A directed history and physical examination usually uncover the etiology of hair loss. The history should focus on when the hair loss started; whether it was gradual or involved “handfuls” of hair; and if any physical, mental, or emotional stressors occurred within the previous three to six months3  (Table 1). Determining whether the patient is complaining of hair thinning (i.e., gradually more scalp appears) or hair shedding (i.e., large quantities of hair falling out) may clarify the etiology of the hair loss.4
Alopecia areata is believed to be an autoimmune disease resulting from a breach in the immune privilege of the hair follicles.[4] Risk factors include a family history of the condition.[2] Among identical twins if one is affected the other has about a 50% chance of also being affected.[2] The underlying mechanism involves failure by the body to recognize its own cells with subsequent immune mediated destruction of the hair follicle.[2] 

I am 31; as a child I had beautiful brown smooth hair with a hint of a wave. As soon as I hit puberty at 13 (1st period on my 13th b-day), my hair turned wavier. Same year, I remember looking down on my legs horrified at the hair I had developed. Only 1 thought came to me: “NOT NORMAL!” Body hair on women is a tricky subject, though, with media heavily influencing what’s considered ‘normal’. My mom, similarly hairy, just told me it’s genetic and normal.

In either sex, hair loss from androgenetic alopecia occurs because of a genetically determined shortening of anagen, a hair's growing phase, and a lengthening of the time between the shedding of a hair and the start of a new anagen phase. (See "Life cycle of a hair.") That means it takes longer for hair to start growing back after it is shed in the course of the normal growth cycle. The hair follicle itself also changes, shrinking and producing a shorter, thinner hair shaft — a process called "follicular miniaturization." As a result, thicker, pigmented, longer-lived "terminal" hairs are replaced by shorter, thinner, non-pigmented hairs called "vellus."


My dermatologist recently prescribed 100 mg spironolactone for a month and told me to increase the dose to 200 mg after that. He also told me to use Rogaine for men. The Rogaine instructs that it not be used in the front of the scalp (where a lot of my hair loss is) but to only use it on the crown of the head. Can I safetly use it in front? Also, how do you deal w/ putting foam on your head 2 xs a day? My hair is thin with no body. If I add foam I’ll need to restyle it. Am I missing something? I don’t mind taking a pill but the Rogaine has me freaked so I haven’t started it. Any suggestions? I’m having a hard time thinking of using Rogaine the rest of my life.
I’m interested in what took place 4 months before the onset of your hair loss (and others with telogen effluvium). For me, it has always been either a baby born or a course of antibiotics. Oral birth control can also cause a sudden change in the gut flora–as can pretty much any medication. Staph infections are another connection I think should be pursued. Some women don’t know they’re colonized with Staph but they constantly have dry, cracked (mild or severe) sores in their noses.
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:
SOURCES: George Cotsarelis, MD, director, Hair and Scalp Clinic, University of Pennsylvania School of Medicine, Philadelphia. Andrew Kaufman, MD, assistant professor, department of dermatology, University of California, Los Angeles; medical director, Center for Dermatology Care, Thousand Oaks, Calif. Tom Barrows, PhD, director of product development, Aderans Research Institute Inc., Atlanta. Cotsarelis, G. and Millar, S.E. Trends in Molecular Medicine, July 2001; vol 7: pp 293-301. American Society for Dermatologic Surgery web site. American Academy of Facial and Reconstructive Plastic Surgery web site. American Hair Loss Council web site. Springer, K. American Family Physician, July 1, 2003; vol 68: pp 93-102. Hair Loss Help web site, "Interview with Dr. Ken Washenik from Bosley." Fuchs, E. Developmental Cell, July 2001: vol 1: pp 13-25.

Bald spots, thinning, and breakage can be symptoms of a serious underlying health condition such as alopecia, lupus, thyroid issues, and other common types of disease that cause hair loss. If you have noticed a dramatic increase in shedding or other change in the appearance of your hair, Drs. Robert J. Dorin and Robert H. True can help. During an evaluation at one of our offices in New York, New Jersey, or Boston, we can discuss your options and provide you with solutions to restore your appearance and confidence.
Alopecia areata tends to occur most often in adults 30 to 60 years of age. However, it can also affect older individuals and, rarely, young children. Alopecia areata is not contagious. It should be distinguished from hair shedding that may occur following the discontinuation of hormonal estrogen and progesterone therapies for birth control or the hair shedding associated with the end of pregnancy. There are a number of treatable conditions that could be confused with alopecia areata.

in between all these years, i also tried some homeopathic methods. i read dr. andrew weil’s book on health and used to take 2000mg of alpha-linolenic acid either by evening primrose oil, grapeseed oil or borage oil. it didn’t regrow my hair but i do feel that it helped stall it. only problem is that after a year or so it stopped working for me, but it may help some of you out. there’s a connection, according to dr. weil, between alpha-linolenic acid and hair. i’ve also used homemade rosemary water and washed my hair with it, but it only helps with making me smell like the bush it comes from.
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.
I do not believe birth control pills nor rogaine to be an appropriate long lasting answer for hair loss. I do not want to be on drugs for a length of time. Luckily, I have researched how the answer possibly lies within your lifestyle. What you eat, How much you exercise, how much sleep you get and stress you have. As for hormone-caused hair loss, the adrenal gland produces a 1/4 tsp of hormones per year. If you go slightly under or over that amount, a hormone imbalance is the result. If you use table salt, or are on a low-salt diet…you may be negatively affecting your hormones.
The characteristic finding of alopecia areata is one or more well-circumscribed areas of otherwise normal, hairless skin in hair-bearing areas. Occasionally, it may be necessary to biopsy the scalp to confirm the diagnosis. Other findings that may be helpful are the appearance of short hairs that presumably represent fractured hairs, short thin hairs, and gray hair growing in a bald area. Other causes of hair loss are generally excluded from the consideration by history and clinical evaluation.
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-
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