birth defects. Spironolactone, although not approved by Health Canada for this purpose, is a medication that may help women who are losing hair due to excess testosterone. Biotin is a vitamin that makes hair and nails stronger and is often used as an adjuvant therapy.
I understand how you feel, I really do. I’ve spent so much time crying that I’m certain all my tears could have filled up an olympic size swimming pool by now. You must not give up hope, even when it seems there is none. It is so important. Without that I don’t know how I would get by. Once you say what city/state you are in, I really hope someone can recommend a good doctor. I think that is part of your despair, that you haven’t really been heard out by a physician and received the bloodwork you want and are entitled to.
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