Finasteride inhibits 5α-reductase type 2, resulting in a significant decrease in dihydrotestosterone (DHT) levels.6 Studies have shown that, compared with placebo, 1 mg per day of finasteride slows hair loss and increases hair growth in men.6,7,9 Dosages as low as 0.2 mg per day result in decreased scalp and serum DHT levels in men, although the DHT levels may not correlate clinically with changes in hair loss.10
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 most common cause of hair loss in both men and women is androgenetic alopecia, which is genetic pattern hair loss,” explains Dr. Michael B. Wolfeld, a board-certified plastic surgeon and an assistant clinical professor of plastic surgery at the Icahn School of Medicine at Mount Sinai Hospital in New York. The root cause of this type of hair loss is dihydrotestosterone (DHT), a byproduct of testosterone that shrinks certain hair follicles until they eventually stop producing hair.
Diphencyprone (DPCP): This medicine is applied to the bald skin. It causes a small allergic reaction. When the reaction occurs, a patient has redness, swelling, and itching. Dermatologists believe this allergic reaction tricks the immune system, causing it to send white blood cells to the surface of the scalp. This fights the inflammation. It also prevents the hair follicles from going to sleep, and causing the hair loss.

Sinclair Scale: The 5-point Sinclair Scale is a modified visual grading scale. Grade 1 is normal. This pattern is found in all girls prior to puberty, but in only half of women age 80 or over. Grade 2 shows a widening of the central part. Grade 3 shows a widening of the central part and thinning of the hair on either side of the central part. Grade 4 reveals the emergence of diffuse hair loss over the top of the scalp. Grade 5 indicates advanced hair loss. This grade is uncommon, occurring in less than 1% of women.


There is really sadness in my soul today. It is just like I’m constantly searching for hair with no answer in sight. I’m just having a really bad day and want to feel better about this situation. I keep reminding my self it is not an arm or leg or foot or hand I can continue in life without physical limitations. I have my sight and hearing and senses. And health but stress is really affecting. I’ve have been working out so hard just trying to relish in that. I am slim and feel good in my clothes. I just keep reminding myself of all these wonderful blessings but I have sadness in my soul. I miss my hair more than I can even put into words. I miss it I miss it I miss it I miss it. Just feel desperate today. I wish I could just touch it and feel the density I once had. I just had to write and get this off my chest. Why are there no answers? Why? Why can’t this be fixed without horrific side affects and a lifelong commitment to drugs and potions! I miss my hair. I miss who I was 2 years. That person no longer exists. And I miss her. I miss the way I use to look forward to getting up and not knowing what was in store but whatever happened I could tackle and handle. But not now I crumble I’m intimidated, I’m insecure, I’m hesitant, I’m preoccupied, I’m hurt, I’m damaged, I’m a shell of the person I used to be.
Hi there.. I to am experiencing hair loss.. lots of it.. Doesn’t even feel like hair.. and my scalp hurts.. almost like a throbbing.. I have leukemia and have had since 2005 but doesn’t appear to present a problem. I’ve had trouble a couple of times in the past few years due to stress (lost a sister in a car wreck) but my hair got healthy again. This time around there has been no stress.. I was low in B12 (261), however, I’ve been getting shots and its up to 450. They’ve ruled out thyroid.. Any ideas what else it could be and how I should move forward in figuring it out? I’m very anxious.. I’ve always had long very thick coarse hair but always healthy.. now it looks limp and always feels dirty..
Anti-androgens. Androgens include testosterone and other "male" hormones, which can accelerate hair loss in women. Some women who don't respond to minoxidil may benefit from the addition of the anti-androgen drug spironolactone (Aldactone) for treatment of androgenic alopecia. This is especially true for women with polycystic ovary syndrome (PCOS) because they tend to make excess androgens. Doctors will usually prescribe spironolactone together with an oral contraceptive for women of reproductive age. (A woman taking one of these drugs should not become pregnant because they can cause genital abnormalities in a male fetus.) Possible side effects include weight gain, loss of libido, depression, and fatigue.
My current solution is this : I have bought clip in hair extensions from Sally’s Beauty Supply store (about 100$) I actually just trim them myself and dye the hair left on my head and the extensions using an ammonia free hair dye (L’oreal or Garnier) in order for them to blend. I use a lot of root lifter and fill in the balding spots with Toppik (dark brown) and top it off with a shine spray. I’m telling you, most people have NO clue of my problem. I feel this is the best way to feel like a woman as I continue on this quest to solve my hair loss problem. I’d be happy to tell more of you about the regimine … high maintenance yes, but you know what, we all have to do what we need to do.
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.
I have not heard anyone talk about the “HairClub” use to be a center called the “Hair Club for Men” but now seems to also be catering to women. I had a consultation last week and the consultant looked at my scalp with an instrument that showed my scalp on a screen, she performed a microscopic hair and scalp analysis. Of course I really needed to see my scalp magnified a trillion times and seeing both thick and thin hair and of course all the empty spots where hairs use to be. She was very informative and showed me the cycle of healthy hair and also the ones that are not and how they thin and eventually fall out and the hair follicle closing. Their pamphlet show women with different stages of hair lost, from patches to almost bald. She explained that there was hope and that with a yearlong regiment of going once a month and having my scalp treated with their products and some sort of scalp stimulation I can get my hair back. Of course this comes at a price, almost 3k for the year. She did say that the monthly regiment will include hair styling as well. woohooo. Anyways I want to know if anyone has been to one of these Hair club facilities and if they have had any success with the personalized program without having to resort to surgery. My prayers go out to all of you.
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.
There are many potential causes of hair loss in women , including medical conditions, medications, and physical or emotional stress. If you notice unusual hair loss of any kind, it's important to see your primary care provider or a dermatologist, to determine the cause and appropriate treatment. You may also want to ask your clinician for a referral to a therapist or support group to address emotional difficulties. Hair loss in women can be frustrating, but recent years have seen an increase in resources for coping with the problem.

Brushing your hair every morning about 30 mins and evening about the same duration of time with rounded tip hair-brush, will do recondition your scalp with better blood circulations. Do not use comb, it will damage your scalp. Also take hair supplements/vitamins. Believeth or not, ladies still flirting on me, even-though I’m in my mid 40s with lots of hair. 🙂
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:
Current evidence suggests that alopecia areata is caused by an abnormality in the immune system that damages hair follicles. This particular abnormality leads to autoimmunity, a misguided immune system that tends to attack its own body. As a result, the immune system attacks particular tissues of the body. In alopecia areata, for unknown reasons, the body's own immune system attacks the hair follicles and disrupts normal hair formation. Biopsies of affected skin show immune lymphocytes penetrating into the hair bulb of the hair follicles. Alopecia areata is occasionally associated with other autoimmune conditions such as thyroid disease, vitiligo, lupus, rheumatoid arthritis, and ulcerative colitis. The diagnosis or treatment of these diseases is unlikely to affect the course of alopecia areata. Sometimes, alopecia areata occurs within family members, suggesting a role of genes.
Anti-androgens. Androgens include testosterone and other "male" hormones, which can accelerate hair loss in women. Some women who don't respond to minoxidil may benefit from the addition of the anti-androgen drug spironolactone (Aldactone) for treatment of androgenic alopecia. This is especially true for women with polycystic ovary syndrome (PCOS) because they tend to make excess androgens. Doctors will usually prescribe spironolactone together with an oral contraceptive for women of reproductive age. (A woman taking one of these drugs should not become pregnant because they can cause genital abnormalities in a male fetus.) Possible side effects include weight gain, loss of libido, depression, and fatigue.
"Firstly, even the very good ones won’t get to the root of the issue - pardon the pun - and prevent or treat male or female pattern baldness which is caused by genetics, nor deal with hormonal issues at the heart of female hair loss. But they can help make the hair you do have stronger and healthier. And they can be useful in putting a hair loss regime in place, along with medication like Minoxidil or Finasteride and/ or a hair transplant.
I’m typing on my iPad so forgive the many mistakes I will make. Thank you so much fornrplying I’ve been wondering where u and Pilar are. And good for u for not visiting. Ive had my moments where I can stay away and eve feel good. I had all of my extensions removed and I think it has affected the way I feel. But bit feels so good for them to be gone! And in all honesty my hair is in even better shape than it was before I got them. My ends are not as wispy as they were. I wore them for two months and they really made me feel better but I could never wash my hair like I wanted and every time my husband touched my head he said when are u going to get these out! Anyway I’ve felt not as good since I had them removed. I like to hibernate but my husband is a social butterfly; I use to be……but we All know how this changes you! Please please let me know how the propecia works. If there are any side affects, etc….like weight gain, moodiness, gloating etc…..there is a lady bin our office on spire and I have been reading the horrific side affects it has and I’m wondering about propecia. I hope u r doing really good. U sounded really strong in ur post and I’m glad. And yes I am deeply depresses over this. I would so get a hair system but my husband is soooooo anti fake anything. Which drives me crazy. I just want to feel better. Have a blessed nite and thank u. Please keep in touch and thank u for replying I felt I would hear from u. Have u spoken to the doc since u ve been on pro?
Most people naturally shed about 50 to 100 hairs a day, but sometimes men and women can shed much more, leading to thinning hair, hair loss, and over time, baldness. The causes of this hair loss can be a result of hormones, underlying medical conditions, and even certain medications like antidepressants, high-blood pressure medications, and NSAIDS (non-steroidal anti-inflammatory medications). Sometimes, hair loss is purely genetic and can run in families.

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: 

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.
If you do decide to start treatment to save your hair, a good place to start is with minoxidil, more commonly known as Rogaine. Don’t expect this hair-loss treatment to create luscious locks; minoxidil is better at slowing down or preventing more loss rather than promoting hair growth. But, according to Dr. Amy McMichael, professor and chair of Wake Forest Baptist Medical Center’s Department of Dermatology, it is effective “if used as recommended, with evidence of improvement seen around six to nine months.” Simply massage the foam or solution into your scalp once or twice daily, and for best results, use a formula with 5 percent concentration.
I’m going to see an endocrinologist, a trichologist, a hematologist and a gastroenterologist and maybe this Dr. Redmond. I’m done with ‘hair loss experts’ pushing cosmetic surgery and trying the all around approach. My insurance is crap, but….Anyway, thanks all for your stories and knowing I’m not alone in hair loss and the fight against disinterested medical establishment. xxx
Thank you all for sharing, For the pass years I have been having hair loss on and off. I have tried several natural treatment, example : hot oil , moist heat, acupuncture. Have seen several doctors and specialists which cost me thousands of dollars. I have insurance, but they will not accept, because they will not get pay, it is experimental my insurance paid for my lab tests. at this time my diagnosis is hypothyroidism. I am using organic foods, juicing; sunflowers seeds , pumpkin seed to make smoothie and oils from doTerra to massage my scalp. trying vitamins etc. etc. I cannot pinpoint what makes the improvement because I have used
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.
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.
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.
Oops forgot to mention also went to Dermatologist who said it is probably just stress related but I really don’t stress ever. I am going back for a scalp biopsy just to be sure nothing going on there. I did lose 12 kg over a 15 week period last year (ending about May – hair loss started in July) but it was done properly eating well and just increasing my exercise level so not sure if this is related other than that I am totally lost as to why I am BALD.
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?
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.
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:
Duke’s dermatologists diagnose and treat hair disorders, such as hair loss (alopecia), excessive hairiness (hirsutism), and abnormal hair growth (hypertrichosis). We understand that abnormal hair growth can be distressing and affect your self confidence. We work closely with you to diagnose the cause of your condition, and develop a personalized treatment plan that meets your medical needs, improves your condition, and helps you regain a positive self-image.
PCOS or Polycystic ovary syndrome is an imbalance in male and female sex hormones. An excess of androgens can cause ovarian cysts, higher risk of diabetes, weight gain, changes in menstrual period infertility and also hair thinning. Because male hormones are over-represented in polycystic ovary syndrome, women may also experience more hair on their body and face.
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.
If you have hair loss, you have options, like topical treatments, oral medications, red light procedures, to prevent more hair loss.   But, Curtis says,  "The only way to guarantee hair is the transplant."    She says once you find out what's causing hair loss, you and your doctor can decide how aggressively you want to approach the problem.   She says, "I say to patients, 'Here's what we can do to prevent further loss...'  If you say, 'Dr. Curtis, I want hair." Here's what we have to do, we're going to move it from the back to the front, nobody will know, it will look fantastic."
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?
Some of the skin disorders like lupus and sarcoidosis can cause hair loss. In case of lupus, the hair tends to get brittle and may fall out in patches. Lupus hairs or short, broken hairs usually appear above the forehead. Hair loss is not permanent in general here. Some individuals with lupus also develop a form of lupus known as discoid or cutaneous lupus that affects the skin. Scars that sometimes develop on the skin of the scalp may lead to hair loss.
The main symptom of alopecia areata is hair loss. Hair usually falls out in small patches on the scalp. These patches are often several centimeters or less. Hair loss might also occur on other parts of the face, like the eyebrows, eyelashes, and beard, as well as other parts of the body. Some people lose hair in a few places. Others lose it in a lot of spots.
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“If you don’t want a scar because you like to wear your hair short, you might opt for a “scarless” hair transplant,” says Dr. Joyce. Also known as follicular unit extraction (FUE), grafts are harvested one at a time with tiny punches that heal virtually undetected so you can still buzz your head. “If you’ve gone so bald that you don’t have a lot of donor hair on your head, we can do FUE extractions with body hair such as on your chest, stomach, back, and sometimes even the pubic area,” says Dr. Joyce.
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.
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