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.

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.
Thank you all for sharing your stories. I have various health issues including arthritis of the spine, GI problem and Poly ovarian cyst syndrom… I had exetremely thick and full hair all my life 5yrs ago my hair started falling out in huge clumps all day long so much so that I leave huge hair balls under my desk at work… I also have sjordren syn. When I first went to my family doctor he told me it was because of my high stress job… I said that I did research on the internet and that all my conditions were supposed to be linked to hairloss he was mad and said why did I come to him if I had all the answers… I have been to 2 dermos who said its nothing. I went to the only endocrinologist in a 100 plus mile radius of my home who was taking new patients who said that there is nothing wrong with me and that if I cared about my health as much as my hair loss I would loss weight ( I know I not skinny but…) he did not even LOOK at my tests when he came in he said we didnt get your urine samples results back. I said that I went 3 weeks ago. He then said oh here they are… but did not even look at them before his fat comment… since I do not want to swear on here I will just say “jerk”. I cried the whole way home. I went back to my family doc and saw the PA because it seems he is sick of me. Again among other sympt. my hairloss is getting worse… the PA’s answer “yea that’s pretty bad.” (wow I’m paying for this advice ) She brought me back samples and said this should help. it was an anti depressant….I said I am not depressed I am upset that everyone can acknowledge my sympt. but no one seems to be able to help my. My arthritis doctor ran tests only to shut me up and said my folate levels were fine so it had to be stress… not their problem. I came from my 3rd gyno today who said now since my cysts were gone and my test. levels were normal that I can’t have children anyhow then I shouldn’t worry about hairloss… no advice whatsoever about the diease less than 5 mins. $400.00 40 mile trip another day of work gone. This doc. did even think I should be concerned that I cannot get preg. or my pain (so it does not surprise me about the hairloss) I said is there anything else that can cause my hair to fall out besides test. levels he said not gyno related…. He said if you like we can test you again in three more months. I would give up but I know it is not something just in my head or even just a cosmetic problem…. I feel sometimes they just want to milk my insurance dry my running the wrong test so they can keep charge you for the expensive stuff instead of working on a cure for you. The worst maybe is that my family and friends are also sick of me and think I just like attention. From your post I looks like a lot of have similar health and experiences. Although I am very upset I am glad be able to vent to people who also my have be treated like hypocons… and armed me will more info.
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.  
How to use minoxidil: Be sure that your hair and scalp are dry. Using the dropper or spray pump that's provided with the over-the-counter solution, apply it twice daily to every area where your hair is thinning. Gently massage it into the scalp with your fingers so it can reach the hair follicles. Then air-dry your hair, wash your hands thoroughly, and wash off any solution that has dripped onto your forehead or face. Don't shampoo for at least four hours afterwards.
Finasteride has relatively few side effects, and a dosage of 1 mg per day costs about $49.50 per month. Women who could be pregnant should not handle finasteride, because it may cause birth defects in a male fetus. Finasteride has not proved effective in the treatment of female AGA and is not FDA-approved for use in women.11 [Evidence level A: randomized controlled trial] Continued use is required to maintain benefits.
The trick about all of these hair-loss products and treatments is that they’ll stop working as soon as you stop using them. “They have to be ready for a lifetime commitment,” says Rieder. But, just like brushing your teeth, as long you keep on keeping on with the scientifically proven preventative treatments, those hairs on your head should be just fine.
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.
At RHRLI, we’ve seen clients who deal with all types of hair loss and there are several types of hair loss related to autoimmune diseases. We want you to know all about the relationship between autoimmune conditions and hair loss. And if you’re looking for a permanent solution to your hair loss or thinning hair, we have one. It’s called the ARTAS® system and it uses state of the art robotic technology to give you a fuller, healthier head of hair.
About one-third of women experience hair loss (alopecia) at some time in their lives; among postmenopausal women, as many as two-thirds suffer hair thinning or bald spots. Hair loss in women often has a greater impact than hair loss does on men w, because it's less socially acceptable for them. Alopecia can severely affect a woman's emotional well-being and quality of life.
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).
"The majority of men lose their hair not through stress, or bad diet, or lack of sleep, but through the genetic trait of male pattern baldness which is hard to treat through shampoos or supplements alone. Women lose their hair for very different reasons, but the argument still stands that a lot of the hair loss products on the market are just offering false hope. That said, there are a few that really work."
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I also suspect, as you suggest, that the trichodynia is a result of rapid hair loss. I share your frustrations with how very little we dermatologists know on the subject. The only observational study on Trichodynia and chronic telogen effluvium involved only 8 patients. Only one of those eight went on to have androgenetic, permanent hair loss. The numbers followed is pathetic!
Alopecia areata occurs when your immune system attacks your hair follicles, causing varying degrees of hair loss. Alopecia areata usually starts with one or more small, round, smooth bald patches on your head, and can eventually cause complete hair loss on your scalp or even on your entire body. Full body hair loss is known as alopecia universalis.
Thank you so much ladies, I am grateful I was able to find this website. Can anyone suggest a Doctor in the South Florida Area ( West Palm Beach, Ft. Lauderdale, Hollywood or Miami)? I have seem countless of Doctors in the past 20 years; felt like none really cared or took an honest interest. The last Doctor I visited didn’t even bother to see me in person, she just called me on the phone and told me nothing can be done, use Rogaine if you want, she said. Needless to say my condition is serious. After this I am at the point of giving up but if I could find a Doctor that really cares I am willing to try again. Any advise is welcome. Thanks 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.
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

Without a doubt, poor nutrition (often caused by eating disorders and crash dieting) is a common trigger of temporary hair loss. If you don’t get enough protein in your diet, your body may respond by shutting down hair growth—resulting in hair loss. Great source of protein include red meat and dairy products, as well as quinoa, legumes, and nuts and nut butters (all great options for vegetarians). Hair loss can also be triggered by anemia, or a deficiency in iron. Getting enough iron (found in red meat) is key to treating this; often times, an iron supplement can help. If this is the cause of your hair loss, our dermatologists can do a simple blood test to confirm this.
I have recently noticed my hair thinning about a year ago. I was 19 when it stated and I am now 20. I have seen well over 10 different doctors including dermatologist, gynecologist and your normal everyday doctor. They have done thousands of dollars worth of blood work on me and they have yet to figure out what is going on. I went from loosing 20 hairs a day to 100 and talk about wanting to cry every night. I have lost over 50% of my hair and everyone including my parents blow me off like it completely normal. My doctors have strung me out in every medicine and when that didn’t work they thought it was all in my head. They told me that it’s normal to lose hair and that it will eventually stop. I’ve had doctors laugh and blow me off, I’ve had doctor to prescribe me depression medicine and a psych. I feel like I’m alone and no one understands what I’m going through. I went from being the funny outgoing person who didn’t care what people think to a self conscious and antisocial person I don’t know. It’s been the worst year of my life, sometimes it feels like a nightmare. I just hope the next doctor I see will give me hope that one day I’ll have my think pretty long hair that I use to have.

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Results from several small studies suggest that biotin supplements may improve thinning hair and brittle nails. Less commonly known as vitamin H, biotin is part of the B complex vitamins, which help your body metabolize fats and protein. Some experts even recommend a daily supplement for everyone since it’s generally safe and pretty hard to get too much of it.
Alopecia areata occurs when your immune system attacks your hair follicles, causing varying degrees of hair loss. Alopecia areata usually starts with one or more small, round, smooth bald patches on your head, and can eventually cause complete hair loss on your scalp or even on your entire body. Full body hair loss is known as alopecia universalis.
I just came across this website and would welcome any recommendations on hair loss specialists in the suburbs of Philadelphia, PA. I have an appointment with my family doctor in a couple weeks, and I’m sure she’s going to run blood work. I’m a 55 yo female and have been experiencing large amounts of hair loss in the past few months. I am generally in good health with the exception of some “structural” issues (scoliosis, etc.). Thank you!
I do not believe birth control pills nor rogaine to be an appropriate long lasting answer for hair loss. I do not want to be on drugs for a length of time. Luckily, I have researched how the answer possibly lies within your lifestyle. What you eat, How much you exercise, how much sleep you get and stress you have. As for hormone-caused hair loss, the adrenal gland produces a 1/4 tsp of hormones per year. If you go slightly under or over that amount, a hormone imbalance is the result. If you use table salt, or are on a low-salt diet…you may be negatively affecting your hormones.
I have not heard anyone talk about the “HairClub” use to be a center called the “Hair Club for Men” but now seems to also be catering to women. I had a consultation last week and the consultant looked at my scalp with an instrument that showed my scalp on a screen, she performed a microscopic hair and scalp analysis. Of course I really needed to see my scalp magnified a trillion times and seeing both thick and thin hair and of course all the empty spots where hairs use to be. She was very informative and showed me the cycle of healthy hair and also the ones that are not and how they thin and eventually fall out and the hair follicle closing. Their pamphlet show women with different stages of hair lost, from patches to almost bald. She explained that there was hope and that with a yearlong regiment of going once a month and having my scalp treated with their products and some sort of scalp stimulation I can get my hair back. Of course this comes at a price, almost 3k for the year. She did say that the monthly regiment will include hair styling as well. woohooo. Anyways I want to know if anyone has been to one of these Hair club facilities and if they have had any success with the personalized program without having to resort to surgery. My prayers go out to all of you.
Because of its psychologic nature, the mainstays of treatment are counseling, behavior modification techniques, and hypnosis. Selective serotonin reuptake inhibitors and other medications for depression or obsessive-compulsive disorder may be used in some cases, although no medications are FDA-approved for treatment of trichotillomania.17 If a more moth-eaten appearance of hair loss is present and no evidence of hair-pulling behavior can be elicited, syphilis should be suspected.
"Firstly, even the very good ones won’t get to the root of the issue - pardon the pun - and prevent or treat male or female pattern baldness which is caused by genetics, nor deal with hormonal issues at the heart of female hair loss. But they can help make the hair you do have stronger and healthier. And they can be useful in putting a hair loss regime in place, along with medication like Minoxidil or Finasteride and/ or a hair transplant.
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.
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!
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.
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
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.
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."
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
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.
Hello all, it feels so good to know that I am not alone in this hair battle. I started noticing hair thinning at around 16 (I had ‘horse hair’ before (thick and strong) as my mom would call it). I chalked it up to the crash diet I did at 15 where I lost about 30lbs in about 2 months…since then my hair has gotten thinner and weaker over the years. I just turned 26 and this had been the worst year for my hair. I got married in Aug and some would say it could be the stress from that event but I say NO to that. I’ve had extensive blood work done…iron, testosterone, etc etc blah blah blah…EVERYTHING came back NORMAL! It seems as if nothing can help me! This last derm I saw today just told me to stick to rogaine, and when I asked about Provillus (these pills I heard about) he said he never heard of it and to try it and let him know! I have cried so much this year! I can’t even part my hair in the middle anymore because it’s so thin..and washing it? omg that’s an emotional rollercoaster on it’s own…my scalp is always so oily and the rogain is making it worst! and so ITCHY! AND FLAKY! What can I do now? who should I see? What makes this even more bizzare is that my acne now is worst than it ever was! I was skinny with lots of hair and clear skin in HS and now? It seems I can’t lose the 15lbs I’ve packed on and this acne stuff isn’t making it better! My husband isn’t much help because he doesn’t get it..I don’t know what else to do, someone please help me.
@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.

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.
Diphencyprone (DPCP): This medicine is applied to the bald skin. It causes a small allergic reaction. When the reaction occurs, a patient has redness, swelling, and itching. Dermatologists believe this allergic reaction tricks the immune system, causing it to send white blood cells to the surface of the scalp. This fights the inflammation. It also prevents the hair follicles from going to sleep, and causing the hair loss.

Leprosy (Hansen's disease) is a disfiguring disease caused by infection with Mycobacterium leprae bacteria. The disease is spread from person to person through nasal secretions or droplets. Symptoms and signs of leprosy include numbness, loss of temperature sensation, painless ulcers, eye damage, loss of digits, and facial disfigurement. Leprosy is treated with antibiotics and the dosage and length of time of administration depends upon which form of leprosy the patient has.
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