In addition to diagnosing and treating any underlying disorder, treatments for alopecia areata include immunomodulating agents and biologic response modifiers (Table 5).6 Although topical and oral corticosteroids have been used, the treatment of choice in patients older than 10 years with patchy alopecia areata affecting less than 50 percent of the scalp is intralesional corticosteroid injections (Figure 8).6
It is perfectly normal for people to shed 50 to 100 hairs per day. This generally doesn't cause noticeable thinning of scalp hair because new hair is growing in at the same time that hair is shedding. However, hair loss occurs when this hair growth cycle and shedding is disrupted or when the hair follicle becomes destroyed and replaced with scar tissue. Female pattern hair loss (androgenetic alopecia) is the most common form of hair loss in women. This occurs gradually and is caused by genetics (from either side of the family), age, and the action of a specific male hormone, dihydrotestosterone (DHT). This hormone is found in lesser amounts in women and it preys on the hair follicles, preventing them from receiving vital nutrients for proper hair follicle growth, leading to the hairs shrinking, and resulting in a shorter lifespan. Interestingly, DHT does not need to be elevated to generate hair loss. Estrogen, when lowered as commonly seen in menopause, creates a change in the ratio of male to female hormones, giving an edge to these male hormones. Compounded with the sensitivity of DHT to the hair follicles, heredity can affect the age at which a woman begins to lose her hair, as well as the rate of hair loss and the extent of baldness. 
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.
"Dr. Yaker is ABSOLUTELY AMAZING! He is innovative, highly professional, incredibly skilled and extremely passionate about hair restoration. His bedside manner is one of complete dedication and compassion with genuine care for his patients and their needs. He strives for excellence in everything he does, and it's evidenced by his loyal client following and their satisfaction with their incredible outcomes. I'd recommend him to anyone & everyone interested in hair restoration or transplantation."
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.  

Ironically, taking the hormone levothyroxine to treat an underactive thyroid can contribute to some hair loss, among other side effects, but this seems to be more common within the first month of treatment and more often in children than adults. This hair loss is only temporary and will go away as treatment is continued and thyroid hormone levels stabilize.
So far, I’ve only been on the Propecia for about three weeks. I don’t notice any side-effects thus far. I am taking 2.5 mg of Proscar, to be exact. I feel good and have not noticed any difference in my hair. I continue to lose about 20 hairs when I shower and brush it each day. That may not sound like a lot but I have already lost so much of my hair, that I think that represents more hair loss than it sounds. At least it is stable for now…I thank GOD that it is not getting worse. I DO have re-growth but it is fine and “wispy” as you said. It is not the same as the rest of my “normal” hair but hey, at least some of it is growing back in. Slowly and finer. That seems to support the AGA diagnosis. The thing that really drives me crazy is that I still don’t know WHY the TE started in the first place. The TE unmasked the AGA, but why the damn TE and what from here? Anyway….I digress and obsses!
For my hair loss I’ve seen four dermatologists, two endocrinologists and have spoken about it with my gynecologist, and general practitioner as well as have also seen someone who “specialized” in thyroid problems. All that’s missing is a partridge in a pear tree These are the total numbers I can recall over the last 8 years. Since my hair loss is hormone related I think that the endocrinologists were probably the most knowledgeable and most helpful about my situation. That’s me though, everyone’s hair loss and causes are different.
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.
Treatment options for AGA (Table 3)6 focus on decreasing androgen activity. Minoxidil (Rogaine) and finasteride (Propecia) are the only medications approved by the U.S. Food and Drug Administration (FDA) for the treatment of AGA (Figure 4).6 Minoxidil is available without a prescription as a 2-percent topical solution that can be used by both men and women and as a 5-percent solution (Rogaine Extra Strength) that should be used by men only. The mechanism of action by which minoxidil promotes hair growth is unknown, but it appears to act at the level of the hair follicle. Minoxidil is an effective treatment for male and female AGA and is recommended as first-line treatment by the American Academy of Dermatology guidelines.5
Try and find a doctor that seems to care about women’s hair loss, and understands the emotional devastation it causes. I don’t want my doctor to dismiss my hair loss, and I don’t want him/her to tell me it’s no big deal. It is a big deal and if your doctor makes you feel uncomfortable in any way, they he/she is not for you. If possible try and speak with the doctor by phone (believe it or not some doctors will talk to you on the phone first) and if the rules of the office don’t permit this then try and ask as many questions to the receptionist, such as, does Dr. X see a lot of women for hair loss? Does he order blood work? What does he usually prescribe for treatment? The reality of that last question is that their is no “usual treatment” every woman is different and hopefully the receptionist tells you something to that effect. I don’t want to see a doctor that prescribes Rogaine as his/her first line of defense even before making a proper diagnosis with blood work or any other necessary tests. I firmly believe you should not be walking out with a bottle of Rogaine the first day of your appointment. Sure the doctor can probably be able to tell if your hair is experiencing miniaturization, but what about the blood work to determine the causes? Rogaine may be the right treatment for you, but I’d like to know why.
Its been 1.5 years since my problem started. I noticed first the texture became course or wiry. Then I wore a hair net and hard hat for 8 years I don’t know if that helped with my condition or not. Then I went to got my hair highlighted within 1 week my hair broke off to 1/2″ just in front the rest was full. Since then I have tried all kinds of hair therapy. The texture changed to being normal but I have Nice shiny almost bald spot on my head. Nothing I tried helped in regrowth. Went over all my mess with my doctor she said no should damage my hair. Also it grows but as soon as it starts looking decent I have breakage. What to do what to do.
I have had alopecia universalis for 12 years now. It was very difficult in the beginning when my hair began to fall out. I was in college and devastated because I thought my life was over. I have now grown to accept myself and the way I look now. I know I would not be who I am today without this having happened, and I really like me! It does get better, but it is a process. A good support system and love from family and friends gets you through. Good luck to you all on your journey.
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
One day in my mid 20s I got feed up with my at that point frizzy hair. I took a close look at individual hairs. I almost had a heart attack. Again this thought:”NOT NORMAL!!” I had tons of KINKY, ROUGH, even ZEBRA-STRIPED hair!! Much resembling pubic hair. The striped hairs were few, but they were literally striped in the darkest shade of brown I have & white!

Interesting. After reading these posts, I called a dermatologist in the Houston, TX area asking for an appt. and whether he prescribes medication for hair loss in women. I mentioned Spironolactone. He told the nurse that he does not, and that it can actually cause hair loss. This is exactly the frustration we all experience. You hear a different opinion from each Dr. and don’t know what the right answer is. If anyone knows of a good endocrinologist in Houston, please let me know. I’ve been losing hair for about 5 yrs (now 39 yrs) and have to use hair-loc extensions just to feel confidence when in public. I did not see much about Propecia in these posts. Have any women taken it w/ much success?

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

*All medications have both common (generic) and brand names. The brand name is what a specific manufacturer calls the product (e.g., Tylenol®). The common name is the medical name for the medication (e.g., acetaminophen). A medication may have many brand names, but only one common name. This article lists medications by their common names. For information on a given medication, check our Drug Information database. For more information on brand names, speak with your doctor or pharmacist.
My name is Leslie and IO was recently diagnosed with pcos. My hair has been falling out for about two years! I am African American and I have always had thick healthy hair now you can see my scalp. I started using a product called regrow and my bald spots are filling in but my hair is still thinning! I was fortunate enought to have a child in 2003 I have been trying to have another child for 3 years with no luck can somebody help me with my thinnig hair and infertility……..I don’t even feel like a woman anymore.
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.
The tricheologist advised me to take four (4) fish oil -1000 (blackmores brand) – this also helped sooth the scalp can reduced the itchiness down further. Using the B Complex and the fish oil daily I also saw more hair growth over the period of eight months and am continuing on this regime. I try aim at 300 minutes of walking a week and drinking water. I don’t drink soft drinks nor have sweets and try to avoid processed food.
A little farther up the follicle is the mysterious feature called the bulge. That's where follicle stem cells live. When they get the right set of chemical signals, these self-renewing cells divide. They don't divide like normal cells, in which both halves become new cells that keep splitting and developing. Only one half of the follicle stem cell does that. The other half becomes a new stem cell, and stays put for future regeneration.

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.
Taking hair supplements can be helpful for anyone who is experiencing hair loss or hair thinning. Dendy Engelman, MD, a board-certified dermatologic surgeon at Medical Dermatology & Cosmetic Surgery in New York City, previously recommended Nutrafol, a research-backed hair supplement, to Prevention. "This uses highly concentrated botanicals to address every stage of the growth cycle," she says. Nutrafol's hair supplements include vitamin E and ashwagandha (an adaptogen that helps balance cortisol levels in the body), among others.
THE TREATMENTS If no trigger is present, it’s likely you have androgenetic alopecia, a hereditary condition that causes the hair follicles to get progressively thinner over the years. The most effective topical medication for the condition is minoxidil (brand name Rogaine), the only treatment for hair loss in women that has been approved by the Food and Drug Administration.
"Others are taking hair follicles out of human scalp and growing them with dermal papilla cells," Cotsarelis says. "If they grow in culture, you might be able to recombine them with skin cells and form new follicles. This would let you expand the number of follicles you get for a hair transplant. This may not be that far off -- five to 10 years, maybe. There's very good evidence you will be able to do that."
Harklinikken (“hair clinic” in Danish) inspires great loyalty. Four out of five users come as referrals from satisfied customers, said Lars Skjoth, the company’s founder and chief scientist. The results are certainly compelling. After four months of daily application — that is, working the tea-colored tonic into the hair section by section, then letting it sit on the scalp for six hours — most users regain at least 30 percent of lost density, and some as much as 60 percent, according to company figures.
What I hate most is how I feel about myself. As others have shared, I don’t want to wash or fix my hair any more than I have to for fear of lossing even more hair, thus I don’t want to leave the house. I also don’t like that most health care professionals give you a standard excuse for the hair loss: you’re getting older, hair thins; it’s hereditary; or the worst one..it’s due to stress! I wasn’t stressed until I pick a clump of hair from the shower drain or my hairbrush daily!
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Many other agents have been used to treat alopecia areata, including minoxidil, psoralen plus ultraviolet A (PUVA), and anthralin (Anthra-Derm), but success rates vary. Anthralin, an anti-psoriatic, in combination with topical corticosteroids and/or minoxidil, is a good choice for use in children and those with extensive disease because it is relatively easy to use and clinical irritation may not be required for efficacy.6 Hairpieces and transplants may be the only options available for persons with severe disease that remains unresponsive to available medical treatments. Patients with recalcitrant, recurrent, or severe disease should be referred to a subspecialist.

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.
I am on Arava and my hair has become extremely coarse, frizzy, and tight tight curls in the back. The sides of my hair are pure frizz and the top is straight, with frizz. It used to be smooth and so easy to manage. Now it takes so long and it looks awful. Anyone find the same thing and anything that helps? I have tried so very many hair products, so has my beautician. She says it is like I have 3 completely different textures on my head.
“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.
I took accutane for my acne for about five months ( I specifically asked my nurse practitioner if accutane could cause hair loss & after she told me no). I felt optimistic about reducing my acne & breakouts. During the fifth month I noticed shedding. Three months later I have a thinning hair line, had to cut my hair and my self esteem (already lowered by years of acne) is non-existent!

“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.
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