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

Family history will often tell the doctor what type of alopecia a person has. Occasionally, a punch biopsy may be necessary to determine the type of hair loss. Looking at plucked hairs under a microscope can help to tell the difference between alopecia areata and androgenic alopecia. Other tests might be done to check for autoimmune diseases like lupus that can accompany alopecia.


Many factors can contribute to hair disorders. Alopecia, or hair loss, may be caused by medical conditions such as lupus, thyroid disorder, protein or iron deficiencies, or hormonal imbalances.  Hirsutism -- abnormal hair growth in women (such as a beard or chest hair) -- may be caused by ovarian, adrenal, thyroid or pituitary conditions. Identifying the cause, and treating the condition are our goal. 
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.

The characteristic finding of alopecia areata is one or more well-circumscribed areas of otherwise normal, hairless skin in hair-bearing areas. Occasionally, it may be necessary to biopsy the scalp to confirm the diagnosis. Other findings that may be helpful are the appearance of short hairs that presumably represent fractured hairs, short thin hairs, and gray hair growing in a bald area. Other causes of hair loss are generally excluded from the consideration by history and clinical evaluation.


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!
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]
Each hair develops from a follicle — a narrow pocket in the skin — and goes through three phases of growth. Anagen (A), the active growth phase, lasts two to seven years. Catagen (), the transition phase, lasts about two weeks. During this phase, the hair shaft moves upward toward the skin's surface, and the dermal papilla (the structure that nourishes cells that give rise to hair) begins to separate from the follicle. Telogen (C), the resting phase, lasts around three months and culminates in the shedding of the hair shaft. 

“While nutritious eating isn’t going to bring your hair back by any means, eating plenty of protein-rich foods and healthy fats can make the hair that you still have look thicker and shinier.” Skimping on the B vitamins in particular can interfere with the formation of hair cells and, therefore, hair growth. The best sources of Bs are protein-packed foods like chicken, fish, eggs, and pork, as well as leafy greens such as spinach. (These foods are also good for melting belly fat, so it’s a win win).
Hi Lisa, hope you were able to speak with your doctor. I also talked at length with my mom and sister and feel a little better. My mom has hair but it is very thin but I forget she has had surgeries and takes a lot of meds for various conditions and she knows this has caused her hair loss. My sister has PCOS and that has made her hair thin out. I had a good appt with my dermatology nurse. She sat and talked with me and listened and was very interested and caring. I cried for about half the visit. She examined my head and does see the thinning but it isn’t consistent for androgentic alopecia and there aren’t any just out of nowhere hairloss in the family (she seemed more concerned with females than male relatives). What I haven’t stated is that I don’t handle stress well, the last time I underwent major stress was with the acne and she thinks it has taken on another form. To be as brief as I can besides taking two night classes, working full time, single mom no help from their dad ( a teen daughter and preteen son!), major stress at work, separated/divorced, financial stress, found out my dad’s prostate cancer came back, aging parents (they can’t take care of things like they used to and I’m living with them and it’s on me now), and just found my ex husband (not my kids’ dad) has lung/brain cancer and we aren’t on speaking terms and we work for the same company, oh yeah and I have new boyfriend. The last of this list happened all this month. I know I haven’t been eating well, and with the constipation if I’m severely stressed it runs right through me, then I know its bad. So she and I decided to go with biotin & a multivitamin, see my PCP she really wants me back on anti anxiety pills, I will still see him but I want to talk to him more at length because it can cause hairloss, we are continuing my 200 mg of aladactone, my orthotricyclen, eat better, I do have regrowth in my bangs. She is very concerned about my mental health (my BFF says to me “how is my ball of nerves today?” that’s how bad I am!). I know I just need to manage it better and talking to her was the first step because she too went through a stress shedding period (I do remember it, it was a year ago) and her hair is coming back in. She said it will come back for me. But for my own psychological health she said for me to get the rogaine foam for men and use it, just so I can see regrowth faster. She said they say not to use if for women because of the pregnancy issue and that isn’t a factor for me. I also had burning and itching but with the use of Nioxin it is better. She also said only wash my hair once a day (I usually do twice), and use low heat for my hair. She is going to see me in three weeks.
Onion - A study published in the Journal of Dermatology examined the results when onion juice was used in people with alopecia areata. Twenty-three people applied onion juice directly to the scalp twice daily for two months. Participants began to experience hair growth after just two weeks of treatment. At four weeks, hair regrowth was seen in 17 people and at six weeks, hair growth was apparent in 20 people.
Spironolactone, an aldosterone antagonist with antiandrogenic effects, works well as a treatment for hirsutism and may slow hair loss in women with AGA, but it does not stimulate hair regrowth. Estrogen may help to maintain hair status in women with AGA, but it also does not help with regrowth. Few controlled studies have examined the many non–FDA-approved hair growth agents such as cyproterone acetate (not available in the United States), progesterone, cimetidine (Tagamet), and multiple non-prescription and herbal products. A full discussion of approved and unapproved treatments for AGA can be found elsewhere.6,7 In all forms of alopecia, hairpieces and surgical transplants can produce satisfactory results but are expensive.
Hi, I cannot afford to go to see Dr. Redmond even though I live in NY (he’s just too pricy, I have no insurance, etc…) but I’m going to see the ob/gyn towards then end of the month to get help because I’m convinced I have PCOS (literally all the symptoms) and I was wondering, what birth control is best for hair? I’ve read Dr. Redmond’s site before and I could have sworn that Yaz or Yasmin kept popping up in the faqs section or somewhere on that site as good bcp for hair loss. I realize some people experienced hair loss after going off those pills, but if you have hair loss prior to bcp, I could have sworn Dr. Redmond listed those as good at helping hair loss and I thought some women claimed (elsewhere, not on his site) that they’ve regrown some hair after going on Yasmin. Sorry if I’m rambling, but does anyone know? Thanks. If I have PCOS, which I’m sure I do, I’m pushing for Spironolactone because I’ve read of a bunch of women who’ve had great success at regrowing hair with it, and one story on this site about a woman named “Jen” had great results. I think it took her 2 years, and she allegedly grew back 90-95% of her hair (also taking Metformin, dieting and exercising, and using Nizoral shampoo) so I’m trying to remain optimistic. It’s not just being 27 & single that makes me horrified at losing hair, though it doesn’t help, I’d still be freaking out if I was 57. If I could regrow even 30% to 50% I’d be elated. Because ultimately, I’m holding out hope for stem cells to be all of our “saviors.” Lol. There are 3 companies working on adult stem cell therapies for hair loss (from what I’ve seen here and elsewhere, they are Histogen, Follica, and Aderans) not to mention a Cairo Dermatologist who has successfully helped children with alopecia areata/totalis regrow significant amounts of hair, though only in one study and the results are only preliminary. Who knows. But still, fingers crossed that I can get these stupid hormones under control and stop my daily horror at washing my hair and seeing my once beautiful hair fall away. I always took my hair for granted and often complained about it, but I’d give anything for my thick long hair back. I had fine hair always, but tons of it and I always wore it long. Now I wear it pulled back in a bun to hide as best I can all that scalp showing through. Thanks for this site, it’s keeping me from going off the deep end.

I am 46 and starting menopause, according to my bloodwork. I didn’t have any tradtional menopause symptoms. My only health issue was burning scalp and hairloss–a lot. (I do not use any chemicals on my hair and don’t even blow dry it.) After losing almost half of my hair in 3 months I went off the pill (mircette which is low estrogen) and withing 48 hours the burning decreased by about 50%. Then I started using progesterone cream. Within 3 days the hairloss slowed from losing 65+ hairs in the morning to just 15-20. By the 6th day the burning is 95% gone. I can wear my hair in a ponytail with a soft scrunchie today! Maybe I have estrogen dominence, which is talked about in Dr. Lee’s book “What Your Doctor May Not Tell You About Menopause: The Breakthrough Book on Natural Progesterone”. I hope that I continue to improve and I hope each one of you finds the solution to your hairloss. By the way, my doctor ( GP) told me to stay on the pill and that nothing could be done for my hairloss. It was the owner of a family-owned pharmacy that suggested the progesterone cream and to stop the pill.


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]
A board certified Dermatologist is best trained to diagnose and manage diseases of the hair. It would be best to select such a doctor who has a special interest in hair loss. If you are considering a surgical treatment, I would recommend selecting a physician who only does hair transplant and nothing else. This type of physician has the most experience to give you the best possible results. 
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.
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. 
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Certain medical issues can also impair hair growth. An overactive or underactive thyroid gland can cause hair loss. So can iron deficiency. When women go through menopause and their estrogen levels fall, their hair often begins to thin. Many women also lose some hair a few months after giving birth because of the hormonal changes the body experiences.

How many of us are out there… feeling alone and pretending to not be ashamed. As a child, I had so much hair that my mother used a thinning shears on my locks. In high school I had a glorious mane, cut into a ‘Gypsy’… what great pictures. By my mid-20’s I had to cut my hair short because it was so thin that it wouldn’t hold a style. Was diagnosed with PCOS and told that this syndrome, combined with heredity, caused my hair loss.
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.

There are numerous nonsurgical treatments that when combined, can offer significant hair improvements. Dr. Yaker’s TCHR Volumizing Glycolic Acid Shampoo and Conditioner help restore vitality to the hair by deep cleaning the scalp and reestablishing lost moisture content and physiological pH to the scalp and hair. Dr. Yaker has also formulated his own oral supplement, which is a blend of Aminoplex hair repair vitamins. This is made up of amino acids (building blocks of protein) that produce keratin, which makes up close to 97% of our hair. In addition, Dr. Yaker’s specially compounded FDA approved topical medication, Minoxidil (brand name: Rogaine®), is clinically proven to help slow down, stop and even reverse hair loss in women. Other nonsurgical therapies offered are Low Level Laser Therapy (LLLT) using the advanced LaserCap®, and Platelet Rich Plasma (PRP) with placenta-derived extracellular matrix therapy to help restore thinning hair. Lastly, Dr. Yaker offers scalp and facial micropigmentation where permanent ink is applied to the skin, creating micro dots that replicate the natural appearance of hair. This is used for the scalp and eyebrows.


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.
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.

"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."


Men may also experience some sexual and emotional side effects while taking it: In a study published in the June 2011 issue of The Journal of Sexual Medicine, Dr. Michael Irwig of George Washington University found as many as 92 percent of test subjects reporting problems in the bedroom. The study also reported that “the mean duration of finasteride use was 28 months and the mean duration of persistent sexual side effects was 40 months,” meaning that side effects lingered long after subjects stopped taking the pill.
although I have plenty of hair round the sides I was rather thin on top, and quite bald on the crown. So I started using onion juice to kick start the folicles. Then after, started to use juiced ginger. After a minute or so of either application I rubbed in coconut oil, and left the mixture on for an hour or so. Problem with wishing to see the hair growth as soon as possible, hair is slow growing and new hair is even slower, so one will have to wait 3 months for a good result. So, once or twice a week use onion and the same with the ginger. I found white onions are best, grate on the smallest hole ( not much needed)…..bonus, white hair turns black.
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.

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.
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.
My hair was healthy. No split ends and thick and tame – I could not break it. The healthy condition of my hair may be the reason that I didn’t loose all of it. My hair loss was due to a “HAIR DESTROYER” causing chemical damage, burning my scalp and my hair ( I think she used a product banned in Australia). I had bald spots on my crown the size of 50 cent pieces and the rest of my hair was singed. I lost my hair gloss, I was left with hair that was as thin a rice paper and breaking everywhere. I had severe itching on my scalp for two years. Not pleasant. I cursed her every day and still do. I bought myself a pair of hairdressing scissors and cut as much hair off as I could; and chipped into it everywhere. I do this every two weeks. Hence I will never go to a hair dresser again and have not colored my hair since December 2012 – I asked for Brown on Brown 10 vol – how could an idiot of a hair destroyer (dresser) get it so wrong.
The main type of hair loss in women is the same as it is men. It's called androgenetic alopecia, or female (or male) pattern hair loss. In men, hair loss usually begins above the temples, and the receding hairline eventually forms a characteristic "M" shape; hair at the top of the head also thins, often progressing to baldness. In women, androgenetic alopecia begins with gradual thinning at the part line, followed by increasing diffuse hair loss radiating from the top of the head. A woman's hairline rarely recedes, and women rarely become bald.
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. 

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.
In either sex, hair loss from androgenetic alopecia occurs because of a genetically determined shortening of anagen, a hair's growing phase, and a lengthening of the time between the shedding of a hair and the start of a new anagen phase. (See "Life cycle of a hair.") That means it takes longer for hair to start growing back after it is shed in the course of the normal growth cycle. The hair follicle itself also changes, shrinking and producing a shorter, thinner hair shaft — a process called "follicular miniaturization." As a result, thicker, pigmented, longer-lived "terminal" hairs are replaced by shorter, thinner, non-pigmented hairs called "vellus."
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.
Hi Celest, My name is Sheena. I’m from a town right past Sugarland. I need to see an endocrinologist, as well, then because my dermatologist has changed my medicine three times, and my hair falls out in huge amounts every day. He diagnosed me with androgenetic alopecia, even though I told him SEVERAL times no one in my family on either side is bald or going bald. If you find a good endocrinologist, please share the name with me. Thank you
Conclusion? EAT MORE SEA SALT. DO NOT use table salt…ever. Low-salt and table salt diets contribute to heart attacks, diabetes, polycystic ovaries and obesity. They also promote toxicity and makes your body have an acidic pH, which is not good. That means gatorade is NOT replenishing. It’s better to take a dash of sea salt with water before and/or after exercising.
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.
Other medical conditions — most commonly telogen effluvium and seborrheic dermatitis — can also cause hair loss, but most people can trace their follicular woes back to androgenetic alopecia, so we focused our search there. We started with more than 200 products, including all-natural solutions and high-tech gadgets, while skipping treatments that focus only on volumizing or thickening hair. We also limited our scope to the scalp, and left out specialty products designed only for eyebrows or beards.

There’s no cure for baldness, but there are ways to hold on to what you've got. The six dermatologists and the clinical studies point to three methods: minoxidil, laser treatments, and prescription finasteride. The key is finding the combination and hair loss regimen that works for you. A doctor is your best bet for that kind of guidance — but we found a few trustworthy products that will work for most people.


Shedding is never fun — just ask my vacuum cleaner. It’s even less fun when you realize the golf ball size bits of hair you’re tugging out of the roller came from your own head. Oh, the horror! As we get older (yes ladies, this is for you too) our once glorious crown of healthy hair can become brittle, or even worse, be genetically predisposed to jump ship, leaving our poor, bald heads to fend for themselves.
You lose up to 100 hairs from your scalp every day. This is normal, and in most people, those hairs grow back. But many men – and some women – lose hair as they grow older. You can also lose your hair if you have certain diseases, such as thyroid problems, diabetes or lupus. If you take certain medicines or have chemotherapy for cancer, you may also lose your hair. Other causes are stress, a low protein diet, a family history or poor nutrition.
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