In addition to diagnosing and treating any underlying disorder, treatments for alopecia areata include immunomodulating agents and biologic response modifiers (Table 5).6 Although topical and oral corticosteroids have been used, the treatment of choice in patients older than 10 years with patchy alopecia areata affecting less than 50 percent of the scalp is intralesional corticosteroid injections (Figure 8).6
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

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.
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.
Our other recommendation is the HairMax Ultima 12 LaserComb. The comb uses low-level lasers to stimulate hair follicles and modulate dihydrotestosterone (DHT) — a hormone that causes the most common type of hair loss. While it sounds like something from a sci-fi movie, the treatment works, and the dermatologists we consulted reported that their patients saw thicker and longer hair when combined with our top pick. The only catch: The comb isn’t as effective as minoxidil treatments, and at nearly $400, it’s a much bigger investment. Still, it’s the best option if you’re looking for a non-invasive, non-chemical treatment.
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? 

Topical immunotherapy (i.e., contact sensitizers) is the most effective treatment option for chronic severe alopecia areata (Table 5).6 Response ranges from 40 to 60 percent for severe alopecia areata, and reaches approximately 25 percent for alopecia totalis and alopecia universalis.6 Because of potentially severe side effects, only clinicians who have experience with these agents should prescribe them.

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.
Anti-androgens. Androgens include testosterone and other "male" hormones, which can accelerate hair loss in women. Some women who don't respond to minoxidil may benefit from the addition of the anti-androgen drug spironolactone (Aldactone) for treatment of androgenic alopecia. This is especially true for women with polycystic ovary syndrome (PCOS) because they tend to make excess androgens. Doctors will usually prescribe spironolactone together with an oral contraceptive for women of reproductive age. (A woman taking one of these drugs should not become pregnant because they can cause genital abnormalities in a male fetus.) Possible side effects include weight gain, loss of libido, depression, and fatigue.

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…
I was searching the internet and came across this wonderful site. I really appreciate you posting this article. I have always had a small bald patch on one side of my head. My mom told me it had always been there so I didn’t worry about it. Recently it has been getting larger and the hair around it is getting lighter. On the other side my hair is thinning and the color and texture is changing. It also seems to be falling out. I have excessive hair loss on a regular basis. I am only 24 years old and I can’t stand that my hair is falling out. I went to the dermatologist and he gave my injections but they didn’t work. He said I have alopecia areata and that the other side was a normal receding hairline. (He barely even looked at it) He then told me after the injections weren’t working to try Rogaine. I think it might be helpful to see an endrocrinologist as I have also been having problems with anemia. Again, thank you so much for the information you have provided.
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.
Ludwig Scale: This is the most common classification for female pattern hair loss. There are 3 stages (ranging from mild hair loss to extensive, severe widespread thinning) and in each stage hair loss occurs on the front and top of the scalp with relative preservation of the frontal hairline. Regardless of the extent of hair loss, only women with stable hair on the back and sides of the scalp are candidates for hair transplant surgery.
Trying to figure out exactly what is causing your hair loss is going to require a little detective work on the part of your physician. Several lab tests are going to need to be done. I’ll make sure to make another post this week about the standard lab tests that should be ordered to start the process. Hopefully you don’t have to bring the list to the doctors office, he/she should know already. I get concerned when women have to bring a list of tests that should be ordered to their doctor. My feeling is that if they don’t know what to order then how are they going to be able to accurately read the results. But… a good doctor is a good doctor, and if you have one that really cares and takes a strong interest in your hair loss with a willingness to work with you in finding the cause then great.
"We developed a protocol to drive human pluripotent stem cells to differentiate into dermal papilla cells and confirmed their ability to induce hair growth when transplanted into mice," said Prof. Terskikh. The next step in their research is "to transplant human dermal papilla cells derived from human pluripotent stem cells back into human subjects."
Alopecia areata is characterized by a localized area of complete hair loss (Figure 5). This may extend to the entire scalp (alopecia totalis) or the entire body (alopecia universalis)12,13 (Figure 6). Alopecia areata is probably secondary to an autoimmune reaction involving antibody, T-cell, and cytokine-mediated losses.14–16 The trait appears to be polygenic, affecting 0.1 to 0.2 percent of the population, with men and women equally affected.14 On microscopic evaluation, “exclamation-point” hairs are found, in which the proximal hair shaft has thinned but the distal portion remains of normal caliber (Figure 7). Spontaneous recovery usually occurs within six to 12 months, with hair in areas of re-growth often being pigmented differently.1,13 Prognosis is not as good if the condition persists longer than one year, worsens, or begins before puberty. Persons with a family history of the disorder, atopy, or Down syndrome also have a poorer prognosis.1 The recurrence rate is 30 percent, and recurrence usually affects the initial area of involvement.12 Thyroid abnormalities, vitiligo, and pernicious anemia frequently accompany alopecia areata.1,12,14
What a helpful website, thank you ladies for sharing. I am 55 and am loosing hair by handfuls when I shampoo. I have been using Minoxodil extra strength for about 5 years and it was helping but not anymore. I also have been taking Nioxin hair vitamins and they helped for the first 3 years but not now. I am going to check out Dr Redmond like several of you recommended and head to Sallys for hair extensions also. Does anyone know of a good Dermotologist or Endo Dr. in Humble or Kingwood Tx area? Karen
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.
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.

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. 
Re-growing hair: It is likely that the hair will grow back even without treatment. It may fall out again, though. Most patients lose their hair more than once before the disease goes away for good. Even people who lose all the hair on their scalp and body can have their hair grow back. When hair loss is widespread (lots of hair loss on the scalp and/or body), there is a greater chance that the hair will not re-grow.
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 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."

The follicles on the sides of the scalp are more genetically resistant to DHT, which is why male pattern baldness often results in a “crown” of hair. But its downsides are serious. “With women, finasteride is not an option,” says Dr. Wolfeld. “It’s not FDA-approved for women to take, so we don’t prescribe it.” In fact, due to the drug’s effect on hormone levels, pregnant women are advised to not even touch broken or crushed tablets.
Alopecia areata, also known as spot baldness, is a condition in which hair is lost from some or all areas of the body.[1] Often it results in a few bald spots on the scalp, each about the size of a coin.[2] Psychological stress may result.[2] People are generally otherwise healthy.[2] In a few, all the hair on the scalp or all body hair is lost and loss can be permanent.[1][2]
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]
The scalp pain has not gone away. I have tried 100 things prescribed by 100 doctors. Dermatologists have told me to add zinc supplements to my diet, use a cream with “clobetasol propionate” on my scalp, improve the quality of my scalp by getting rid of any flakiness – hundreds of options. Trichodynia – pain of the scalp – is a poorly understood subject. I don’t know if it is hormonally related, and exacerbated by the stress (of losing so much hair) – I cannot answer you.
I want to say that all of you are very courageous and sharing. I appreciate everything I have read here. Thankfully, I am starting out in a slightly better position – I still have a fair amount of hair left. I started with a HUGE amount of hair. For the last 6 – 12 months, I have been losing handfulls of hair in the shower every morning, then some more when I comb it out, then a bit more when I put styling product in it, then just a bit more during the day. The shower is the huge hit, though. I’m 37 and on a ton of medication – synthroid, neurontin (an amitryptiline derivative), anti-depressants, and a host of pain medications for a degenerative back problem. I brought my hair loss up to a doc around the time it started, since I was already on synthroid, he re-tested my levels, and said everything was fine. My hair structure has always been on the thin side, but there was just so damn much it didn’t matter – now there is a lot less. What used to take upwards of 20 minutes to dry with a dryer, now takes 5. I’ve been worried about it for quite a while, and didn’t know what to do. I started my on-line research today with hair extensions and stumbled on this site. I am encouraged that I’m starting my search for an answer relatively early in my hair loss journey. I have some great advice and questions to go in to see my doc about. If anyone has any recommendations for the Boise, ID area for a dermatologist and endocrinologist, I would really appreciate it.
With those pinned down, it wasn’t hard to determine which don’t actually work. Pretty much all the “active” ingredients listed in ineffective treatments — from biotin and zinc to emu oil and saw palmetto — have never been proven, and are instead marketed based on logical-seeming correlations. It would make sense that biotin, a B vitamin readily found in hair, skin, and nails, could help hair grow more quickly. And caffeine is a stimulant that works in coffee, so rubbing some on your scalp might wake some of those sleepy follicles… right?
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’ve come across this site before, but today has been an already 5 hour session reading everything that has been posted and researching things on the side. first and foremost, i want to thank you all for your words, rants, and honesty. i stayed home from work today after breaking down in the bathroom, already dressed for work, because of my hair. a few posts made me cry, a few made me smile and all remind me that i am not alone. i, like a few of you, hate that i focus on my hair, but even though i try my damndest to not do so, it really does depress me. i know i will bounce out of it, but it’s only a matter of time before it comes back. today is the first day that i have ever not gone in to work because of the hair situation. here’s my story:
For the first time in my life also, I have been experiencing a lot of scalp pain. I think it is because this time, it is not slow and diffuse like it was in my teenage years, at the onset of PCOS. Quitting the pill after 5 years of dependency meant a major hormonal shock to the system which provoked both a mix of both Telogen Effluvium (shock loss), and Androgenic Alopecia (the testosterone from the PCOS back in full form, killing hair follicles).
Playing around with your haircut can sometimes mask the issue, so talk to your stylist about a style that will add volume and bounce, making hair appear thicker. Simply shifting your part can work wonders, and changing up your color can help, too. Light reflects more off lighter hair, so the color provides less contrast between the hair and the scalp, concealing any empty patches. Additionally, a light perm or wave will give hair more body and make it look thicker, and frequent trims will help prevent breakage.

The follicles on the sides of the scalp are more genetically resistant to DHT, which is why male pattern baldness often results in a “crown” of hair. But its downsides are serious. “With women, finasteride is not an option,” says Dr. Wolfeld. “It’s not FDA-approved for women to take, so we don’t prescribe it.” In fact, due to the drug’s effect on hormone levels, pregnant women are advised to not even touch broken or crushed tablets.
So in closing, I echo my initial sentiments that I would always suggest seeing more than one doctor if possible. Look for one that is not only knowledgeable but one that also cares. Hair loss is not the same thing has having a blackhead removed from your back and requires more sensitivity and emotional understanding on the part of the physician. Ask a lot of questions and do your own research, even after receiving your “diagnosis.” Doctors are people and make mistakes too, this is your body and you have to be comfortable with the treatment.
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.
Minoxidil (Rogaine, generic versions). This drug was initially introduced as a treatment for high blood pressure, but people who took it noticed that they were growing hair in places where they had lost it. Research studies confirmed that minoxidil applied directly to the scalp could stimulate hair growth. As a result of the studies, the FDA originally approved over-the-counter 2% minoxidil to treat hair loss in women. Since then a 5% solution has also become available when a stronger solution is need for a woman's hair loss.
I have been losing my hair over this past year but within the last 6 months it has changed texture and still falling out! Now my hair is very coarse and kinky! For 42 years I had long straight-as-a-board hair and now I look like a poodle! Every time I comb or brush my hair handfuls of hair comes out! My hairdresser, gyno, GP and 3 dermatologists have told me it was normal to lose this amount of hair! Many contribute it aging but I find that hard to believe. Finally, my most recent derm said I was low in iron and said that might be a factor. Now, I’m going in to see if I might be anemic. My gyno ran the same tests and said all seemed normal! It’s the most frustrating and stressful event, especially when everyone tells you things are “normal”! Has anyone experienced their hair texture changing over a short period of time? Thanks-
×