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.
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.
I’m a dermatologist and am more interested in telogen effluvium these days because I have it bad–and this time it’s not because I just had a baby. I’m learning more about the gut-skin-hair connection and am suspicious that it has to do with the bacterial flora in your gut. You can learn more about changing your gut flora at BodyEcology.com. Her book is intense but I’ve decided to give it a try after recommending it and seeing it work so well with acne patients.
Many other agents have been used to treat alopecia areata, including minoxidil, psoralen plus ultraviolet A (PUVA), and anthralin (Anthra-Derm), but success rates vary. Anthralin, an anti-psoriatic, in combination with topical corticosteroids and/or minoxidil, is a good choice for use in children and those with extensive disease because it is relatively easy to use and clinical irritation may not be required for efficacy.6 Hairpieces and transplants may be the only options available for persons with severe disease that remains unresponsive to available medical treatments. Patients with recalcitrant, recurrent, or severe disease should be referred to a subspecialist.
Trying to figure out exactly what is causing your hair loss is going to require a little detective work on the part of your physician. Several lab tests are going to need to be done. I’ll make sure to make another post this week about the standard lab tests that should be ordered to start the process. Hopefully you don’t have to bring the list to the doctors office, he/she should know already. I get concerned when women have to bring a list of tests that should be ordered to their doctor. My feeling is that if they don’t know what to order then how are they going to be able to accurately read the results. But… a good doctor is a good doctor, and if you have one that really cares and takes a strong interest in your hair loss with a willingness to work with you in finding the cause then great.
The dermatologist also will carefully look at your scalp and hair. During an exam, the dermatologist may pull on your hair. Sometimes a dermatologist needs to pull out a hair to get the necessary evidence. And sometimes a dermatologist needs to look at the hair on the rest of your body to see whether there is too little or too much hair in other areas.
I’m seventeen and my hair has been gradually thinning for 7 years now. I’ve met some pretty unhelpful doctors who just prescribe me iron pills, always it’s the iron pills. I just wish i could have hair like i used to and thinking about it makes me feel really bad and just kills my self-esteem at times. But what i’ve learned is that there are alot of tough things to go through in a person’s life and instead of complaining 24/7 about what i don’t have, I’ve learned to appreciate the things that i do. Im not saying i wouldn’t be the happiest person in the world of by some miracle my hair decided it wanted to grow back again..that would be awesome! But i know i would give up every hair on my body for the things that i do have, like friends and family and my comfortable life and my freedom. Hair is really really important but i know things that are way more important to me. I hope all of you will keep that in mind too! I wish you all the best of luck so keep trying!!!!!
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).
In contrast to trichotillomania, traction alopecia involves unintentional hair loss secondary to grooming styles. It often occurs in persons who wear tight braids (especially “cornrows”) that lead to high tension and breakage in the outermost hairs (Figure 10). Traction alopecia also occurs commonly in female athletes who pull their hair tightly in ponytails. The hair loss usually occurs in the frontal and temporal areas but depends on the hairstyle used. Treatment involves a change in styling techniques. Other hair-growth promoters may be needed in end-stage disease, in which the hair loss can be permanent even if further trauma is avoided.1
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.
Hormonal changes and medical conditions. A variety of conditions can cause permanent or temporary hair loss, including hormonal changes due to pregnancy, childbirth, menopause and thyroid problems. Medical conditions include alopecia areata (al-o-PEE-she-uh ar-e-A-tuh), which causes patchy hair loss, scalp infections such as ringworm and a hair-pulling disorder called trichotillomania (trik-o-til-o-MAY-nee-uh).
According to the International Society of Hair Restoration Surgery, since 2004, the number of female surgical hair restoration patients worldwide increased 24 percent. Modern surgical hair restoration procedures such as Follicular Unit Transplantation (FUT) and Follicular Unit Extraction (FUE) allow surgeons to take hair from the back of the head (genetically permanent hair zone) and transplant it to the areas where balding has occurred. The reason why the hair does not fall out once transplanted in its new location is because those hair follicles take on the same characteristics as the hair in the area where it originated, the genetically permanent zone. Both approaches result in lasting outcomes. In order to know if you are a candidate, Dr. Yaker will go over your medical history and examine your hair and scalp. He will determine if you have ample, good quality hair in the permanent hair zone in order to be able to relocate those hair follicles to the areas of hair loss.
Triamcinolone acetonide (Kenalog), 0.1 mL diluted in sterile saline to 10 mg per mL, is injected intradermally at multiple sites within the area to a maximum dosage of 2 mL per visit.6 The main side effect, atrophy, can be minimized by not injecting too superficially and by limiting the volume per site and the frequency of injection (no more often than every four to six weeks).6 Because spontaneous resolution often occurs in patients with alopecia areata, assessing treatment response can be difficult. Intralesional steroids should be discontinued after six months if no improvement has been noted.
Minoxidil (Rogaine). This is an over-the-counter (nonprescription) medication approved for men and women. It comes as a liquid or foam that you rub into your scalp daily. Wash your hands after application. At first it may cause you to shed hair as hair follicles. New hair may be shorter and thinner than previous hair. At least six months of treatment is required to prevent further hair loss and to start hair regrowth. You need to keep applying the medication to retain benefits.
Also, re: the Proscar, I think that it may already be helping some as I think my shedding may be tapering off a bit more. I am losing a few less hairs Per day now. Maybe? I don’t know, but I am trying to stay positive!! I have no real regrowth. Just wisps, extremely fine hair, almost hard to see. Kind of transparent. I am not expecting miracles, but trust me…. THe moment I feel I have any true results to share with you girls, I will definitely be posting them! There aren’t many success stories out here. We need more. I guess people don’t come out here as much if they are experiencing good things w their hair?
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
The trick about all of these hair-loss products and treatments is that they’ll stop working as soon as you stop using them. “They have to be ready for a lifetime commitment,” says Rieder. But, just like brushing your teeth, as long you keep on keeping on with the scientifically proven preventative treatments, those hairs on your head should be just fine.
If a pregnant woman comes in contact with crushed or broken Finasteride tablets, wash the contact area right away with soap and water. If a woman who is pregnant comes into contact with the active ingredient in Finasteride, a healthcare provider should be consulted. If a woman who is pregnant with a male baby swallows or comes in contact with the medicine in Finasteride, the male baby may be born with sex organs that are not normal.
Hi Lisa, hope you were able to speak with your doctor. I also talked at length with my mom and sister and feel a little better. My mom has hair but it is very thin but I forget she has had surgeries and takes a lot of meds for various conditions and she knows this has caused her hair loss. My sister has PCOS and that has made her hair thin out. I had a good appt with my dermatology nurse. She sat and talked with me and listened and was very interested and caring. I cried for about half the visit. She examined my head and does see the thinning but it isn’t consistent for androgentic alopecia and there aren’t any just out of nowhere hairloss in the family (she seemed more concerned with females than male relatives). What I haven’t stated is that I don’t handle stress well, the last time I underwent major stress was with the acne and she thinks it has taken on another form. To be as brief as I can besides taking two night classes, working full time, single mom no help from their dad ( a teen daughter and preteen son!), major stress at work, separated/divorced, financial stress, found out my dad’s prostate cancer came back, aging parents (they can’t take care of things like they used to and I’m living with them and it’s on me now), and just found my ex husband (not my kids’ dad) has lung/brain cancer and we aren’t on speaking terms and we work for the same company, oh yeah and I have new boyfriend. The last of this list happened all this month. I know I haven’t been eating well, and with the constipation if I’m severely stressed it runs right through me, then I know its bad. So she and I decided to go with biotin & a multivitamin, see my PCP she really wants me back on anti anxiety pills, I will still see him but I want to talk to him more at length because it can cause hairloss, we are continuing my 200 mg of aladactone, my orthotricyclen, eat better, I do have regrowth in my bangs. She is very concerned about my mental health (my BFF says to me “how is my ball of nerves today?” that’s how bad I am!). I know I just need to manage it better and talking to her was the first step because she too went through a stress shedding period (I do remember it, it was a year ago) and her hair is coming back in. She said it will come back for me. But for my own psychological health she said for me to get the rogaine foam for men and use it, just so I can see regrowth faster. She said they say not to use if for women because of the pregnancy issue and that isn’t a factor for me. I also had burning and itching but with the use of Nioxin it is better. She also said only wash my hair once a day (I usually do twice), and use low heat for my hair. She is going to see me in three 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
It is perfectly normal for people to shed 50 to 100 hairs per day. This generally doesn't cause noticeable thinning of scalp hair because new hair is growing in at the same time that hair is shedding. However, hair loss occurs when this hair growth cycle and shedding is disrupted or when the hair follicle becomes destroyed and replaced with scar tissue. Female pattern hair loss (androgenetic alopecia) is the most common form of hair loss in women. This occurs gradually and is caused by genetics (from either side of the family), age, and the action of a specific male hormone, dihydrotestosterone (DHT). This hormone is found in lesser amounts in women and it preys on the hair follicles, preventing them from receiving vital nutrients for proper hair follicle growth, leading to the hairs shrinking, and resulting in a shorter lifespan. Interestingly, DHT does not need to be elevated to generate hair loss. Estrogen, when lowered as commonly seen in menopause, creates a change in the ratio of male to female hormones, giving an edge to these male hormones. Compounded with the sensitivity of DHT to the hair follicles, heredity can affect the age at which a woman begins to lose her hair, as well as the rate of hair loss and the extent of baldness.
As the name suggests, androgenetic alopecia involves the action of the hormones called androgens, which are essential for normal male sexual development and have other important functions in both sexes, including sex drive and regulation of hair growth. The condition may be inherited and involve several different genes. It can also result from an underlying endocrine condition, such as overproduction of androgen or an androgen-secreting tumor on the ovary, pituitary, or adrenal gland. In either case, the alopecia is likely related to increased androgen activity. But unlike androgenetic alopecia in men, in women the precise role of androgens is harder to determine. On the chance that an androgen-secreting tumor is involved, it's important to measure androgen levels in women with clear female pattern hair loss.
Alopecia areata is not contagious. It occurs more frequently in people who have affected family members, suggesting heredity may be a factor. Strong evidence of genetic association with increased risk for alopecia areata was found by studying families with two or more affected members. This study identified at least four regions in the genome that are likely to contain these genes. In addition, alopecia areata shares genetic risk factors with other autoimmune diseases, including rheumatoid arthritis, type 1 diabetes, and celiac disease. It may be the only manifestation of celiac disease.
One of the first research studies linking alopecia with celiac disease was published in 1995. Italian doctors had noticed that several of their patients with alopecia also had celiac disease and that in one of these patients—a 14-year-old boy—the missing hair on his scalp and body completely regrew after he adopted a gluten-free diet. This boy's case and a few others prompted the doctors to screen a large group of alopecia patients for celiac disease.
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.
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.
Tinea capitis is a fungal infection of the scalp, usually caused by Microsporum or Trichophyton species of dermatophytes19 (Figure 11). It usually occurs in prepubertal patients. The most severe form of tinea capitis is a kerion, a fluctuant, boggy lesion with overlying hair loss. Tinea capitis can result in widespread hair loss with increased fragility of the hairs and frequent breakage. If fungal infection is suspected, a potassium hydrochloride slide or culture can be obtained. A Wood's lamp fluoresces several types of fungi; however, the most common fungus in the United States (i.e., Trichophyton tonsurans) does not fluoresce, lessening the value of this test. Treatment includes oral antifungal agents such as griseofulvin (Grifulvin), itraconazole (Sporanox), terbinafine (Lamisil), and fluconazole (Diflucan), with the newer agents having fewer side effects.20 Oral steroids may be necessary if a patient has a kerion, to decrease inflammation and potential scarring.
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.
Graccey, you are spot on with the PPD allergy. It is amazing how difficult it is to connect the dots. It took me a year to figure it out. It caused 2 very aggressive cases of TE, my hair is not coming back on it’s own. I have been using Johnson and Johnson baby shampoo (I put one baby aspirin in it to balance the PH level because it is very alkalinity and the baby aspirin is an acid that brings it down, a lot of research to figure that one out too, but I just put the baby aspirin in an ounce of filtered water to dissolve and pour it in the baby shampoo) but anyway it was the only thing I wasn’t sensitive to and yes you are right it is something that continues to progress and makes you sensitive to all chemicals. I went a year without coloring my hair to allow it to rest. And now I will only foil it leaving 1/2″ of roots showing. This has devastated me beyond. I have just started using rogaine and the hairmax comb (for scalp health) I don’t think the comb helps with hair regrowth but it does seems to help with scalp health. It is a miracle I can use rogaine but it does seem to be helping. I use the women’s 2% every other night. Good luck with your regrowth. You are right on with the PPD and I think it is much more common than people think!
And though this treatment appears to be safe and somewhat effective, it’s hard to tell who will react well to this low-level light therapy, which is why the doctors I spoke with were hesitant to fully endorse it. “We’re not sure what the optimal power is, what the optimal wavelength is, we don’t even really know the mechanism of action of how this is working,” says Rieder. Plus, it doesn’t work on everyone. “There are subpopulations of patients who do respond to low-level laser light, but this is not easily predictable,” explains McMichael, though she adds that the risk of using the LaserComb is low.
I too have problem with hair loss. I had seen a dermatologist that charged me $85 just to pull my hair and told me nothing wrong with me. I told her my hair normally fall off a lot when I wash me hair, but she insisted that my hair is healthy. She spent approximately 5 minutes with me. From that experience, I don’t go see anybody else about my hair, bad experience. That was 10 years ago. I am not 43 years old. I just don’t trust the doctors any more. I still have problem with my hair so if any of you know a recommend/good caring doctor(s) in Houston Texas, please let me know. Thank you.
Honestly, for female pattern baldness (what I have) I don’t think there really is any effective treatment — the only hope is learning to cope psychologically. (Just my humble opinion) So I don’t totally “hate” him for not being able to help me medically regarding the hair — but he was such a let down. I really expected more. (he’s an excellent dermatologist, for skin things at least)
I don’t know what ingredients are in the protein shakes; but i believe that you need to eat real food – small amounts of fish, chicken, beef with lots of leafy green and orange vegetables including onions. Drink nettle tea (if you can find it), drink green tea,water and eat pumpkin seeds. In tandem if you may choose to take a Vitamin B complex tablets, if so then choose one which contains inositol, biotin, b5 and b6. Also try taking fish oil tablets (speak to the Trichologist on what quantity to take).
Diffuse female hair thinning and hair loss during premenopausal age is usually not heredity. It is usually caused by hormonal imbalances seeing in PCOS or thyroid disorder, nutritional deficiency (low iron), and stress. Women with PCOS produce high levels of androgens such as testosterones and DHEAS. The ratio of LH and FSH is also more than 2. Make sure you get your sex hormones check if you notice your hair thinning.
I’m so glad I came across this site. I’m 41 and started to lose my hair in Aug 2011. It started out as two bald spots in the back near the hairline. I went to a Dermatologist who started me on steroid injections, Topicort, and hair, skin and nails vitamins. After a few months, they didn’t seem to help. I went to my Internal Medicine md. He ordered all types of blood tests, $4,000 worth, which all but my Vitamin D came back normal. I started a Vitamin D supplement. He suggested I live my life and be happy. I then went to an Integrative Medicine md, who ran more blood tests that came back normal, urine tests that came back normal, and had me do a GI Repair Kit. I even tried going gluten free. I take a multivitamin, Omega 3, B Complex, Vitamin D 10,000 units, and hair, skin and nail Vitamins. I’ve cut out fast food and processed food. Drinking lots of water. Not exercising like I should. I began to gray in my twenties and have been dyeing my hair for years. The Dermatologist told me it didn’t cause the hair loss. I went months without dyeing my hair just to see if it would help. Nothing has helped or stopped my hair loss. I have now lost most of the hair in the back and on the left side over my ear leading to the front. A month a go I noticed a huge bald area on the right side in the front. I have been so depressed and self-conscious about my hair loss. I have been staying in the house and avoiding gatherings for fear of someone noticing. After spending lots of money and not getting any answers, I feel so helpless. I purchased a wig, but since my remaining hair is long and covers the bald areas, I haven’t started wearing it yet. It is a comfort knowing that I’m not the only one going through this. People don’t seem to understand. I know I’m not my hair, and my hair doesn’t make me, but it is a very traumatic thing to go through. I’ve decided to take my Internal Medicine md’s advice and to just live my life. I can’t continue to be depressed over something I can’t control. I wish everyone luck and I will continue to follow.
Speaking of a new style: Don’t choose one that’s so high maintenance that it needs to be heat styled daily—the damage you’ll do with too much hot tool usage can leave strands damaged and fried, and breaking before it can grow to a certain length. Plus, thinner hair tends to break easier, so you want to avoid any extra damage-inducing practices at all costs. Make a conscious effort, too, to brush more gently, and use a moisturizing and reparative hair mask to hydrate hair and nourish the scalp—where hair gets most of its strength.
Minoxidil (Rogaine, generic versions). This drug was initially introduced as a treatment for high blood pressure, but people who took it noticed that they were growing hair in places where they had lost it. Research studies confirmed that minoxidil applied directly to the scalp could stimulate hair growth. As a result of the studies, the FDA originally approved over-the-counter 2% minoxidil to treat hair loss in women. Since then a 5% solution has also become available when a stronger solution is need for a woman's hair loss.
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.
"This is an oral, prescription-only medication with the brand name Propecia that’s also FDA approved to treat hair loss," says Spencer. Male pattern hair loss occurs when a hormone called dihydrotestosterone (DHT) prevents hair follicles from getting the nutrients they need. Finasteride works by blocking the production of DHT, which protects the follicles.
I have been losing my hair over this past year but within the last 6 months it has changed texture and still falling out! Now my hair is very coarse and kinky! For 42 years I had long straight-as-a-board hair and now I look like a poodle! Every time I comb or brush my hair handfuls of hair comes out! My hairdresser, gyno, GP and 3 dermatologists have told me it was normal to lose this amount of hair! Many contribute it aging but I find that hard to believe. Finally, my most recent derm said I was low in iron and said that might be a factor. Now, I’m going in to see if I might be anemic. My gyno ran the same tests and said all seemed normal! It’s the most frustrating and stressful event, especially when everyone tells you things are “normal”! Has anyone experienced their hair texture changing over a short period of time? Thanks-
Each hair develops from a follicle — a narrow pocket in the skin — and goes through three phases of growth. Anagen (A), the active growth phase, lasts two to seven years. Catagen (), the transition phase, lasts about two weeks. During this phase, the hair shaft moves upward toward the skin's surface, and the dermal papilla (the structure that nourishes cells that give rise to hair) begins to separate from the follicle. Telogen (C), the resting phase, lasts around three months and culminates in the shedding of the hair shaft.