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.
Each follicle produces hair for 2 to 6 years and then takes a break for several months. While the hair follicle is in its rest phase, the hair falls out. There are around 100,000 follicles on the scalp, but because each follicle rests at a different time and others produce hairs, hair loss is usually unnoticeable. More noticeable hair loss occurs when there is a disruption to the growth and shedding cycle, or if the hair follicle is obliterated and replaced with scar tissue.
I also suspect, as you suggest, that the trichodynia is a result of rapid hair loss. I share your frustrations with how very little we dermatologists know on the subject. The only observational study on Trichodynia and chronic telogen effluvium involved only 8 patients. Only one of those eight went on to have androgenetic, permanent hair loss. The numbers followed is pathetic!
Alopecia areata is characterized by a localized area of complete hair loss (Figure 5). This may extend to the entire scalp (alopecia totalis) or the entire body (alopecia universalis)12,13 (Figure 6). Alopecia areata is probably secondary to an autoimmune reaction involving antibody, T-cell, and cytokine-mediated losses.14–16 The trait appears to be polygenic, affecting 0.1 to 0.2 percent of the population, with men and women equally affected.14 On microscopic evaluation, “exclamation-point” hairs are found, in which the proximal hair shaft has thinned but the distal portion remains of normal caliber (Figure 7). Spontaneous recovery usually occurs within six to 12 months, with hair in areas of re-growth often being pigmented differently.1,13 Prognosis is not as good if the condition persists longer than one year, worsens, or begins before puberty. Persons with a family history of the disorder, atopy, or Down syndrome also have a poorer prognosis.1 The recurrence rate is 30 percent, and recurrence usually affects the initial area of involvement.12 Thyroid abnormalities, vitiligo, and pernicious anemia frequently accompany alopecia areata.1,12,14

Thank you for all your post. My daughter had extremely thick hair about eight years ago. It was so thick you could barely put it in a scrunchie. Her hair has been continuously thinning to the point that you can see through it. All the women in my family on both sides have extremely thick hair. We live in the north east and have seen several GP and a Dermatologist who act like there is nothing wrong. I work in the medical field and when I hear this I get so mad because I feel like they want to just brush of like no big deal. It is a big deal to all women no matter what ages. I have written done some of the post advise and will continue to look for an endocrinologist for her. Please keep me postes on any new developements.
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.
You can buy minoxidil over the counter, for about $25 for a three-month supply. But you’ll also need to invest some patience. Minoxidil can take six months or even a year to work. Dr. Avram estimates that the drug, which must be applied twice a day, stops hair loss in 80 percent of the women who use it properly and it can actually stimulate hair regrowth in about half the users.

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.


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).
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.
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.
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.

The complex actions of genetics, DHT, shifting of hormone ratios and age-related volume loss can commonly occur in women in their 40’s and 50’s. However, just like in men, genetic hair loss can appear at all ages after puberty.  In fact, hair loss occurs with relatively high frequency even in women in their 20’s and 30’s. The majority of women with female pattern hair loss initially develop diffuse thinning over the front and top of the scalp, while maintaining the frontal hairline. This thinning may present with a widening through the central part line while others may present initially with either episodic or continuous hair shedding, prior to any noticeable decrease in hair volume. In addition, thinning may also be seen throughout the scalp, including the temple areas as well as the back and sides.

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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.

I have had thin, fine and ugly hair since I had a hysterectomy in my 20’s. I am 73 now. My mother had very sad hair as did my grandmother. My hair was thick and good until my surgery. I went to 3 dermatologists and they seemed almost embarrassed to look at my hair. I have tried men’s Rogaine but do not see any improvement. I take lots of vitamins and health aids but they don’t seem to help. I also take Premarin and blood pressure meds which may add to the problem. I wear a hair piece which clips into my hair and the lower back and sides and bangs are my real hair. It all mixes together. It is human hair and has a mono scalp which has a part and looks real. It is not a perfect solution but helps me go in public. As you can tell I have pretty much given up on a good solution and from reading what everyone has to say I am afraid that some of us are just destined to have bad hair.

There are many different potential causes of alopecia. Hair loss - temporary or permanent - can be triggered by any number of factors. These can include allergies, irritants, toxins, burns, injuries, and infections. We also know that certain medications (especially anabolic steroids), chronic kidney failure, radiation, and chemotherapy can cause hair to fall out. Sometimes, hair loss may be due to a vitamin A overdose, iron deficiency anemia, a malfunctioning thyroid gland, fever, hormonal imbalances, or pregnancy.
I got really sick at the age 40, 2 years after my second child was born,I started losing weight,I went from 54kg down to 47kg,my skin was splitting on the backs of my legs,both my hands,I had blisters up my arms ,on the tops of my feet,migraines that would have me vomiting none stop for ten hours,then only to sleep for 2 days to recover,no doctors were interested,I saw 8 and they all wanted me on anxiety medication because I was going through a break up that was there answer to the way I was feeling.No one wanted to listen to me.Almost feeling like
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