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] 

Eva if you can look at some of Pilar’s post she mentions in one of them a dr she sees in NYC. She loves her and the dr has done a lot for her. I would say there is no doubt it is the Retin A that has caused your loss, but it is probably Telogen Efflivium which is temporary and the recovery is nothing like they say it is. Especially if your scalp is miserable because there is a lot of inflammation that will need to calm down before everything can reset itself. Please try to find her post where she list the derm she sees. She loves her.

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.

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.
Side effects of JAK inhibitors identified so far include stomach upset, an increase in chest and skin infections and transaminaitis (an alteration in liver function identified by blood testing). Mild skin and upper respiratory tract infections have been reported in 25% of patients. Very few patients with alopecia areata elect to stop the medication as a result of side effects. Nevertheless patients receiving these medications require close medical supervision.
I suspect Hypervitaminosis A for my hair loss due to prolonged use of a high dosage of Retin A but I can’t find anyone who will test me. I had a PAINFUL scalp, too sensitive to touch and unbearable itching. I stopped the Retin-A 2 months ago and the scalp pain and a lot of itching stopped a week afterwards. I saw a PCP and 3 derms. All recognized hair loss but shrugged it off as hormonal or a lack of deep conditioning! Please avoid these NYC doctors at all costs:
I also have been experiencing hair loss for the last 6 years and it is truly devastating. It is so hard to get up in the morning and go to work I feel so embarrassed, insecure and feel like every one around me is just staring at my head. I also just came across this website and I feel every one’s pain. For a woman, it is such a terrible thing to deal with. I will pray that we can all find the solution to this terrible situation. I live in Houston, TX and will be making an appointment with an endocrinologist soon.
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.
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. 
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:
Hair transplants are not an options for a very large proportion of women with genetic hair loss as the pattern of hair loss is diffuse or the amount of thinning is not suitable for restoration.  Also, hair transplantation is not an option for women with chronic telogen effluvium, nor for women with active frontal fibrosing alopecia, lichen planopilaris and a host of other conditions. 
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.
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.
I am scared to find out whether I have PCOS…I was hoping to find out about my insulin as I sensed a major blood sugar problem for years, but I took the news surprisingly poorly. I’m more stressed than before and am terribly depressed. The doctor, by the way, had zero to say about it all. Nothing. His words “Ask your gynocologist, I am just a lowly MD.” [gasp]
But you must start these medical therapies before you lose all your hair. McAndrews likens it to brushing your teeth, in that both are preventative measures. “The sooner you start doing it, the better at slowing down this aging process,” he explains, adding, “Is toothpaste perfect? No, you’re still getting tooth decay with toothpaste, but you’re slowing down tooth decay.”
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.

I want to first write that I am not a fan of hair transplants for women, I personally think that most women with androgenetic alopecia are NOT candidates for this procedure. Having said that, I get emailed all the time from women looking for a good hair transplant surgeon. If you are deadset on having a consultation, please visit the International Alliance of Hair Restoration Surgeons. The IAHRS (http://www.iahrs.org) is an organization that selectively screens skilled and ethical hair transplant surgeons. Read my thoughts about hair transplants here.
The main type of hair loss in women is the same as it is men. It's called androgenetic alopecia, or female (or male) pattern hair loss. In men, hair loss usually begins above the temples, and the receding hairline eventually forms a characteristic "M" shape; hair at the top of the head also thins, often progressing to baldness. In women, androgenetic alopecia begins with gradual thinning at the part line, followed by increasing diffuse hair loss radiating from the top of the head. A woman's hairline rarely recedes, and women rarely become bald.
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.
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. 

In 2010, a genome-wide association study was completed that identified 129 single nucleotide polymorphisms that were associated with alopecia areata. The genes that were identified include those involved in controlling the activation and proliferation of regulatory T cells, cytotoxic T lymphocyte-associated antigen 4, interleukin-2, interleukin-2 receptor A, and Eos (also known as Ikaros family zinc finger 4), as well as the human leukocyte antigen. The study also identified two genes, PRDX5 and STX17, that are expressed in the hair follicle.[18]

Dermatologist: The short answer is a doctor who specializes in the diagnosis and treatment of problems related to the skin, its structure, functions, and diseases, as well as its appendages (nails, hair, sweat glands). The longer definition (as defined by wikipedia) Dermatologists are physicians (Medical Doctors, M.D.) or Doctors of Osteopathy (D.O.) specializing in the diagnosis and treatment of diseases and tumors of the skin and its appendages. There are medical and surgical sides to the specialty. Dermatologic surgeons practice skin cancer surgery (including Mohs’ micrographic surgery), laser surgery, photodynamic therapy (PDT) and cosmetic procedures using botulinum toxin (‘Botox’), soft tissue fillers, sclerotherapy and liposuction. Dermatopathologists interpret tissue under the microscope (histopathology). Pediatric dermatologists specialize in the diagnoses and treatment of skin disease in children. Immunodermatologists specialize in the diagnosis and management of skin diseases driven by an altered immune system including blistering (bullous) diseases like pemphigus. In addition, there is a wide range of congenital syndromes managed by dermatologists.
I’m a dermatologist and am more interested in telogen effluvium these days because I have it bad–and this time it’s not because I just had a baby. I’m learning more about the gut-skin-hair connection and am suspicious that it has to do with the bacterial flora in your gut. You can learn more about changing your gut flora at BodyEcology.com. Her book is intense but I’ve decided to give it a try after recommending it and seeing it work so well with acne patients.
I took accutane for my acne for about five months ( I specifically asked my nurse practitioner if accutane could cause hair loss & after she told me no). I felt optimistic about reducing my acne & breakouts. During the fifth month I noticed shedding. Three months later I have a thinning hair line, had to cut my hair and my self esteem (already lowered by years of acne) is non-existent!
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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 affects people of all ages including young children. It produces circular patches of hair loss that appear overnight. More patches appear over time and eventually about 5% of people affected lose every hair on their body. This includes eyebrows, eyelashes and even nose hairs. In some people, hair grows back, either in the same place or on a previously unaffected part of the scalp or body.
The characteristic finding of alopecia areata is one or more well-circumscribed areas of otherwise normal, hairless skin in hair-bearing areas. Occasionally, it may be necessary to biopsy the scalp to confirm the diagnosis. Other findings that may be helpful are the appearance of short hairs that presumably represent fractured hairs, short thin hairs, and gray hair growing in a bald area. Other causes of hair loss are generally excluded from the consideration by history and clinical evaluation.

One more disease that causes hair loss is male pattern baldness. About two out of three men, experience hair loss by their age of 60 and most of the time, the hair loss is because of male pattern baldness. Such type of hair loss, caused by a combo of genes and male sex hormones, usually follow a classic pattern where the hair recedes at the temples, thus leaving an M-shaped hairline.
^ Martinez-Mir A, Zlotogorski A, Gordon D, Petukhova L, Mo J, Gilliam TC, Londono D, Haynes C, Ott J, Hordinsky M, Nanova K, Norris D, Price V, Duvic M, Christiano AM (February 2007). "Genomewide scan for linkage reveals evidence of several susceptibility loci for alopecia areata". American Journal of Human Genetics. 80 (2): 316–28. doi:10.1086/511442. PMC 1785354. PMID 17236136.
It’s also possible that some of Harklinikken’s users are women whose hair would have grown back even if they’d done nothing. Many women who arrive in a dermatologist’s office with prior diagnoses of female pattern hair loss actually have what’s called telogen effluvium. That’s a period of acute shedding of hair — meaning up to 60 percent of hair — three months after a triggering event like pregnancy, significant weight loss or starting or stopping hormone medications.

Eva if you can look at some of Pilar’s post she mentions in one of them a dr she sees in NYC. She loves her and the dr has done a lot for her. I would say there is no doubt it is the Retin A that has caused your loss, but it is probably Telogen Efflivium which is temporary and the recovery is nothing like they say it is. Especially if your scalp is miserable because there is a lot of inflammation that will need to calm down before everything can reset itself. Please try to find her post where she list the derm she sees. She loves her.


Hello. Chris, I am so happy that you made an appt to see Dr. Redmond. How did it go? I really hope it helped. i have been on treatment now for almost 3 months. Dr. Redmond told me to be patient, that things could take a year to improve, but I do feel mostly that things have stabilized. In my work (i am a physician) I have seen alot of sad cases in the last few weeks. Young patients with major illnesses, some possibly incurable and fatal. It has made me really sad. It has also made me realize that regardless of what is happening to my hair, I have to try and be happy. I have to be thankful that I am healthy and have wonderful family and friends. Not that it is a consolation, but for us, our illness is on the surface and not life threatening…unless we make it by the psychological part. Thank you for everyone who has contributed to this website so that I can deal with the psychological part better. I am doing research into wigs now and will let all of you know when I have more info. Supposedly there is a soap opera star who was bald at 14 and has been wearing wigs for a long time. She has made a line of wig’s I think called Amy’s presence. It seems that she has led a happy life despite her hairloss. Once I found out more, I will let you know. I know its not a cure, but at least it is a remedy. One day at a time, I know we can all get through this. Be well.
Hi everyone! First off I just wana say this is a great site and thank all of you for sharing your experiences with hair loss. I too am having a huge problem with this. I’m 21 years old, and it’s been going on since about October of last year. Since then it has gotten much worse. I’m so scared to wash my hair, because every time I do, 100 or more hairs fall out. I’m also having the sore scalp feeling like somebody is pulling at it. It’s horrible. I’v had long, fine, but thick and straight hair forever. It’s always been very healthy. But now it jsut looks awful. I plan to see a doctor soon, but not looking forward to it. I guess I’m just really depressed about this right now. Last night I cried myself to sleep. It’s the first time that’s happened since this has started. I’v tried to stay strong, but holding it in hasn’t helped. So anyway, I’m looking into wigs, but I really need some help finding a natural human hair wig that is affordable. If anyone knows of a place or site, please let me know. I’m so sorry that all of you are having this problem and I feel your pain.
No one wants to lose their hair, but for women it is especially traumatic. Men can shave their heads and look hip, even sexy. Most women don’t want to be bald. Though it is more common — and visible — in men, many women lose their hair. According to the American Academy of Dermatology, 30 million women in this country have hereditary hair loss, compared with 50 million men. But many additional women experience thinning hair that results from menopause or health problems.

What is a Dermatologist? A certification by the Board of Dermatology; practitioners treat pediatric and adult patients with disorders of the skin, mouth, hair and nails as well as a number of sexually transmitted diseases. They also have expertise in the care of normal skin, the prevention of skin diseases and cancers, and in the management of cosmetic disorders of the skin such as hair loss and scars.
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.

You ARE the same inside, but you are also different… you’ve been through a lot and it is so difficult to to stay strong through this experience. I won’t even go into the hair stuff, because it sounds to me that this is not what your post is about. You need to get some really solid support and find something other than your hair to focus on. You need an awesome hair system…and support system. From there, I hope and pray for you, that you will be able to find happiness and balance in your life again. You are a glorious human…don’t doubt that for a moment!


Hair transplants will likely lead to better results in the long run (you are introducing new hairs to the balding areas), but you’ll still need to use minoxidil or finasteride after surgery to maintain the results. Like all hair loss treatments, hair transplants are best when combined with other methods, and you’ll want to speak with your doctor to see what combination is best for you.
Laser devices: Brushes, combs, and other hand-held devices that emit laser light might stimulate hair growth. These devices might make hair look more youthful in some people. Because the FDA classifies these products as medical devices, the products do not undergo the rigorous testing that medicines undergo. The long-term effectiveness and safety for these devices are not known.
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. 
During this procedure, surgeons remove a narrow strip of scalp and divide it into hundreds of tiny grafts, each containing just a few hairs. Each graft is planted in a slit in the scalp created by a blade or needle in the area of missing hair. Hair grows naturally this way, in small clusters of one to four follicles, called follicular units. As a result, the graft looks better than the larger "plugs" associated with hair transplants of yesteryear.
I had embolization and an angiogram for an AVM on my jaw. I was told there would be some hair loss because of the radiation (The size of a quarter). Well I have lost all but 1/3 of my hair left …not the area of a quarter! Has anyone ever had this happen? My doctor says the hair should grow back, but it has been three months and it is still coming out and no new growth. I don’t know what to do! Any suggestion? As with many women my hair was a part of my identity. I am not bragging but people remember me as the girl with all the hair. I realize we are more than our hair, but it makes me so sad!
Im new here and suffer from hair loss. I’m 25 and have developed bald spots about 2 yrs ago back in 09. On the side of my head near my temple areas. I hide the bald spots with headbands every chance i have because i feel as if people just look directly there…im self concious about myself because about a year ago i had a head full of hair and now i dont..I want to seek help just doesnt know where to begin…im currently takin biotin and keep hope alive…
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.
Just happened to find this website and have spent 3 hrs getting to know the trials us women go through with or without our hair. I have cried with you, laughed with you and felt your pain. I have frontal fibrosing alopecia and have gone to Stanford Medical Center and saw a dermatologist. I have been using clobetasol 0.05% topical solution on my hair line and sides every night and morning as well as take finasteride 2.5mg daily. Not sure if it is doing anything and what falls out will never grow back with scaring alopecia. If it gets to the point where I can’t hide it anymore I will get a real hair wig. The main thing is how beautiful each and every one of you are! The light you shine towards others makes you beautiful and makes us feel beautiful! Being thankful for what we do have always lifts the spirit and our outward appearance.
"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’s no cure for baldness, but there are ways to hold on to what you've got. The six dermatologists and the clinical studies point to three methods: minoxidil, laser treatments, and prescription finasteride. The key is finding the combination and hair loss regimen that works for you. A doctor is your best bet for that kind of guidance — but we found a few trustworthy products that will work for most people.
Androgenetic alopecia (AGA), or male-pattern baldness, is hair thinning in an “M”-shaped pattern; hair loss occurs on the temples and crown of the head with sparing of the sides and back5 (Figure 2). This pattern reflects the distribution of androgen-sensitive follicles in most people.6 Starting at puberty, androgens shorten the anagen phase and promote follicular miniaturization, leading to vellus-like hair formation and gradual hair thinning.6
I just came across this website, I thought by chance but I think not! I have been having scalp pain, like my skull wanted to crack open. Then the tendersness of my hair folicals when the wind would blow. I started to loose lots of hair so went to my family doctor. All the test were done for Thyroid problems…all turned out what they call “normal”. Have you seen the wide range which is considered normal? How can this be when everyone is so different? I am loosing hair as I sit and write this message. The hair just gently falling onto my shoulder. I need to color my hair as it is time from the length of my silver roots but the last time I had my hair touched up, I thought I was going to die from the pain when the stylist tried to just shampoo the color off. Oh my God! Painful, painful. I used to be a stylist so you can imagine my shock when I was told it wasn’t my Tyroid!
No one wants to lose their hair, but for women it is especially traumatic. Men can shave their heads and look hip, even sexy. Most women don’t want to be bald. Though it is more common — and visible — in men, many women lose their hair. According to the American Academy of Dermatology, 30 million women in this country have hereditary hair loss, compared with 50 million men. But many additional women experience thinning hair that results from menopause or health problems.
As much as 30 percent of women will experience some sort of hair thinning, usually first noticed with age as a skinnier ponytail or a little more visible scalp peeking out. Thick hair screams “youth,” which makes thinning a tough pill to swallow. But there are many ways you can help slow down thinning and hair loss, from eating the right foods to cutting back on stress, even strategically styling your locks. Here, seven ways to stave off hair loss and keep your ‘do looking young and healthy for longer. 
I am scared to find out whether I have PCOS…I was hoping to find out about my insulin as I sensed a major blood sugar problem for years, but I took the news surprisingly poorly. I’m more stressed than before and am terribly depressed. The doctor, by the way, had zero to say about it all. Nothing. His words “Ask your gynocologist, I am just a lowly MD.” [gasp]
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