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.


I have been trying to deal with thinning hair for the past several years. I am 37 yrs and used to have very thick, lock, curly hair. I am not an arrogant person, but I did love my hair and I thought it was a beautiful feature. My attempts to cover up the hair loss by using Toppik has been somewhat favorable, but it has not been a solution by any means. I tried Rogaine and as a result, I ended up looking like a warewolf with hair growth on my cheeks. (I had to laugh at that sight!) I have been to a dermatologist who recommended Rogaine and ordered expensive labs that my insurance would not cover (I did not follow through with the labs b/c I do not have the money and I did not return to him because I was disappointed in his suggestion for Rogaine with the initial visit.) My endocrinologist (I have hypothyroidism) shrugged off my report of hair loss by saying “it’s not that noticable.” I’ve been to two different nutritionalists and spent hundreds (if not close to a thousand) on supplements. I have new insurance and I’m looking for a new endocrinologist and dermatologist. I was recently diagnosed with fibromyalgia, so I am trying to control my stress level to decrease the pain. At times I feel guilty for being consumed by my insecurities and by the lack of results for my hair regrowth. So many others have much more serious conditions, and I remind myself that the situation could be much worse. I continue with the Toppik applications and I have ordered a topper in case my hair loss worsens. I am afraid that I will embarrass my son and that my boyfriend will not see me as attractive any more. But, I do continue to have faith that the Lord will see us through any trial, and in the end, we will come out stronger. Sometimes I need to vent and get things off my chest, and I don’t have anyone who can relate so this forum is very helpful for me. I thank you all for your stories and I hope that we all find peace and that we do not allow this burden to overcome us. Be encouraged and Be Blessed!
so here i am. i’m ready to try the spiro, alone, especially after reading your posts. i’ve thought of shaving my head, and i may be closer to doing that. i keep my hair in a short bob since it helps not having it knot up when it’s longer, due to its fineness. i try to let it air dry, but blow drying it, upside down, adds volume. plus my curls do not really form anymore because of the texture. i have never counted my lost hairs individually, but i don’t need to have an exact number since just eyeballing what comes out every time i wash, comb, or just touch my hair is stressful enough. it’s hard to be in the sun. we hung out at a garden for Easter yesterday and the sun was burning my scalp. i have tried expensive shampoos, but nothing. i may look in to the toppik. i used to use this bumble and bumble brown hair powder, but since it didn’t quite match my color (it’s only available in three shades) it didn’t look so convincing. the toppik makes more sense since it’s a fibrous material.
I want to first write that I am not a fan of hair transplants for women, I personally think that most women with androgenetic alopecia are NOT candidates for this procedure. Having said that, I get emailed all the time from women looking for a good hair transplant surgeon. If you are deadset on having a consultation, please visit the International Alliance of Hair Restoration Surgeons. The IAHRS (http://www.iahrs.org) is an organization that selectively screens skilled and ethical hair transplant surgeons. Read my thoughts about hair transplants here.

Please help. My hair has always been my pride and joy. I figured since it is pretty damn healthy, it could deal with some bleach damage. And I figured the master stylist who did all the color-corrections would know how much would be too much. I was wrong, and now I want to burst into tears every time I look at my hair or touch it. I just don't know what to do. my hair has also NEVER been shorter than this and it breaks and falls out. What should i do to regrow hair?


Hi, i am only 26 and i’ve been losing so much hair everyday. I used to have a thick and wavy hair, it was shiny as far as i can remember but now my scalp is visible, my hair is kinky and super thin. My friends always ask what happened to my hair and i don’t have aby explaination apart from stress. I haven’t seen any doctor that specialized with hair loss yet but based in the posts that i am seeing i guess there’s no doctor that could tell the root cause of our hair loss problem. I really think i’m too young to be losing all my hair..it’s really depressing that i am losing my self esteem going out with my officemates. After work i would rather go straigth home that entertain there questions about my hair.
I suspect Hypervitaminosis A for my hair loss due to prolonged use of a high dosage of Retin A but I can’t find anyone who will test me. I had a PAINFUL scalp, too sensitive to touch and unbearable itching. I stopped the Retin-A 2 months ago and the scalp pain and a lot of itching stopped a week afterwards. I saw a PCP and 3 derms. All recognized hair loss but shrugged it off as hormonal or a lack of deep conditioning! Please avoid these NYC doctors at all costs:
Thank you all for sharing your stories. I have various health issues including arthritis of the spine, GI problem and Poly ovarian cyst syndrom… I had exetremely thick and full hair all my life 5yrs ago my hair started falling out in huge clumps all day long so much so that I leave huge hair balls under my desk at work… I also have sjordren syn. When I first went to my family doctor he told me it was because of my high stress job… I said that I did research on the internet and that all my conditions were supposed to be linked to hairloss he was mad and said why did I come to him if I had all the answers… I have been to 2 dermos who said its nothing. I went to the only endocrinologist in a 100 plus mile radius of my home who was taking new patients who said that there is nothing wrong with me and that if I cared about my health as much as my hair loss I would loss weight ( I know I not skinny but…) he did not even LOOK at my tests when he came in he said we didnt get your urine samples results back. I said that I went 3 weeks ago. He then said oh here they are… but did not even look at them before his fat comment… since I do not want to swear on here I will just say “jerk”. I cried the whole way home. I went back to my family doc and saw the PA because it seems he is sick of me. Again among other sympt. my hairloss is getting worse… the PA’s answer “yea that’s pretty bad.” (wow I’m paying for this advice ) She brought me back samples and said this should help. it was an anti depressant….I said I am not depressed I am upset that everyone can acknowledge my sympt. but no one seems to be able to help my. My arthritis doctor ran tests only to shut me up and said my folate levels were fine so it had to be stress… not their problem. I came from my 3rd gyno today who said now since my cysts were gone and my test. levels were normal that I can’t have children anyhow then I shouldn’t worry about hairloss… no advice whatsoever about the diease less than 5 mins. $400.00 40 mile trip another day of work gone. This doc. did even think I should be concerned that I cannot get preg. or my pain (so it does not surprise me about the hairloss) I said is there anything else that can cause my hair to fall out besides test. levels he said not gyno related…. He said if you like we can test you again in three more months. I would give up but I know it is not something just in my head or even just a cosmetic problem…. I feel sometimes they just want to milk my insurance dry my running the wrong test so they can keep charge you for the expensive stuff instead of working on a cure for you. The worst maybe is that my family and friends are also sick of me and think I just like attention. From your post I looks like a lot of have similar health and experiences. Although I am very upset I am glad be able to vent to people who also my have be treated like hypocons… and armed me will more info.

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 want to first write that I am not a fan of hair transplants for women, I personally think that most women with androgenetic alopecia are NOT candidates for this procedure. Having said that, I get emailed all the time from women looking for a good hair transplant surgeon. If you are deadset on having a consultation, please visit the International Alliance of Hair Restoration Surgeons. The IAHRS (http://www.iahrs.org) is an organization that selectively screens skilled and ethical hair transplant surgeons. Read my thoughts about hair transplants here.
Alopecia areata is an autoimmune disease, where a person's immune system attacks the body, in this case, the hair follicles. When this happens, the person's hair begins to fall out, often in clumps the size and shape of a quarter. The extent of the hair loss varies; in some cases, it is only in a few spots. In others, the hair loss can be greater. On rare occasions, the person loses all of the hair on his or her head (alopecia areata totalis) or entire body (alopecia areata universalis).
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.
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:
Yes, absolutely. There are certain hair treatments, as well as styles, that can trigger hair loss: tight braids, pigtails, hair weaves, and cornrows can all trigger temporary hair loss called traction alopecia. Chemical relaxers; overuse of chemical colorants; hot-oil treatments; overuse of flat irons, curling irons, or even hot blow-dryers can all damage hair at the root, causing it to fall out. If you are experiencing hair loss, its best to schedule an appointment with our office so that we can help diagnose your issue and determine how best to your hair loss.
Yes, absolutely. There are certain hair treatments, as well as styles, that can trigger hair loss: tight braids, pigtails, hair weaves, and cornrows can all trigger temporary hair loss called traction alopecia. Chemical relaxers; overuse of chemical colorants; hot-oil treatments; overuse of flat irons, curling irons, or even hot blow-dryers can all damage hair at the root, causing it to fall out. If you are experiencing hair loss, its best to schedule an appointment with our office so that we can help diagnose your issue and determine how best to your hair loss. 

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.
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
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!
Dermatologist: The short answer is a doctor who specializes in the diagnosis and treatment of problems related to the skin, its structure, functions, and diseases, as well as its appendages (nails, hair, sweat glands). The longer definition (as defined by wikipedia) Dermatologists are physicians (Medical Doctors, M.D.) or Doctors of Osteopathy (D.O.) specializing in the diagnosis and treatment of diseases and tumors of the skin and its appendages. There are medical and surgical sides to the specialty. Dermatologic surgeons practice skin cancer surgery (including Mohs’ micrographic surgery), laser surgery, photodynamic therapy (PDT) and cosmetic procedures using botulinum toxin (‘Botox’), soft tissue fillers, sclerotherapy and liposuction. Dermatopathologists interpret tissue under the microscope (histopathology). Pediatric dermatologists specialize in the diagnoses and treatment of skin disease in children. Immunodermatologists specialize in the diagnosis and management of skin diseases driven by an altered immune system including blistering (bullous) diseases like pemphigus. In addition, there is a wide range of congenital syndromes managed by dermatologists.
"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.
Moreover, there are so many subtleties in hair restoration surgery that it's important to choose a physician who specializes in the field, not one who has added "hair restoration" to their menu of services along with other cosmetic surgical procedures, and performs a limited number of the procedures per week.  Experience counts, just like anything in life, and there are many of us in the USA who specialize exclusively in hair restoration, and treat only patients with thinning hair.  It's important to meet personally with your surgeon, and have an in-person evaluation, and a micro-analysis of your scalp to receive the highest level of care possible.  
Just found this site today and want to thank everyone who is sharing. I don’t have the words for how devastated I feel about losing my beautiful, beautiful hair. Thank you for the information and fellowship here. I have a wonderful internist, but she hasn’t been able to help, (been dealing with PCOS for 12 years now and severe hair loss since Feb 2008). Will be looking for an endocrinologist and a dermatologist now too. Hope I can give back some day with good news.

Eva if you can look at some of Pilar’s post she mentions in one of them a dr she sees in NYC. She loves her and the dr has done a lot for her. I would say there is no doubt it is the Retin A that has caused your loss, but it is probably Telogen Efflivium which is temporary and the recovery is nothing like they say it is. Especially if your scalp is miserable because there is a lot of inflammation that will need to calm down before everything can reset itself. Please try to find her post where she list the derm she sees. She loves her.
Androgenetic alopecia (AGA), or male-pattern baldness, is hair thinning in an “M”-shaped pattern; hair loss occurs on the temples and crown of the head with sparing of the sides and back5 (Figure 2). This pattern reflects the distribution of androgen-sensitive follicles in most people.6 Starting at puberty, androgens shorten the anagen phase and promote follicular miniaturization, leading to vellus-like hair formation and gradual hair thinning.6
In-office laser light treatments or at-home handheld devices, such as the HairMax LaserComb, supposedly grow new hair by stimulating blood flow to the area (think: an amped-up version of a scalp-stimulating shampoo). Just don’t expect the device to make your noggin go from looking like George Costanza’s to Jerry Seinfeld’s. “These lasers won’t grow any new hair. If anything, they may just help you hang on to some of the hair that you already have a bit longer,” says Dr. Joyce.

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.
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.
Alopecia areata is not contagious.[9] It occurs more frequently in people who have affected family members, suggesting heredity may be a factor.[9] 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.[14] In addition, alopecia areata shares genetic risk factors with other autoimmune diseases, including rheumatoid arthritis, type 1 diabetes, and celiac disease.[3] It may be the only manifestation of celiac disease.[15][16]
Androgenic alopecia, also known as "male pattern baldness" and “female pattern baldness,” can strike younger as well as older people. It's genetic, so having a family history can predict if you might inherit it. In both men and women, it's linked to having an excess of male hormones (androgens) around the hair follicles, which can block hair growth. Women are more likely to develop androgenic alopecia after menopause, when they have fewer female hormones.

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!


As much as 30 percent of women will experience some sort of hair thinning, usually first noticed with age as a skinnier ponytail or a little more visible scalp peeking out. Thick hair screams “youth,” which makes thinning a tough pill to swallow. But there are many ways you can help slow down thinning and hair loss, from eating the right foods to cutting back on stress, even strategically styling your locks. Here, seven ways to stave off hair loss and keep your ‘do looking young and healthy for longer. 
Alopecia areata affects people of all ages including young children. It produces circular patches of hair loss that appear overnight. More patches appear over time and eventually about 5% of people affected lose every hair on their body. This includes eyebrows, eyelashes and even nose hairs. In some people, hair grows back, either in the same place or on a previously unaffected part of the scalp or body.
Clearly, minoxidil is not a miracle drug. While it can produce some new growth of fine hair in some — not all — women, it can't restore the full density of the lost hair. It's not a quick fix, either for hair loss in women . You won't see results until you use the drug for at least two months. The effect often peaks at around four months, but it could take longer, so plan on a trial of six to 12 months. If minoxidil works for you, you'll need to keep using it to maintain those results. If you stop, you'll start to lose hair again.
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.

Hair: It’s a natural part of being a human. But when the temperature climbs, and skin is exposed, it’s one of those things that a good many of us want to control. This week, we’re tackling hairlessness, not just the process of hair removal (electric shavers and ingrown-hair treatments and aesthetician-approved tweezers) but also what to buy when you’re losing your hair, and even how to take care of a Sphynx cat. Here, we’re talking to dermatologists and hair-loss doctors about hair-loss treatments that actually work.
“I think their effectiveness is not as significant as finasteride or minoxidil,” says Dr. Wolfeld, “however, it’s something that can be used quite easily by patients at home. If they use it two or three times a week, I tell them it can help to thicken their hair.” Results can take up to 18 months to show up, so Dr. Wolfeld stresses that patience is a virtue.
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:
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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