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.
There can be several factors behind hair loss such as environmental effects, aging, too much stress, excessive smoking, nutritional deficiencies, hormonal imbalance, genetic factors, scalp infections, use of wrong or chemically enriched hair products, certain medicines and medical conditions like thyroid disorder, autoimmune diseases, polycystic ovary syndrome (PCOS), iron-deficiency anemia, and chronic illnesses.
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.
Hair is a cutaneous appendage - just like sweat glands and oil glands.  As a result, dermatologists treat ALL forms of hair loss not just the most common form, androgenetic alopecia. There are many forms of alopecia - alopecia areata, telogen effluvium, lichen planopilaris, congenital hypotrichosis.....to name a few. The treatment and management of all hair loss disorders is an integral part of a dermatologist's training and board certification.  -Dr. Keaney
There is no cure for the condition.[2] Efforts may be used to try to speed hair regrowth such as cortisone injections.[1][2] Sunscreen, head coverings to protect from cold and sun, and glasses if the eyelashes are missing is recommended.[2] In some cases the hair regrows and the condition does not reoccur.[2] In others hair loss and regrowth occurs over years.[2] Among those in whom all body hair is lost less than 10% recover.[5]

Though we think our hair is super important, our bodies consider it nonessential (read: we don’t need it to stay conscious). Other bodily functions, like breathing, are more pressing and get first access to the nutrients in our diet. Our hair gets the leftovers. Protein is your hair's best friend, so reach for healthy protein such as eggs and fish and avoid fasting or yoyo dieting. These can deprive your body of these essential building blocks for a healthy scalp and hair. Wild salmon, tuna and trout are packed with omega-3 fatty acids that help provide moisture and prevent dry and brittle hair. Foods rich in B vitamins also help keep hair follicles healthy, decreasing the risk for hair loss. Fruits and vegetables, and beans and lean meat sources, such as chicken or turkey breast, are all great sources for vitamin B.

"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.


There’s also a women’s version (Women’s Rogaine Foam) — but a three-month supply costs $22 more online. The only difference between the two products are the instructions; women are instructed to apply once a day instead of twice. If you’re a woman who doesn’t feel like paying extra for marketing, the men’s product will suffice. A cheaper generic version is Kirkland Signature Minoxidil Foam, but with a longer history on the market and more customer testimonials, Rogaine is our first choice.

Alopecia areata: Researchers believe that this is an autoimmune disease. Autoimmune means the body attacks itself. In this case, the body attacks its own hair. This causes smooth, round patches of hair loss on the scalp and other areas of the body. People with alopecia areata are often in excellent health. Most people see their hair re-grow. Dermatologists treat people with this disorder to help the hair re-grow more quickly.


A medical event or condition, such as a thyroid imbalance, childbirth, surgery, or a fever, typically triggers this type of hair loss. Telogen effluvium may also occur as a result of a vitamin or mineral deficiency—iron deficiency is a common cause of hair loss in women—or the use of certain medications, such as isotretinoin, prescribed for acne, or warfarin, a blood thinner. Starting or stopping oral contraceptives (birth control pills) may also cause this type of hair loss.
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.
Laser treatments are the latest frontier in staving off hair loss, and they’ll be the first choice for fans of sci-fi. As silly as they may sound, these treatments do work — the American Journal of Clinical Dermatology in 2014 reported a “statistically significant difference” in hair density with no “serious adverse events” or side effects.The bad news: Laser treatments tend to be expensive, progress is slow, and they don’t always produce stellar results.
If you find yourself snacking at night before bed, it may be because you're bored or anxious — not truly hungry — and eating makes you feel better. Try eating a healthy dinner a bit later in the evening. If your stomach is truly growling before bed, try a protein-based snack like a hard-boiled egg or a slice of cheese. A few spoonfuls of yogurt or some fruit is another good option. 
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?
Almost all hair loss in guys results from male-pattern baldness, a genetic trait that comes from your parents. Other causes include certain medications, too much vitamin A, or not enough protein. Illness or stress can lead to sudden, heavy shedding called telogen effluvium. Good news, though: Hair loss that isn’t from male-pattern baldness often reverses itself.
From doing this I have noticed less hair loss, some re-growth and some thickness, more coverage on the crown area, you cannot see the baldspots any more but just a long faint scalp line. But I will not go to a hairdresser or put colour in my hair. I believe this is why my hair is improving. I didn’t spend money on doctors or dermatologists and certainly will never give money to a hairdresser again. I use products with no parabens and sulfates. I hope my post helps; please try not to give up.

The main symptom of alopecia areata is hair loss. Hair usually falls out in small patches on the scalp. These patches are often several centimeters or less. Hair loss might also occur on other parts of the face, like the eyebrows, eyelashes, and beard, as well as other parts of the body. Some people lose hair in a few places. Others lose it in a lot of spots.
Hair changes about as fast as grass grows, which is to say it’s extraordinarily slow and not visible to anyone checking impatiently in the mirror every day. But during regular follow-up appointments, Harklinikken uses high-tech equipment to photograph and magnify the scalp and count new hairs and active follicles, which motivates users to adhere to the regimen. Too many people give up on treatments like Rogaine and low-level-light devices before they’ve had a chance to work, Dr. Senna said.
@Amanda P. I regrew my hair and you can too. -I've been bleaching my hair on and off since forever. My hair wouldn't grow any longer it would just snap off. I've dreamed about having thick, long hair. And when I say dreamed, I mean it quite literally. So i decided to do something about it. My friend suggested Biotin when we were talking about my hair loss.
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.
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?

As mentioned above, an autoimmune response is commonly associated with hair loss related to alopecia areata. Patients who have this condition see their body’s immune system attack their hair follicles. The patient’s hair follicles become very small and hair growth begins to stop.  A major symptom of alopecia areata is patchy hair loss, according to the American Academy of Dermatology, which says patients often first notice the problem when they see clumps of hair on their pillow or in the shower. 

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.


Bald spots, thinning, and breakage can be symptoms of a serious underlying health condition such as alopecia, lupus, thyroid issues, and other common types of disease that cause hair loss. If you have noticed a dramatic increase in shedding or other change in the appearance of your hair, Drs. Robert J. Dorin and Robert H. True can help. During an evaluation at one of our offices in New York, New Jersey, or Boston, we can discuss your options and provide you with solutions to restore your appearance and confidence.
A hair restoration is a surgical procedure, but per government regulations, any physician of any background with a valid medical license, regardless of training, presence or lack of any board certificate in anything at all, is permitted to call themselves a "hair restoration surgeon."  For instance, a psychiatrist, who has not even seen a surgical instrument in 20 years, can tomorrow decide that he would like to be a hair restoration surgeon, and offer the surgery to the public.  Therefore it is important to make sure your surgeon has actual surgery training, which is usually a 5 to 7 year course of intense training in the years immediately following medical school, and upon successful completion, surgeons receive a board certificate in their chosen specialty.
i also have learned that most people are low in their vitamin d levels, which may also contribute to hair loss. i actually had labs done to check for my vitamin d level, by a cardiologist. my heart is fine, thankfully, but she did tell me to take 2000i.u. daily of vitamin d3, specifically. when i researched about it, i found the possible hair connection. so i do take that daily. i will also be buying vitamin b6 and 12 and biotin. and i will research the gut connection because biologically speaking, it makes sense. i will return with another post in a few months and update.

Hair transplantation involves harvesting follicles from the back of the head that are DHT resistant and transplanting them to bald areas. A surgeon will remove minuscule plugs of skin that contain a few hairs and implant the plugs where the follicles are inactive. Around 15 percent of hairs emerge from the follicle as a single hair, and 15 percent grow in groups of four or five hairs.


I have Alopecia Areata, Hoshimoto Thyroiditus, both are autoimmune diseases. I also now am losing hair all over my head. I have itching, redness, pustules and think it may be Cicatricial Alopecia (Scaring Alopecia). I have tried Biotin 10,000mcg per day for 3 yrs didn’t work, also Nioxin didn’t work. Minoxidil 5% worked the first time I lost some hair but not anymore. I have been given oils, creams, and still no luck.I went to a Derm and he didn’t seem to care. I am embarrassed to go out becauseyoou can really see my scalp through my very thin hair. I use to have very thick hair but that is gone. I can’t afford a wig and don’t know where to turn now. I have to support where I live (Rialto, Calif.). Any Ideas?
What’s important to know: the cause of hair loss is specific to each individual, which is why it is so important to have a board-certified dermatologist examine, diagnose, and treat your condition. DR.DENNIS GROSS will review your symptoms, examine your scalp, perform a possible scalp biopsy, and/or order medical and blood tests if an underlying medical condition (like thyroid disease, diabetes, or autoimmune diseases like lupus) is suspected.
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.  

I am 34 yrs old and trying to get pregnant, with no luck. I knew since I was 26 that I had multiple cysts on both ovaries so I remained on birth control. Around the second month after I stopped my BCP I noticed my hair thinning. As my periods started to get worse and come about every 2 wks or less my hair loss increased. Within 2 wks I lost 50% of my hair. My scalp is very sore and sensitive and burns. I have seen 3 drs, 2 have told me its normal, 1 dr told me I had lice, then had to go to another dr to find out I didn’t have lice. Is the sore scalp part of the hair loss? If this is related to my hormone levels or the cysts will my hair come back once they are under control? I have so many questions, and there is not a single dr out there who will answer them!
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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.
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.
Men, oh yeah, different ball game. Just think how much money is spent on prostate research and medication versus female cancers!!!!! This IS a male society, but just smile, that makes you feel better. Do not let this get under your skin. KNOW who you are with or without hair, you are one fabulous person, loving and shining your light on this world. Step into that, claim it, own it. Whoever is unkind to you, just love them, bless them and wish them well. They have a bigger problem than you, trust me. And the WILL bump into it one day and not know what hit them.
Most people naturally shed about 50 to 100 hairs a day, but sometimes men and women can shed much more, leading to thinning hair, hair loss, and over time, baldness. The causes of this hair loss can be a result of hormones, underlying medical conditions, and even certain medications like antidepressants, high-blood pressure medications, and NSAIDS (non-steroidal anti-inflammatory medications). Sometimes, hair loss is purely genetic and can run in families.
Aside from medication and lasers, some opt for hair transplants — a procedure where hairs are removed from another part of your body and then transplanted to the thinning or balding areas. Does it work? In a word, yes. Research suggests that most hair transplant recipients report are "very satisfied" with their results. While successful, transplants are also far more expensive than medications, foams, or lasers with costs averaging anywhere from $4,000 or $15,000.
Women also may experience AGA, often with thinning in the central and frontal scalp area but usually without frontal–temporal recession (Figure 3). A history and physical examination aimed at detecting conditions of hyperandrogenism, such as hirsutism, ovarian abnormalities, menstrual irregularities, acne, and infertility are indicated. Laboratory tests are of little value in women with AGA who do not have characteristics of hyperandrogenism.5

PCOS or Polycystic ovary syndrome is an imbalance in male and female sex hormones. An excess of androgens can cause ovarian cysts, higher risk of diabetes, weight gain, changes in menstrual period infertility and also hair thinning. Because male hormones are over-represented in polycystic ovary syndrome, women may also experience more hair on their body and face.

The course of typical alopecia areata is not predictable with a high likelihood of spontaneous remission. The longer the period of time of hair loss and the larger the area involved, the less likely the hair will regrow spontaneously. Therefore, there are a variety of treatments, but none of these can confidently be predicted to impact the course of this disease. Local steroid injections intracutaneously may be very helpful in restarting the hair growth cycle in treated areas. Steroid creams, lotions, and shampoos have been used for many years but are of limited benefit at best. Although oral systemic steroids are known to induce hair growth in affected patients, their long-term use is contraindicated because of the likelihood of undesirable side effects.

I haven’t seen any information about DHT blockers which I’ve read iis the leading cause of hair loss. It’s a “bad” hormone released that causes hair loss. Any comment or recommendations? One supplement to reverse DHT contains saw palmetto, which I’ve heard isn’t recommended for women. Totally stumped, depressed and irritated with so many suggestions that may or NOT work. Compassionately sending this message to all those suffering with hair loss….it’s totally devistating.
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.
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