Minoxidil: This medicine is applied to the scalp. It can stop hairs from getting thinner and stimulate hair growth on the top of the scalp. The U.S. Food and Drug Administration (FDA) has approved minoxidil to treat hair loss. It is the only hair re-growth product approved for men and women. A dermatologist may combine minoxidil with another treatment.
“The most common cause of hair loss in both men and women is androgenetic alopecia, which is genetic pattern hair loss,” explains Dr. Michael B. Wolfeld, a board-certified plastic surgeon and an assistant clinical professor of plastic surgery at the Icahn School of Medicine at Mount Sinai Hospital in New York. The root cause of this type of hair loss is dihydrotestosterone (DHT), a byproduct of testosterone that shrinks certain hair follicles until they eventually stop producing hair.
About 2 years ago my hair started thinning. I thought it was because I was in college and stressed. At that point I started going what is known as “CG” in the curly hair world. I no longer color, flat iron, use sulfates and I rarely blow-dry and use silicones. I use shampoos and conditioners with beneficial ingredients, not fillers. After 1.5 years on this Curly Girl routine, I experienced some relief and noticed my hair getting thicker. That lasted a couple months and now I’m back to losing a ton of hair. One day I counted 160 hairs…that was on a decent day. I’m sure I’ve lost 2x that amount before. My hair is noticeably thinner, drier, and it knots. It NEVER use to knot. I think my hair has become finer too, but I’m not positive. It just feels more fragile.
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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]
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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.
Ironically, taking the hormone levothyroxine to treat an underactive thyroid can contribute to some hair loss, among other side effects, but this seems to be more common within the first month of treatment and more often in children than adults. This hair loss is only temporary and will go away as treatment is continued and thyroid hormone levels stabilize.

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?
Lichen planopilaris, a type of alopecia, occurs when a common skin condition, called lichen planus, affects the scalp. Lichen planopilaris may cause a dry, flaky rash to appear on the skin that causes hair on the scalp to fall out in clumps. The scalp may also become red, irritated, and covered in small white or red itchy, painful, or burning bumps.
Starting in my very early 20s i noticed the beginnings of my hair loss and started asking doctors about it with no hope/no answers until my 27.5 year. A local dermatologist “heard” something about the spironolactone/yaz combo and was willing to try it out -along with biotin, rogaine and omegas. I believe she helped the quality of my skin and hair, but did not help the fact that my hair continued to disappear. 

I decided to take a vitamin B complex – one a day; I increased my intake of green leafy and orange vegetables and onions, I also throw in a small amount of beef and chicken..i.e. eating lots of stirfries, curries and salads. I also now include in my diet black beans, walnuts and pumpkin seeds. I like spaghetti with red tomato sauce and use parsely and fenugeek . I also started using a product called Hopes Relief (the shampoo and conditioner) – anything else left a burning sensation on my scalp. This helped greatly with healing my scalp redness and reduced the itching. I was seeing an improvement in regrowth. I went to a trichecologist who advised me I have lost 10% of my hair permanently as she could see the scarring and places where the follicles would not grow.

Hair: It’s a natural part of being a human. But when the temperature climbs, and skin is exposed, it’s one of those things that a good many of us want to control. This week, we’re tackling hairlessness, not just the process of hair removal (electric shavers and ingrown-hair treatments and aesthetician-approved tweezers) but also what to buy when you’re losing your hair, and even how to take care of a Sphynx cat. Here, we’re talking to dermatologists and hair-loss doctors about hair-loss treatments that actually work.
"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."

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]
I am 45 years-old and started noticing a thinning of my hair about 2 years ago. I did see a dermatologist specialized in hair loss and was only prescribed a testosterone lab test which came back normal. My scalp is vey itchy but I do not have dandruff or any signs of dry skin. It sometimes hurts so bad I wake up at night. I was prescribed a steroid shampoo and a steroid lotion which have helped calm down the itchiness and pain if used regularly. I was diagnosed with Female baldness (mostly on the top which is really thin now) and dermatitis. not further explanations. I was also prescribed Rogaine 5% and a mixture of Rogaine and RA to use every 3 days. once a day. should I start using them twice a day? its only been 3 months and I have not noticed a change. I accepted a job to work from home because I was getting too self conscious to go to work at the office. I am very concerned by my appearance usually but this hair loss is a constant worry. 

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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.
Alopecia areata is an autoimmune disease, where a person's immune system attacks the body, in this case, the hair follicles. When this happens, the person's hair begins to fall out, often in clumps the size and shape of a quarter. The extent of the hair loss varies; in some cases, it is only in a few spots. In others, the hair loss can be greater. On rare occasions, the person loses all of the hair on his or her head (alopecia areata totalis) or entire body (alopecia areata universalis).
Each day the scalp hair grows approximately 0.35 mm (6 inches per year), while the scalp sheds approximately 100 hairs per day, and more with shampooing.1 Because each follicle passes independently through the three stages of growth, the normal process of hair loss usually is unnoticeable. At any one time, approximately 85 to 90 percent of scalp follicles are in the anagen phase of hair growth. Follicles remain in this phase for an average of three years (range, two to six years).1 The transitional, or catagen, phase of follicular regression follows, usually affecting 2 to 3 percent of hair follicles. Finally, the telogen phase occurs, during which 10 to 15 percent of hair follicles undergo a rest period for about three months. At the conclusion of this phase, the inactive or dead hair is ejected from the skin, leaving a solid, hard, white nodule at its proximal shaft.2 The cycle is then repeated.
When men have hereditary hair loss, they often get a receding hairline. Many men see bald patches, especially on the top of the head. Women, on the other hand, tend to keep their hairline. They see noticeably thinning hair. The first sign of hair loss for many women is a widening part. In rare cases, men see noticeably thinning hair. And in rare cases, women can see a receding hairline or bald patches. The reasons for this are unknown.
Alopecia areata is believed to be an autoimmune disease resulting from a breach in the immune privilege of the hair follicles.[4] Risk factors include a family history of the condition.[2] Among identical twins if one is affected the other has about a 50% chance of also being affected.[2] The underlying mechanism involves failure by the body to recognize its own cells with subsequent immune mediated destruction of the hair follicle.[2]
When healthy hair is pulled out, at most a few should come out, and ripped hair should not be distributed evenly across the tugged portion of the scalp. In cases of alopecia areata, hair will tend to pull out more easily along the edge of the patch where the follicles are already being attacked by the body's immune system than away from the patch where they are still healthy.[11]
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.
so here i am. i’m ready to try the spiro, alone, especially after reading your posts. i’ve thought of shaving my head, and i may be closer to doing that. i keep my hair in a short bob since it helps not having it knot up when it’s longer, due to its fineness. i try to let it air dry, but blow drying it, upside down, adds volume. plus my curls do not really form anymore because of the texture. i have never counted my lost hairs individually, but i don’t need to have an exact number since just eyeballing what comes out every time i wash, comb, or just touch my hair is stressful enough. it’s hard to be in the sun. we hung out at a garden for Easter yesterday and the sun was burning my scalp. i have tried expensive shampoos, but nothing. i may look in to the toppik. i used to use this bumble and bumble brown hair powder, but since it didn’t quite match my color (it’s only available in three shades) it didn’t look so convincing. the toppik makes more sense since it’s a fibrous material.
Susan – I am horrified to read that two of your doctors actually made fun of you… oh my gosh that is awful! I’m so sorry you had to go through that. I am also surprised that your doctors wouldn’t do any bloodwork other than thyroid. What City/ State do you live in? Maybe someone can recommend a doctor in your area that would be more helpful. While many times bloodwork results end up coming back normal there is that possibility that your results would point to something that may be the cause of your hair loss, especially since you say you have no genetic hereditary hair loss in your family. I know you stated your hair is still falling out, but do you see any results from the propecia and mens rogaine? When did your hair loss start?
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.
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. 
About 2 years ago my hair started thinning. I thought it was because I was in college and stressed. At that point I started going what is known as “CG” in the curly hair world. I no longer color, flat iron, use sulfates and I rarely blow-dry and use silicones. I use shampoos and conditioners with beneficial ingredients, not fillers. After 1.5 years on this Curly Girl routine, I experienced some relief and noticed my hair getting thicker. That lasted a couple months and now I’m back to losing a ton of hair. One day I counted 160 hairs…that was on a decent day. I’m sure I’ve lost 2x that amount before. My hair is noticeably thinner, drier, and it knots. It NEVER use to knot. I think my hair has become finer too, but I’m not positive. It just feels more fragile.
Each day the scalp hair grows approximately 0.35 mm (6 inches per year), while the scalp sheds approximately 100 hairs per day, and more with shampooing.1 Because each follicle passes independently through the three stages of growth, the normal process of hair loss usually is unnoticeable. At any one time, approximately 85 to 90 percent of scalp follicles are in the anagen phase of hair growth. Follicles remain in this phase for an average of three years (range, two to six years).1 The transitional, or catagen, phase of follicular regression follows, usually affecting 2 to 3 percent of hair follicles. Finally, the telogen phase occurs, during which 10 to 15 percent of hair follicles undergo a rest period for about three months. At the conclusion of this phase, the inactive or dead hair is ejected from the skin, leaving a solid, hard, white nodule at its proximal shaft.2 The cycle is then repeated.
I understand how you feel, I really do. I’ve spent so much time crying that I’m certain all my tears could have filled up an olympic size swimming pool by now. You must not give up hope, even when it seems there is none. It is so important. Without that I don’t know how I would get by. Once you say what city/state you are in, I really hope someone can recommend a good doctor. I think that is part of your despair, that you haven’t really been heard out by a physician and received the bloodwork you want and are entitled to.
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