Age-onset thinning, or “miniaturization,” refers to a progressive decrease of the hair shaft’s diameter and length. This happens at least in part because of androgens like dihydrotestosterone (or DHT), a derivative of the male hormone testosterone that causes hair follicles to literally shrink in diameter. This type of hair thinning is referred to as androgenic alopecia, and it occurs in an equal pattern all over the scalp. However, pregnancy, ovarian cysts, medications, emotional or physical shock, and birth control pills can all affect hormone levels, making it complicated to pinpoint the reason for hair loss. For example, polycystic ovarian disease can exacerbate androgens and manifest as thinning, in which case you could treat the condition and fix hair loss. Get your hormone levels checked to see if an underlying health issue is the root cause.
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.
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.
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.

While you won’t find a miracle shampoo on the market, nioxin and some other products can help keep your scalp in tip-top shape to improve the look of any hairs you do have left on your head. In fact, feeding your hair with the proper nutrients both inside and out can make it appear healthier, so you might consider using products with natural herbs, such as rosemary and mint.
I have been amazed and appreciate alot of peoples’ comments and experiences on hair loss. I recently found out that i have PCOS through an endocrinologist. I went in for an infertility consultation. Still working through that. I do have thinning hair on the top of my head and my hair has become really dry in general. I have type 4b/4c hair (kinky/tightly coiled). With PCOS you have to treat each symptom. I am wondering, if i am focused on infertility right now, am i also able to check in with a dermatologist and treat both? It seems likely that the answer is no. Just curious if anyone is going through this or has gone through this and can give any helpful advice.
Hello all!!!! I would suggest all you havent been checked for pcos, to do so!!!! Its prob the issue. It reaks havoc on a womens hair and body. I take saw palmetto and my bc pills everyday and have been happy with results. Saw palmetto is used to stop testostrone from turning into ht with causes . the follicle to shrink and not be able to support a healthy hapr so it bdeaks off and eventually falls out. Ive heard good things about. Hairessentils vitamins
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.
And though this treatment appears to be safe and somewhat effective, it’s hard to tell who will react well to this low-level light therapy, which is why the doctors I spoke with were hesitant to fully endorse it. “We’re not sure what the optimal power is, what the optimal wavelength is, we don’t even really know the mechanism of action of how this is working,” says Rieder. Plus, it doesn’t work on everyone. “There are subpopulations of patients who do respond to low-level laser light, but this is not easily predictable,” explains McMichael, though she adds that the risk of using the LaserComb is low.
I am 31 years old and I been loosing my hair (in the front) for 3 years now. I have seen different 4 different gynecologists and the one I have now she took blood work and other tests and the when all the tests came back everything was fine. I am trying to find a dermologist in my area that accepts my insurance. I just want to know what caused the hair loss and what can be done. It is embarrassing to even go out, when I do go out I make sure that I have a hat on. ???????? 

I just began reading this post this evening. My hair loss began when I was 18, currently 29. No bald spots, but it just keeps getting thinner and thinner and thinner. I have been to many doctors as well. Every PCP and family doctor have been of no help. After four dermatologists I have given up on that as well. I went to Hans Wiemann (in the St. Louis area) that offers laser treatments and hair transplants. The whole appointment was such a sales pitch that I was so aggravated and felt worse by the time I left. I have also tried an herbalist, chinese medicine, and a nutritionist/chiropractor. I try not to think about it, I really do, but let’s face it, that’s about impossible. I know my problem is NOT genetic, everyone in my family has a full head of hair. I’m healthy in terms of exercise and diet, I don’t take any medications, smoke, or drink. None of the doctors have ever found anything with blood work or urine samples. If anyone can suggest a doctor, specialist, anyone that can help in the St. Louis or Chicago area, PLEASE do let me know.
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.
*all photos are models and not actual patients.If you are interested in a prescription product, Hims will assist in setting up a visit for you with an independent physician who will evaluate whether or not you are an appropriate candidate for the prescription product and if appropriate, may write you a prescription for the product which you can fill at the pharmacy of your choice.
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.
This blog is great in all the support and understanding it provides, but I had a pretty hard time finding any suggestions for treatments that have actually helped anyone. I’m 22 and my hair has been rapidly shedding over the past 5 months. It’s also gotten thin and brittle. After 2 blood screenings, a dermatologist visit, and a visit to my general practitioner, nothing has improved. The doctor’s told me to wait it out, and that sometimes this “just happens”. They tested my hairs and saw that most of them were in the “resting” telogen phase, and decided I had Telogen Effluvium (TE) for undetermined causes.
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
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 42 and I noticed my front top and sides thinning about a year ago – a lot coming out when brushing after washing. I went to the doctor who happened to be African-American (I’m caucasion) and she actually asked me if I wore “corn rows” a lot! Needless to say, she was worthless and just prescribed me something for dandruff, which I do not have! I went to an endocrinologist to see if my thyroid or menopause was the problem – tests turned out honky dorie! Now I can see through the top of my head when the sun shines on it (scar-y) and I’m having to cover over the temple areas with sweeps of hair from the other side (interesting, the right side is much thinner). I will say that I’ve gone through hell and back with a mentally ill young adult but if it was stress, wouldn’t it have come out quicker than just in the last year (I’ve been dealing with his illness for 7 years now)?? I’ve heard that sometimes it takes 2 or 3 blood tests and doctors to finally see that one has thyroid problems. Is this the experience of others, and would I be throwing my money away by seeing my general practitioner?
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.

Alopecia areata is thought to be a systemic autoimmune disorder in which the body attacks its own anagen hair follicles and suppresses or stops hair growth.[9] For example, T cell lymphocytes cluster around affected follicles, causing inflammation and subsequent hair loss. It has been suggested that hair follicle in a normal state are kept secure from the immune system, a phenomenon called immune privilege. A breech in this immune privilege state is considered as the cause of alopecia areata.[12] A few cases of babies being born with congenital alopecia areata have been reported.[13]


Not surprisingly, treatments with 5 percent minoxidil work better than treatments with 2 percent minoxidil. A randomized clinical trial published in the American Journal of Clinical Dermatology in 2002 found that, in men with androgenetic alopecia, “5 percent topical minoxidil was clearly superior to 2 percent topical minoxidil and placebo in increasing hair growth.” The difference was actually pretty astounding — after 48 weeks, the men who used 5 percent minoxidil experienced 45 percent more hair growth than the men who used the 2 percent treatment.
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?
Some of the skin disorders like lupus and sarcoidosis can cause hair loss. In case of lupus, the hair tends to get brittle and may fall out in patches. Lupus hairs or short, broken hairs usually appear above the forehead. Hair loss is not permanent in general here. Some individuals with lupus also develop a form of lupus known as discoid or cutaneous lupus that affects the skin. Scars that sometimes develop on the skin of the scalp may lead to hair loss.
Why? Unwanted hair growth (sideburns, for example) is a reported side effect of minoxidil. The belief is that a higher concentration of minoxidil would result in more unwanted hair, which is why women are instructed to use it less often. However, the study in Skin Therapy Letter reports that unwanted hair was more common in 2 percent minoxidil solutions than 5 percent, and women are instructed to use Rogaine’s 2 percent solution twice daily — so what gives?
I’m 42 and I noticed my front top and sides thinning about a year ago – a lot coming out when brushing after washing. I went to the doctor who happened to be African-American (I’m caucasion) and she actually asked me if I wore “corn rows” a lot! Needless to say, she was worthless and just prescribed me something for dandruff, which I do not have! I went to an endocrinologist to see if my thyroid or menopause was the problem – tests turned out honky dorie! Now I can see through the top of my head when the sun shines on it (scar-y) and I’m having to cover over the temple areas with sweeps of hair from the other side (interesting, the right side is much thinner). I will say that I’ve gone through hell and back with a mentally ill young adult but if it was stress, wouldn’t it have come out quicker than just in the last year (I’ve been dealing with his illness for 7 years now)?? I’ve heard that sometimes it takes 2 or 3 blood tests and doctors to finally see that one has thyroid problems. Is this the experience of others, and would I be throwing my money away by seeing my general practitioner?
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