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
I am 30 and am trying Rogaine and spironolactone but only stopped the loss and I want to try Propecia. I know about the side effects for a male fetus, but I have chosen myself that I do not ever want to create a child out of my body. I will adopt or foster, but have intense lockeophobia. I even agreed to sign a legal document saying such, but my doctor would still not prescribe me propecia unless I had had a hysterectomy. He said it was for safety reasons, but as far as I understand it the only safety issue would be to such a fetus that will not exist. So I am confused about his reservations.
Hair loss often occurs in patients suffering or recovering from a medical condition or illness. Amongst a growing list of issues and concerns, hair loss can then lead to additional stress and anxiety as the amount of hair loss becomes more prevalent and noticeable to others. Although there are a vast number of health issues that result in hair loss, some of the most common diseases include:
You ARE the same inside, but you are also different… you’ve been through a lot and it is so difficult to to stay strong through this experience. I won’t even go into the hair stuff, because it sounds to me that this is not what your post is about. You need to get some really solid support and find something other than your hair to focus on. You need an awesome hair system…and support system. From there, I hope and pray for you, that you will be able to find happiness and balance in your life again. You are a glorious human…don’t doubt that for a moment!
I had embolization and an angiogram for an AVM on my jaw. I was told there would be some hair loss because of the radiation (The size of a quarter). Well I have lost all but 1/3 of my hair left …not the area of a quarter! Has anyone ever had this happen? My doctor says the hair should grow back, but it has been three months and it is still coming out and no new growth. I don’t know what to do! Any suggestion? As with many women my hair was a part of my identity. I am not bragging but people remember me as the girl with all the hair. I realize we are more than our hair, but it makes me so sad!
Endocrinologist: The clinical specialty of endocrinology focuses primarily on the endocrine organs, meaning the organs whose primary function is hormone secretion. These organs include pituitary, thyroid, adrenals, ovaries, testes and pancreas. An endocrinologist is a doctor who specializes in treating disorders of the endocrine system and who is trained to diagnose and treat hormone problems by helping to restore the normal balance of hormones to your system. Endocrinologists treat many conditions, including:
I am 30 and am trying Rogaine and spironolactone but only stopped the loss and I want to try Propecia. I know about the side effects for a male fetus, but I have chosen myself that I do not ever want to create a child out of my body. I will adopt or foster, but have intense lockeophobia. I even agreed to sign a legal document saying such, but my doctor would still not prescribe me propecia unless I had had a hysterectomy. He said it was for safety reasons, but as far as I understand it the only safety issue would be to such a fetus that will not exist. So I am confused about his reservations.
If you’re a gentleman who’s been noticing a receding hairline or is worried about balding, the first step is to schedule a visit with a doctor or dermatologist and make sure your hair loss isn’t a sign of a more serious health issue. “Not all hair loss is male-pattern hair loss,” explains Dr. Marc Glashofer, a board-certified dermatologist specializing in hair loss and practicing in northern New Jersey. A thyroid disorder, an autoimmune disease, or even a scalp issue could be making you look like Bruce Willis in Die Hard 2. But most hair loss is androgenetic alopecia, also known as male-pattern baldness, and fortunately (or not, depending on your perspective), it’s just a symptom of getting older.
My name is Leslie and IO was recently diagnosed with pcos. My hair has been falling out for about two years! I am African American and I have always had thick healthy hair now you can see my scalp. I started using a product called regrow and my bald spots are filling in but my hair is still thinning! I was fortunate enought to have a child in 2003 I have been trying to have another child for 3 years with no luck can somebody help me with my thinnig hair and infertility……..I don’t even feel like a woman anymore.
Laser devices: Brushes, combs, and other hand-held devices that emit laser light might stimulate hair growth. These devices might make hair look more youthful in some people. Because the FDA classifies these products as medical devices, the products do not undergo the rigorous testing that medicines undergo. The long-term effectiveness and safety for these devices are not known. 

Greetings ladies, I am so happy I found this website. I have a 19 year old daughter who has been experiencing hair loss for the past 5 years. Throughout high school, she wore hair weave to camouflage what was going on. She is now a sophomore in college and wants to wear her natural hair. It is frustrating her because we don’t know why its happening. Does anybody know of a good endocrinologist in Chicago? Do you think treatments varies depending on ethnicity? She is African American.
I had Melanoma a few years ago, a wide-excision surgery and lymph node(s) removal. I also had sleep apnea and then surgery for that. Also had a hysterectomy 10 years ago for excessive bleeding,I’ve had the clotting factor tests w/normal results though even though even having my blood taken will cause me to bleed alot and bruise.Each time I’ve had surgery, I’ve had to stay in Recovery a looong time because of the bleeding.(hence the clotting tests) Have been anemic most of my adult life too.I am under a lot of stress(have always been) I mention all this in case it rings a bell w/anyone else.
Other medical conditions — most commonly telogen effluvium and seborrheic dermatitis — can also cause hair loss, but most people can trace their follicular woes back to androgenetic alopecia, so we focused our search there. We started with more than 200 products, including all-natural solutions and high-tech gadgets, while skipping treatments that focus only on volumizing or thickening hair. We also limited our scope to the scalp, and left out specialty products designed only for eyebrows or beards.
Hair transplants will likely lead to better results in the long run (you are introducing new hairs to the balding areas), but you’ll still need to use minoxidil or finasteride after surgery to maintain the results. Like all hair loss treatments, hair transplants are best when combined with other methods, and you’ll want to speak with your doctor to see what combination is best for you.
The mission of the National Institute of Arthritis and Musculoskeletal and Skin Diseases is to support research into the causes, treatment, and prevention of arthritis and musculoskeletal and skin diseases; the training of basic and clinical scientists to carry out this research; and the dissemination of information on research progress in these diseases.
My story is little different it seems. My fiancé was dionosed with Rocky Mountain Spotted Fever from a tick bite. And after test after test almost losing her and so many blood drawings then blood transfusions along with dialysis. Fighting depression trying to stay possitive is getting harder everyday. We ask all her doctors about why her nails break so easy, skin changing and hair falling out handfulls at a time…..then being looked at like we’re crazy has took my faith out of their hands.

Our other recommendation is the HairMax Ultima 12 LaserComb. The comb uses low-level lasers to stimulate hair follicles and modulate dihydrotestosterone (DHT) — a hormone that causes the most common type of hair loss. While it sounds like something from a sci-fi movie, the treatment works, and the dermatologists we consulted reported that their patients saw thicker and longer hair when combined with our top pick. The only catch: The comb isn’t as effective as minoxidil treatments, and at nearly $400, it’s a much bigger investment. Still, it’s the best option if you’re looking for a non-invasive, non-chemical treatment.
Spironolactone, an aldosterone antagonist with antiandrogenic effects, works well as a treatment for hirsutism and may slow hair loss in women with AGA, but it does not stimulate hair regrowth. Estrogen may help to maintain hair status in women with AGA, but it also does not help with regrowth. Few controlled studies have examined the many non–FDA-approved hair growth agents such as cyproterone acetate (not available in the United States), progesterone, cimetidine (Tagamet), and multiple non-prescription and herbal products. A full discussion of approved and unapproved treatments for AGA can be found elsewhere.6,7 In all forms of alopecia, hairpieces and surgical transplants can produce satisfactory results but are expensive.
I’m 42 and I noticed my front top and sides thinning about a year ago – a lot coming out when brushing after washing. I went to the doctor who happened to be African-American (I’m caucasion) and she actually asked me if I wore “corn rows” a lot! Needless to say, she was worthless and just prescribed me something for dandruff, which I do not have! I went to an endocrinologist to see if my thyroid or menopause was the problem – tests turned out honky dorie! Now I can see through the top of my head when the sun shines on it (scar-y) and I’m having to cover over the temple areas with sweeps of hair from the other side (interesting, the right side is much thinner). I will say that I’ve gone through hell and back with a mentally ill young adult but if it was stress, wouldn’t it have come out quicker than just in the last year (I’ve been dealing with his illness for 7 years now)?? I’ve heard that sometimes it takes 2 or 3 blood tests and doctors to finally see that one has thyroid problems. Is this the experience of others, and would I be throwing my money away by seeing my general practitioner?
Thank you for all your post. My daughter had extremely thick hair about eight years ago. It was so thick you could barely put it in a scrunchie. Her hair has been continuously thinning to the point that you can see through it. All the women in my family on both sides have extremely thick hair. We live in the north east and have seen several GP and a Dermatologist who act like there is nothing wrong. I work in the medical field and when I hear this I get so mad because I feel like they want to just brush of like no big deal. It is a big deal to all women no matter what ages. I have written done some of the post advise and will continue to look for an endocrinologist for her. Please keep me postes on any new developements.
CURRENT REGIMEN: 6 weeks ago I purchased Hair Essentials… and am seeing some fine hair growth. Weight loss & exercise can also heighten follicular dormancy. (Have lost 90 lbs. in the last year.) Important to maintain 50-60mg/daily protein levels, as well as routine multi-vitamin, higher levels of B-Complex, D and Calcium levels while dieting… heavily impacts hair, nails & skin. Am researching possible relationship between gastrointestinal health and hair loss.
Wow, I just started doing some research on this because I have been having problems with my hair thinning on the top of my head for several years, along with some sensitivity. I went to my internal medicine Doctor and he didn’t say much, which struck me as odd… he referred me to my women’s doctor who was slightly more sypathetic but offered no suggestions other than to see a dermatologist. I have been putting it off because I feel like I am getting the run-around. I see that I am not alone!

I took spironolactone several years ago, and after 3 days got tinnitus (ringing in ears) permanently. Quit using it. Now, I take Fo-ti, Beta sitosterol, saw palmetto, and black cohosh. Also don’t use commercial hair dyes, as they made more hair fall out and if you have a yeast infection, take yeast defense as an itchy scalp from yeast (think too much sugar in diet) will make your hair fall out. Fructis has come out with a shampoo called Fall Fight that seems to help. My hair loss has stopped, although the volume has not come back. Look for solutions on your own, plenty of articles on the internet. Good luck!
It’s also possible that some of Harklinikken’s users are women whose hair would have grown back even if they’d done nothing. Many women who arrive in a dermatologist’s office with prior diagnoses of female pattern hair loss actually have what’s called telogen effluvium. That’s a period of acute shedding of hair — meaning up to 60 percent of hair — three months after a triggering event like pregnancy, significant weight loss or starting or stopping hormone medications.

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.
The pattern of hair loss, especially whether it is focal or diffuse, also may be helpful (Figure 1). The hair-pull test gives a rough estimate of how much hair is being lost.2,4  It is done by grasping a small portion of hair and gently applying traction while sliding the fingers along the hair shafts. Usually one to two hairs are removed with this technique. The hairs are then examined under a microscope (Table 2).
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Why? Unwanted hair growth (sideburns, for example) is a reported side effect of minoxidil. The belief is that a higher concentration of minoxidil would result in more unwanted hair, which is why women are instructed to use it less often. However, the study in Skin Therapy Letter reports that unwanted hair was more common in 2 percent minoxidil solutions than 5 percent, and women are instructed to use Rogaine’s 2 percent solution twice daily — so what gives? 

You are what you eat – and that’s true for your hair as well. A diet containing mostly whole foods, especially the skin of plants such as cucumbers, potatoes, peppers, and even bean sprouts are rich in the mineral silica and contribute to hair strength. Foods like lean meats are high in iron and are essential to the protein-based, building blocks of hair growth.
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.
Hair transplantation involves harvesting follicles from the back of the head that are DHT resistant and transplanting them to bald areas. A surgeon will remove minuscule plugs of skin that contain a few hairs and implant the plugs where the follicles are inactive. Around 15 percent of hairs emerge from the follicle as a single hair, and 15 percent grow in groups of four or five hairs.
The pattern of hair loss, especially whether it is focal or diffuse, also may be helpful (Figure 1). The hair-pull test gives a rough estimate of how much hair is being lost.2,4  It is done by grasping a small portion of hair and gently applying traction while sliding the fingers along the hair shafts. Usually one to two hairs are removed with this technique. The hairs are then examined under a microscope (Table 2).

Too much stress is bad for health and beauty, but did you know there’s a known connection between stress and hair loss, too? Constant stress can cause cortisol levels to spike, which can contribute to increased hair shedding. To relieve stress and its damaging effects on your hair, try meditation, regular exercise, keeping a regular sleep schedule, or any other activity that helps you decompress.


I just came across this website, I thought by chance but I think not! I have been having scalp pain, like my skull wanted to crack open. Then the tendersness of my hair folicals when the wind would blow. I started to loose lots of hair so went to my family doctor. All the test were done for Thyroid problems…all turned out what they call “normal”. Have you seen the wide range which is considered normal? How can this be when everyone is so different? I am loosing hair as I sit and write this message. The hair just gently falling onto my shoulder. I need to color my hair as it is time from the length of my silver roots but the last time I had my hair touched up, I thought I was going to die from the pain when the stylist tried to just shampoo the color off. Oh my God! Painful, painful. I used to be a stylist so you can imagine my shock when I was told it wasn’t my Tyroid!
When alopecia areata is associated with celiac disease, treatment with a gluten-free diet allows for complete and permanent regrowth of scalp and other body hair in many people, but in others there are remissions and recurrences.[15] This improvement is probably due to the normalization of the immune response as a result of gluten withdrawal from the diet.[15]
Trichotillomania is a psychiatric impulse-control disorder.17 The mean age of onset is eight years in boys and 12 years in girls, and it is the most common cause of childhood alopecia.1,15 Although any part of the body can be involved, the scalp is the most common. Patients also may eat the plucked hairs (trichophagy), causing internal complications such as bowel obstruction.18 The hair loss often follows a bizarre pattern with incomplete areas of clearing (Figure 9). The scalp may appear normal or have areas of erythema and pustule formation. A scalp biopsy may be necessary to rule out other etiologies, because patients may not acknowledge the habit.
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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.
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.
In answer to which doctor should I see for my hair loss, my opinion is that you should probably see both. Most doctors don’t know enough about hair loss as it is, so seeing doctors in different specialties may actually help you get a better, more accurate diagnosis. I am sure there are various conditions of hair loss that might be better served by seeing one more than the other. Perhaps a dermatologist would be better suited in determining if the cause was an infectious skin condition such as ringworm or scaring alopecia, and an endocrinologist may be better at diagnosing hormone related hair loss. The truth is, any doctor whether it is an endocrinologist, dermatologist, or general practitioner with a strong interest and knowledge in hair loss can make a proper diagnosis and work with you on the the treatment they think will produce the best results. The operative words here are “interest and knowledge.”
Taking hair supplements can be helpful for anyone who is experiencing hair loss or hair thinning. Dendy Engelman, MD, a board-certified dermatologic surgeon at Medical Dermatology & Cosmetic Surgery in New York City, previously recommended Nutrafol, a research-backed hair supplement, to Prevention. "This uses highly concentrated botanicals to address every stage of the growth cycle," she says. Nutrafol's hair supplements include vitamin E and ashwagandha (an adaptogen that helps balance cortisol levels in the body), among others.
When healthy hair is pulled out, at most a few should come out, and ripped hair should not be distributed evenly across the tugged portion of the scalp. In cases of alopecia areata, hair will tend to pull out more easily along the edge of the patch where the follicles are already being attacked by the body's immune system than away from the patch where they are still healthy.[11]
Happily divorced in 2006. Coming up to my 52nd birthday, my hair is thin and fine, my hairdresser just shakes her head. In pictures all you see is scalp with a faint nimbus that is what’s left of my hair. Lost my job in December. When I interview, no one looks me in the eyes… they talk to my nearly naked scalp. So here I am, wanting to date and find work, and feel constantly judged because of an outward manifestation of something that’s happening inside of (what appears to be) a healthy body. It looks like I’m on chemo, or at the affect of some kind of some huge illness or medication… and shunned. How much of my self-image is subliminally dictated by my lack of hair… working on that with my therapist. LOL!!
Hair loss in women isn't always as straightforward as it is in most men. In men, about 95 percent of all cases are caused by male pattern baldness. In women, however, hair loss can be triggered by a multitude of conditions and circumstances. During the consultation, Dr. Yaker utilizes specialized hair and scalp scanning technology to assess the distribution of hair loss, hair thickness, and how much hair is present in a particular area. It is important to note, that for women, a proper diagnosis begins with a process of elimination. More than one cause for the hair loss may coexist and need to be recognized or excluded. A comprehensive medical history, which includes a list of all medications, history of hair loss, a thorough scalp exam, a discussion of medical and skin disorders, and a complete nutritional evaluation will be needed. Blood work analysis may be required, and a scalp biopsy may also be performed if the cause of hair loss is uncertain or there is a concern for scarring alopecia.

The follicles on the sides of the scalp are more genetically resistant to DHT, which is why male pattern baldness often results in a “crown” of hair. But its downsides are serious. “With women, finasteride is not an option,” says Dr. Wolfeld. “It’s not FDA-approved for women to take, so we don’t prescribe it.” In fact, due to the drug’s effect on hormone levels, pregnant women are advised to not even touch broken or crushed tablets.


This blog is great in all the support and understanding it provides, but I had a pretty hard time finding any suggestions for treatments that have actually helped anyone. I’m 22 and my hair has been rapidly shedding over the past 5 months. It’s also gotten thin and brittle. After 2 blood screenings, a dermatologist visit, and a visit to my general practitioner, nothing has improved. The doctor’s told me to wait it out, and that sometimes this “just happens”. They tested my hairs and saw that most of them were in the “resting” telogen phase, and decided I had Telogen Effluvium (TE) for undetermined causes.
There are numerous diseases that can affect the hair and scalp. Hair loss can be caused by a variety of conditions. Diseases such as alopecia areata, anemia, male/female pattern baldness, and infections of the scalp can all cause significant difficulty and loss of daily well-being. Stanford Dermatology has established a special clinic focusing on the diagnosis and treatment of these disorders of the hair.
Blow dryers, flat irons, and other devices: Frequent use of a blow dryer tends to damage hair. The high heat from a blow dryer can boil the water in the hair shaft leaving the hair brittle and prone to breakage. Dermatologists recommend that you allow your hair to air dry. Then style your hair when it is dry. Dermatologists also recommend limiting the use of flat irons (these straighten hair by using high heat) and curling irons. 

I have Alopecia Areata, Hoshimoto Thyroiditus, both are autoimmune diseases. I also now am losing hair all over my head. I have itching, redness, pustules and think it may be Cicatricial Alopecia (Scaring Alopecia). I have tried Biotin 10,000mcg per day for 3 yrs didn’t work, also Nioxin didn’t work. Minoxidil 5% worked the first time I lost some hair but not anymore. I have been given oils, creams, and still no luck.I went to a Derm and he didn’t seem to care. I am embarrassed to go out becauseyoou can really see my scalp through my very thin hair. I use to have very thick hair but that is gone. I can’t afford a wig and don’t know where to turn now. I have to support where I live (Rialto, Calif.). Any Ideas?

The only nonchemical option offered up by the dermatologists I spoke with — short of a surgical hair transplant or platelet-rich plasma therapy, which is like Kim Kardashian’s vampire facial but for your scalp — was the laser comb. First cleared by the FDA in 2009, the HairMax LaserComb is a handheld laser device that is designed to promote hair growth. As the manufacturer explains in a letter to the FDA, “The device provides distributed laser light to the scalp while the comb teeth simultaneously part the user’s hair to ensure the laser light reaches the user’s scalp,” which, in turn, stimulates the hair follicles.
Cicatricial alopecias tend to cause permanent hair loss. These disorders destroy hair follicles without regrowth and follow an irreversible course.21 It is likely that they involve stem-cell failure at the base of the follicles, which inhibits follicular recovery from the telogen phase.21 Inflammatory processes, including repetitive trauma as in trichotillomania, also may lead to stem-cell failure. Other processes may be caused by autoimmune, neoplastic, developmental, and hereditary disorders. Among these are discoid lupus, pseudopelade in whites, and follicular degeneration syndrome in blacks. Dissecting cellulitis, lichen planopilaris, and folliculitis decalvans also may cause scarring alopecia. Some disorders respond to treatment with intralesional steroids or antimalarial agents.21 Patients with these conditions should be referred to a physician who specializes in hair loss disorders.

A hair growth cycle consists of three phases. During the anagen phase, hair grows actively. This phase may last for years. During the catagen phase, hair stops growing and separates from its follicle, which is the structure beneath the skin that holds the hair in place. The catagen phase lasts about 10 days. During the telogen phase, the follicle rests for two or three months, and then the hair falls out. The next anagen phase begins as a new hair grows in the same follicle. Most people lose 50 to 100 hairs per day as part of this natural cycle.


When healthy hair is pulled out, at most a few should come out, and ripped hair should not be distributed evenly across the tugged portion of the scalp. In cases of alopecia areata, hair will tend to pull out more easily along the edge of the patch where the follicles are already being attacked by the body's immune system than away from the patch where they are still healthy.[11]

I too have been having bad hair loss. I am 25 years old and since the birth of my second child 2 1/2 years ago, it has not stopped. It is normal for it to fall out for a few months after child birth so I wasn’t too worried at first. After about 6 months it started to slow down then all of a sudden started up again. And has been falling out ever since. I am really thin in the front and around the temples and just recently, has become really unhealthy. It breaks and is very course. I have been to 3 derms. and 2 PCP’s. All my lab work has always come back normal. And they just tell me to use Rogain. The past 6 months I have been trying to get pregnant again and haven’t been able to. I got pregnant with my last 2 very easy and feel that my hair loss and not being able to get pregnant are intertwined. I also have gained about 15 pounds. I don’t want to use the Rogain because I am trying to get pregnant and don’t know the effects it will have if I did get pregnant. I don’t know what to do next. I am in the Phoenix area so if anyone know of any good docs around here please let me know.
My hopes and prayers are for all of us… that somewhere a doctor, an organic chemist, SOMEONE… ANYONE… will care enough to actually research this. Thank you, all of you, for your tears, suggestions and sharing. I WILL NOT WEAR A WIG… WHAT LIES BEHIND US, WHAT LIES AHEAD OF US, PALES IN COMPARISON TO WHAT IS INSIDE OF US. WE ARE STRONG, VIBRANT… WE WILL PREVAIL.
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