Figure 2 is used with permission from Utah Valley Family Practice Residency Program.Figures 3 and 10 are used with permission from the Utah Valley Family Practice Residency Program. Figure 5 is used with permission from Mark Luba, M.D., Good Samaritan Family Practice Residency. Figure 6 is used with permission from Richard Usatine, M.D., UCLA. Figures 9 and 11 are reprinted with permission from the American Academy of Dermatology.
i also have learned that most people are low in their vitamin d levels, which may also contribute to hair loss. i actually had labs done to check for my vitamin d level, by a cardiologist. my heart is fine, thankfully, but she did tell me to take 2000i.u. daily of vitamin d3, specifically. when i researched about it, i found the possible hair connection. so i do take that daily. i will also be buying vitamin b6 and 12 and biotin. and i will research the gut connection because biologically speaking, it makes sense. i will return with another post in a few months and update.
I don’t know in which proportion including diet, all of these things occurred but I believe A-Ret abuse was a large part of it as evidenced by blood tests taken by my PCP which I was never able to get re-evaluated due to doctor apathy. My sister is experiencing an unrelated bout of hair loss concentrated at her crown and feels hopeless. I’m sending her to this board and to all of your suggestions right away. My problem seems to have subsided but I’m remaining only optimistically cautious and still very vigilant about monitoring hair loss. Thank you everyone again for contributing to this board.
Loss of hair from the eyelashes could be caused by an underlying medical condition—or from pulling at your lashes (e.g. from curling lashes, from glues used for false lashes, and from tugging to remove mascara or false lashes). Whatever the reason, we regularly treat thinning lashes by prescribing Latisse®—the first, and only, FDA-approved treatment for thinning lashes. Our patients have reported excellent results (fuller, longer, darker lashes) with this cream. (Note: if you wear contact lenses, you can use Latisse®; you just need to remove the contact lenses before application and re-insert them at least 15 minutes after applying.) Just contact our office to speak with one of DR.DENNIS GROSS about whether Latisse® is right for you. Also important to note: Latisse® is currently in clinical trials as a treatment for hair loss on the scalp. It could be available for this use within the next couple of years.

Lisa, don’t know if you are out there and reading this but I called my dermatology office today. I have worked with them since about 2003/2004 when I had severe cystic acne (it is about as bad as hair loss in dealing with it) and together the nurse and I were successful. I have hope, I got in to see her tomorrow and I’m taking all the meds/vitamins I am taking. Call Arizona Skin & Cancer Institute, they are in Chandler AZ right by Chandler Regional. I’ve been in tears all day because a clump came out. I thank God for my beautiful children who were there for me through the acne and my mom. You just listen to me talk about what I am going through. Getting through work was hard today. Anyway, Lisa call them and try to get in. I don’t know if I will have success but I’ve done a lot a research and I know what to ask. I did look up symptoms of protein deficiency – strange I had great hair in October 07 and my nails were really hard and now they are brittle and breaking and my hair is falling, I also went through a couple of weeks of this werid swelling of my arms, legs, feet, hands in April. And have been constipated, and my running isn’t giving me the usual firm legs, all signs of not enough protein. Maybe I’m grasping at straws but anyway…hope you are doing ok.


I have used Rogaine (5% – the real risk is if your pregnant, or trying to get pregnant. I didn’t think there was a point to taking “women” rogaine which is a 2% solution). You can buy this in sam’s club with no prescription. I think it may have caused some stabilization but it was hard for me to use it because it would make my hair oily and the thinning would appear worse. So I use it randomly and not twice a day as it should be used.
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.

Hi,this is really tough for me and I don’t know what to say. I have always lost a lot of hair but I had a ton of hair. However,my mom commented that she noticed that it has thinned out more than usual and it has. And today, I just took picture of the top of my head and see a spot. Like you Lisa, I am completely freaked out, I am two weeks away from my 34th birthday. Sorry, Lisa I don’t know of any doctors except for my dermatologist that I am calling tomorrow and I found an endocrinologist through United Healthcare that I will call. I’m so upset that the crying just won’t stop. What worries me is that I’ve been on aladactone for about a year for acne (but was only at 50 mg) BUT she did up the dosage about 5 months ago (but only consistently take at the 200 mg for 3 months). But my fear is that the aladactone didn’t help prevent it for me. But the thinning out has been noticeable since about May/June of this year so maybe there is hope. Now, I have to put in there I went through a very stressful period from March until now. And had a rapid weight loss of 35 pounds (went from 168 to 133) and I’ve been doing a lot of running. But my concern is my sister has female pattern balding and so does my mom so I am very worried. My sister said the doctor said to up her protein and get super b-12 complex which I started two weeks ago, my sister said she has seen some regrowth. Today, I went and got biotin, magnesium and iron. And bought Nioxin shampoo as i heard it help give the appearance of more hair. I am calling the doctors tomorrow in hopes that it really was just my rapid weight loss, I have to admit I was under a lot of stress and barely eating, I’m eating better now though but again it runs in my family and I am completely freaked out. Lisa if I have any success I will let you know who my doctors were. Know that I too, live in Phoenix and am going through the same thing. It is hard, now I am afraid my boyfriend will leave me. Keep faith.
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. 

Ludwig Scale: This is the most common classification for female pattern hair loss. There are 3 stages (ranging from mild hair loss to extensive, severe widespread thinning) and in each stage hair loss occurs on the front and top of the scalp with relative preservation of the frontal hairline. Regardless of the extent of hair loss, only women with stable hair on the back and sides of the scalp are candidates for hair transplant surgery.
Leprosy (Hansen's disease) is a disfiguring disease caused by infection with Mycobacterium leprae bacteria. The disease is spread from person to person through nasal secretions or droplets. Symptoms and signs of leprosy include numbness, loss of temperature sensation, painless ulcers, eye damage, loss of digits, and facial disfigurement. Leprosy is treated with antibiotics and the dosage and length of time of administration depends upon which form of leprosy the patient has.
Figure 2 is used with permission from Utah Valley Family Practice Residency Program.Figures 3 and 10 are used with permission from the Utah Valley Family Practice Residency Program. Figure 5 is used with permission from Mark Luba, M.D., Good Samaritan Family Practice Residency. Figure 6 is used with permission from Richard Usatine, M.D., UCLA. Figures 9 and 11 are reprinted with permission from the American Academy of Dermatology. 

Evaluating and treating hair loss (alopecia) is an important part of primary care, yet many physicians find it complex and confusing. Hair loss affects men and women of all ages and frequently has significant social and psychologic consequences. This article reviews the physiology of normal hair growth, common causes of hair loss, and treatments currently available for alopecia.

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.


I’ve been to one Endocrinologist, probably 5 Dermatologists, and a Trichologist for my hair loss. I agree that you will probably need more than one doctor to get to the bottom of the cause of your hair loss. I wasn’t really happy with any of the doctors I saw (which is why I kept finding new Dermatologists). I even went to a Dermatologist “specialist” in hair loss at UCLA, and he just said I had TE and told me I could try Rogaine to jump-start my re-growth, but otherwise he had no suggestions. I think the most valuable visit I had was to a Trichologist, because he was the most caring and had the greatest knowledge about hair loss. He, along with some of the Derms, told me I had TE, and no miniaturization.
Finally people who understands what I am going through …I am in a desperate search for doctors in the Miami/Boca Raton, Florida area. Can anyone help? I dont know yet what has been causing my hair loss…I had been loosing some hair throighout the years, and sometimes it gets lees severe but lately has just gotten worse and there is no stopping it seems. I had mt Tyroid checked by PCP a coulpe months ago and my iron level also looked normal …getting desperate. Would appreciate some help.

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!

Almost all hair loss in guys results from male-pattern baldness, a genetic trait that comes from your parents. Other causes include certain medications, too much vitamin A, or not enough protein. Illness or stress can lead to sudden, heavy shedding called telogen effluvium. Good news, though: Hair loss that isn’t from male-pattern baldness often reverses itself.
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? 

Have you experienced anything dramatic? Car wreck? Tremendous unusual stress? Are you on Birth Control? Did you stop? Did you dye your hair? I believe the arrhythmia is due to anxiety but you may want to go to the doctor for that. All of these questions may answer the problem. There is a condition called telogen efflivium (it is a temporary condition) and will run it’s course for 3-9 months no one knows the exact length. All we do know is that there is nothing to stop it. You are wise to not start rogaine but you really need to look into these questions. And if your answers are all No. Go to another dermatologist and voice your concerns. Ask for all the blood tests related to hair loss do a scalp biopsy get to the bottom of it. Find out if it is temporary and if it is let it run it’s course and do whatever you can to not stress. Then if it is more than that get into action and start treatment because the sooner you treat it the better the results. Hair loss is not cookie cutter there is no one answer for all of us at this time. I wish you the absolute best.
If you find yourself snacking at night before bed, it may be because you're bored or anxious — not truly hungry — and eating makes you feel better. Try eating a healthy dinner a bit later in the evening. If your stomach is truly growling before bed, try a protein-based snack like a hard-boiled egg or a slice of cheese. A few spoonfuls of yogurt or some fruit is another good option. 
My daughter is 17 and has had significant hair loss over the past 4 years. It has really made her self conscience and depressed. We have been to dermatologists that have done scalp biopsies , natural doctors for herbs, etc. Does anyone know of a really good dermatologist that specializes in hair loss and is knowledgable about immune disorders? We live in St Louis, but are willing to travel for help.
Typical first symptoms of alopecia areata are small bald patches. The underlying skin is unscarred and looks superficially normal. Although these patches can take many shapes, they are usually round or oval.[6] Alopecia areata most often affects the scalp and beard, but may occur on any part of the body with hair.[7] Different areas of the skin may exhibit hair loss and regrowth at the same time. The disease may also go into remission for a time, or may be permanent. It is common in children.

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]

for the next 10 years i dealt with it. noticing my hair getting thinner with every passing year. a quick side note, my father is bald and my mother has always had beautiful, thick wavy locks. taking in to account that the supposed gene for hair is carried maternally, i was confused because my maternal grandmother who passed at age 86 had the most abundant set of thick hair i’d ever seen. it just didn’t make sense to me and only served to depress me more. my mother has since developed traction alopecia, due to her pulling her hair tightly back daily, for work, for years. she has since kept her hair short, but mine looks worse. back to where i left off. at 34 i decided to go to one of the hair restoration places. they took pictures and walked me through the process. it was an odd place, though. small, small place. one guy. said i was a good candidate. he showed me pictures of what my hair loss would possibly look like in another 10 years. i started sobbing. it felt more like a scare tactic than anything so i left, and decided against it, for the time being. still haven’t gone back.


With those pinned down, it wasn’t hard to determine which don’t actually work. Pretty much all the “active” ingredients listed in ineffective treatments — from biotin and zinc to emu oil and saw palmetto — have never been proven, and are instead marketed based on logical-seeming correlations. It would make sense that biotin, a B vitamin readily found in hair, skin, and nails, could help hair grow more quickly. And caffeine is a stimulant that works in coffee, so rubbing some on your scalp might wake some of those sleepy follicles… right?

“There’s people selling pills and creams and lotions and whatever else, and sometimes you can’t even trust what ingredients they have in there,” he warned us when we spoke to him over the phone. Key takeaway: The hair loss industry is crazy dishonest, so we eliminated any treatments (especially homeopathic methods) that aren’t based in concrete, peer-reviewed science.

Alopecia areata typically causes a few temporary bald patches on the scalp. It tends to run in families and often strikes in childhood. The hair loss seems to be part of an immune system problem, in which the body's natural defences mistakenly attack its own tissue. Once the hair has fallen out in certain spots, new growth is suppressed for weeks or months. This type of alopecia sometimes affects people who have other "autoimmune" diseases like thyroid disease, lupus, or pernicious anemia. Sometimes, it may produce complete scalp baldness (alopecia totalis) or total loss of body hair (alopecia universalis).
One is how much emphasis the company places on compliance, the major stumbling block in the efficacy of any treatment, said Dr. Senna, an author of studies on the subject. Prospective users are questioned about their ability to stick to a regimen because the extract must be applied every day, and they are told that the more conscientious they are, the better. Users are also reminded and encouraged with regular check-ins.

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."
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.
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.
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