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Dr. Williams' medical and surgical hair restoration practice is dedicated to the art and science of hair surgery, integrating medical, regenerative PRP and stem cell therapies, and surgical restoration in treating hair loss in men and women. He was one of the earliest cosmetic hair transplant surgeons to incorporate Follicular Unit Extraction (FUE) into his cosmetic surgical practice. He is active in the international hair restoration societies teaching hair surgery and FUE to his professional colleagues. He relates easily to his hair loss patients and is the recipient of approximately 10,200 follicular grafts with FUE.
Many medications are being studied, including abatacept, MEXIS/M6S, triamcinolone, secukinumab, tralonkinumab, apremilast, botulinum toxin, INCB018424, bimatoprost, clobetasol, AS101, autologous platelet-rich plasma, topical minoxidil, and nitric oxide gel. Some of these medications are approved for other diseases, others are not available outside of studies.
Hi, I’m 25 years old, and started having hair loss at 15. It started and has continued to thin around my hairline only on one side, to the point that one side is receded and extremely thin. About a year and a half ago, my overall scalp started thinning as well. It’s been about a year since I’ve dyed my hair and I rarely ever put hairspray or any other chemical in my hair. I try to just wash it and let it air dry in fear that anything I do will make more hair fall out. I haven’t been to a doctor at all so far because I’ve never had health insurance. I’m about to have insurance next month and will be looking for a doctor to go to ASAP. I’ve been trying to look online and see what information I can find about what’s happening with me, but I dont’ see anything about a similar case to mine. I used to have long, thick hair and could do anything with it, and now it’s short and thin, and I can never style it at all, and my receding hairline on my right side has me so self conscious. I live in Baton Rouge, Louisiana, does anyone have any suggestions to my situation or a reputable doctor in this area?
Dr. Williams is an author, researcher, internationally renown hair surgeon, and lecturer in hair loss surgery and disorders. He is Diplomate of the American Board of Hair Restoration Surgery, Fellow of the International Society of Hair Restoration Surgery. He primary practices as a hair restoration surgeon and physician offering medical and surgical treatment for hair loss disorders for men and women. He has been practicing medicine, surgery, and cosmetic surgical care in Orange County since 1986 and a native and lifelong resident of Orange County. He completed his undergraduate premedical studies in 1980 at the University of California, Irvine; and a graduated from medical school in 1984 from the Western University of Health Sciences in Pomona, California.
A clinician diagnoses female pattern hair loss by taking a medical history and examining the scalp. She or he will observe the pattern of hair loss, check for signs of inflammation or infection, and possibly order blood tests to investigate other possible causes of hair loss, including hyperthyroidism, hypothyroidism, and iron deficiency. Unless there are signs of excess androgen activity (such as menstrual irregularities, acne, and unwanted hair growth), a hormonal evaluation is usually unnecessary.
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.
The mission of the National Institute of Arthritis and Musculoskeletal and Skin Diseases is to support research into the causes, treatment, and prevention of arthritis and musculoskeletal and skin diseases; the training of basic and clinical scientists to carry out this research; and the dissemination of information on research progress in these diseases.
In contrast to trichotillomania, traction alopecia involves unintentional hair loss secondary to grooming styles. It often occurs in persons who wear tight braids (especially “cornrows”) that lead to high tension and breakage in the outermost hairs (Figure 10). Traction alopecia also occurs commonly in female athletes who pull their hair tightly in ponytails. The hair loss usually occurs in the frontal and temporal areas but depends on the hairstyle used. Treatment involves a change in styling techniques. Other hair-growth promoters may be needed in end-stage disease, in which the hair loss can be permanent even if further trauma is avoided.1
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.
I”m sitting here reading all your letters hoping that you’ve helped someone and hoping that you can help me, too. I’m 48 and all my life I’ve been told how beautiful my hair was. I now live in S Florida and within the last couple of years I stopped styling my hair because of the heat and the humidity. I usually wear it in a ponytail (never tight – I’m sure that’s not the problem). About a year ago I noticed athat a lot of hair was on the back of my car seat.I mean A LOT.When I went home to NY I tried to style my hair like I used to and it didn’t work. It just layed there.The more I looked I noticed how thin it was. I came back to Fl and went to a dermatologist who barely looked at me and told me to try rogaine.
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.
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. Alopecia areata most often affects the scalp and beard, but may occur on any part of the body with hair. 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.
About 2 years ago I lost approximately 50% of my hair and the quality went from thick, strong, straight, healthy hair to thin, weak, frizzy, kinky dry hair that not only sheds but breaks and flakes off pieces at my ends. My skin has become very dry and my nails have become weak also. I went to an endocronologist that put me on 125mg spironolactone which had been increased slowly over a period of a year. He also decided he wanted to give me a layered approach by adding on 2 other medications over a year, one was Glumetza ER 500mg twice a day and Actos 15mg once a day. He said my DHEA was a little high and that these drugs used for off label treatment would help grow my hair back. My hair stopped falling out and a little grew back but the quality of my hair was still very sickly almost like someone on a chemo drug. I was concerned about my liver and stopped taking the drugs, unfortunately my hair started shedding again.
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.
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.
According to practitioners of traditional Chinese medicine, hair health is tied to two things: kidney energy and the blood, which nourish the hair. The solution: acupuncture and Chinese herbs. While there isn't a lot of hard science to back this up, Maureen Conant, a TCM practitioner at Full Bloom Acupuncture in Seattle, says that she's seen women's hair stop falling out and then gradually regenerate after a few months of weekly treatments.
Hi Everyone I thought I was the only person with major hairloss because everywhere I look all I see is beautiful heads of hair. I am 34 years old and my hair started thinning 7 months ago at first I thought it was just my ponytail getting thinner but my hair became horrible with split ends and dryness too (I have always had extremely healthy hair and never had split ends) – I thought I had burnt my hair using a straightener and that’s why it was thinning. However it has gotten worse and worse and I finally visited a doctor. I have had full blood tests for thyroid issues, hormone levels, cholesterol etc etc all were perfectly normal, I had a thyroid antibody test which was at the high end of normal but still within normal range, I had a thyroid function test which was within normal limits however he thought I did have some slight inflammation ie thyroiditis. My doctor said this isn’t causing the hair loss either. I have loads of energy, don’t get tired, eat well am normal weight range the only other thing I have noticed is my eyelashes seem stunted in growth (not thinned out though) and my eyebrows have thinned on the outer edges. My last two nails on both hands have a dark (looks like they have lifted slight) strip just below the white nail part. I am booked to have a stress test, pelvic ultrasound and to see an endocrinologist also to rule out all other possible reasons for hairloss. I am now getting to the point of embarrassment to go out it is soooo thin on top particularly on one side of temple and majorly down the centre where I used to part my hair. HELPPPPPP!!!!!
Testosterone replacement is becoming popular for men. Cotsarelis warns that this may accelerate hair loss. Propecia might help -- but because it prevents testosterone breakdown, it might affect the dose of male hormone replacement therapy. Cotsarelis warns men taking both Propecia and testosterone replacement to make sure their doctor carefully monitors their testosterone levels.
Hi, I am now 25, I have been losing my hair for the past 6 years. I did find an excellent Dermatologist in Orlando, FL Dr. Crotty who helped me alot in this whole process. He started me on a regimen of 3,000 mmg of Biotin daily. I also did Kenalog shots (which is a steroid). He did localized injections in the scalp and also in the hip. I also was prescribed Olux E Complex foam to put in my hair twice daily. I had to stop using the Kenalog b/c I thought I was getting headaches from it ( IT WAS NOT THE KENALOG – (TMJ/Migraines). This three regimen combo produce amazing results for me, within months. Unfortunately, my hair has now started coming out in the front and on the right side but I changed my insurance and cannot find a in network doctor that will treat the Alopecia. I am very tempted to just Pay OOP for Dr. C. So anyone living in the Orlando area suffering from this condition please contact his office. They are the most caring individuals ever also. I love them!!!!!
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."
I have been losing my hair over this past year but within the last 6 months it has changed texture and still falling out! Now my hair is very coarse and kinky! For 42 years I had long straight-as-a-board hair and now I look like a poodle! Every time I comb or brush my hair handfuls of hair comes out! My hairdresser, gyno, GP and 3 dermatologists have told me it was normal to lose this amount of hair! Many contribute it aging but I find that hard to believe. Finally, my most recent derm said I was low in iron and said that might be a factor. Now, I’m going in to see if I might be anemic. My gyno ran the same tests and said all seemed normal! It’s the most frustrating and stressful event, especially when everyone tells you things are “normal”! Has anyone experienced their hair texture changing over a short period of time? Thanks-
Playing around with your haircut can sometimes mask the issue, so talk to your stylist about a style that will add volume and bounce, making hair appear thicker. Simply shifting your part can work wonders, and changing up your color can help, too. Light reflects more off lighter hair, so the color provides less contrast between the hair and the scalp, concealing any empty patches. Additionally, a light perm or wave will give hair more body and make it look thicker, and frequent trims will help prevent breakage.
Minoxidil should be applied twice daily, and one year of use is recommended before assessing its efficacy.6,7 Women also may benefit from adjunctive treatments such as estrogen (hormone replacement or oral contraceptives) or spironolactone (Aldactone). In men, minoxidil may work better in areas with higher concentrations of miniaturized hairs, and its efficacy may be increased by the synergistic use of once-daily tretinoin (Retin-A) applied at separate times during the day.6,8 Minoxidil does not work on completely bald areas and has relatively few side effects; a dosage of 2 mL per day of a 2-percent solution costs about $10.00 to $12.50 per month.
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?
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
Alopecia areata is a disease that attacks your hair follicles (the part of your skin that makes hair). In most cases, hair falls out in small, round patches about the size of a quarter. This causes only a few bare patches. Some people may lose more hair. In only a few people, the disease causes total loss of hair on the head or loss of all body hair.
You are what you eat – and that’s true for your hair as well. A diet containing mostly whole foods, especially the skin of plants such as cucumbers, potatoes, peppers, and even bean sprouts are rich in the mineral silica and contribute to hair strength. Foods like lean meats are high in iron and are essential to the protein-based, building blocks of hair growth.
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.
However, ketoconazole is still not FDA approved for hair loss treatment, which means it cannot be endorsed or marketed as such. Put simply, ketoconazole likely curbs hair loss, but additional research is needed for the FDA to give it approval. While it is safe to use as a supplement to our top picks, we wanted to recommend products with as much scientific backing as possible. So, we stuck with FDA approved minoxidil or FDA cleared laser treatments. But we’ll keep a close eye on products like ketoconazole shampoos and update as new research appears.
The loss of hair can be sudden, developing in just a few days or over a period of a few weeks. There may be itching or burning in the area before hair loss. The hair follicles are not destroyed and so hair can re-grow if the inflammation of the follicles subsides. People who experience just a few patches of hair loss often have a spontaneous, full recovery without any form of treatment.
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 look forward to seeing you both there. There are quite a few ladies that have experiences with different wigs and head coverings, including a really wonderful stylist that works with women who are losing their hair. She can also be of great help for those looking into different wig or hair system options. Her name is Mystique and here is her page:
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.
Jimenez, J. J., Wikramanayake, T. C., Bergfeld, W., Hordinsky, M., Hickman, J. G., Hamblin, M. R., & Schachner, L. A. (2014). Efficacy and Safety of a Low-level Laser Device in the Treatment of Male and Female Pattern Hair Loss: A Multicenter, Randomized, Sham Device-controlled, Double-blind Study. American Journal of Clinical Dermatology, 15(2), 115–127.
It may take some time to find the right dosage of thyroid hormone to get your thyroid under control. If you're uncomfortable with the look of your hair while treatment is underway, there are options to consider. Wearing a hair piece or wig or getting a new hairstyle can help camouflage hair loss as you wait for the results of thyroid treatment to begin. Ask your doctor if it makes sense to try a topical medication that helps spur hair growth like mixoxidil (Rogaine).
Cicatricial alopecias tend to cause permanent hair loss. These disorders destroy hair follicles without regrowth and follow an irreversible course.21 It is likely that they involve stem-cell failure at the base of the follicles, which inhibits follicular recovery from the telogen phase.21 Inflammatory processes, including repetitive trauma as in trichotillomania, also may lead to stem-cell failure. Other processes may be caused by autoimmune, neoplastic, developmental, and hereditary disorders. Among these are discoid lupus, pseudopelade in whites, and follicular degeneration syndrome in blacks. Dissecting cellulitis, lichen planopilaris, and folliculitis decalvans also may cause scarring alopecia. Some disorders respond to treatment with intralesional steroids or antimalarial agents.21 Patients with these conditions should be referred to a physician who specializes in hair loss disorders.
I would like to encourage you to join the Network if you have not already. There are so many wonderful women in this beloved Network that would love to hear your stories. The emotional toll that hair loss can have on women can be devestating and knowing that we are not alone helps to set us on a firmer foundation as we walk this journey called “hairloss.”
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.
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.
Happily divorced in 2006. Coming up to my 52nd birthday, my hair is thin and fine, my hairdresser just shakes her head. In pictures all you see is scalp with a faint nimbus that is what’s left of my hair. Lost my job in December. When I interview, no one looks me in the eyes… they talk to my nearly naked scalp. So here I am, wanting to date and find work, and feel constantly judged because of an outward manifestation of something that’s happening inside of (what appears to be) a healthy body. It looks like I’m on chemo, or at the affect of some kind of some huge illness or medication… and shunned. How much of my self-image is subliminally dictated by my lack of hair… working on that with my therapist. LOL!!
Anagen effluvium is rapid hair loss resulting from medical treatment, such as chemotherapy. These potent and fast-acting medications kill cancer cells, but they may also shut down hair follicle production in the scalp and other parts of the body. After chemotherapy ends, hair usually grows back on its own. Dermatologists can offer medication to help hair grow back more quickly.
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?