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.
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.
The topical sensitizers, diphencyprone or squaric acid dibutylester, have been used in those suffering from recalcitrant alopecia areata or those with more than 50% hair loss. The goal of treatment is to create an allergic contact dermatitis of the scalp. This alteration in the immune response occasionally is accompanied by hair regrowth. The efficacy of the topical sensitizers has been demonstrated in both young children and adults, but it probably works less than half the time. Recent success using oral janus kinase inhibitors, including tofacitinib, ruxolitinib, and baricitinib, have been shown to be efficacious in severe, extensive alopecia areata in adults, but long-term therapy has potential side effects. The durability of response to these medications is variable, and most patients experience recurrence of hair loss after discontinuation. Perhaps topical therapy with these types of drugs may be available in the near future.
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.
Mistakenly thought of as a male disease, around 40% percent of women will suffer from some form of hair loss by the age of 50. A woman’s hair is an important part of her aesthetic make-up. It represents her style and taste, and frames her face while accentuating her best features. Unfortunately, most physicians don’t have answers or solutions for women who begin to lose their hair.  Plano, TX hair restoration surgeon, Dr. Joseph Yaker, understands that this can be extremely catastrophic to a woman’s self-confidence, body image and quality of life. Clinical studies have shown that psychiatric disorders such as depression and anxiety are more common in people with hair loss, especially women.

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 am on Arava and my hair has become extremely coarse, frizzy, and tight tight curls in the back. The sides of my hair are pure frizz and the top is straight, with frizz. It used to be smooth and so easy to manage. Now it takes so long and it looks awful. Anyone find the same thing and anything that helps? I have tried so very many hair products, so has my beautician. She says it is like I have 3 completely different textures on my head.
In May I was diagnosed with rhuematoid arthritis and was put on arava, which is known to cause hair loss. After four months I noticed I was losing a bit more hair than normal so the rhuematologist added Enbrel, which I inject once a week. After a month on both my hair really started to fall out and thin. The nurse practitioner (who thinks she’s an MD) told me to stop the Arava and not to stress about it. Yeah, right! I went back to my gyne who ran lab work and found my testosterone level to be 235, way high! I had an MRI of my adrenal glands and my ovaries since these two produce testosterone. I also had an ultrasound of my ovaries. All exams were normal.
While diet alone won’t save your hair, there may be some truth to the old adage that you are what you eat. “You’re not going to have the healthiest hair if you’re living off doughnuts, because being nutrient-deficient weakens strands and makes them more prone to breakage,” says Denise Kernan, owner of DK Hair Techs, Inc., a member of the International Society for Hair Restoration Surgery, and a hair transplant technician who has worked on everyone from senators to sports stars to actors to mafia guys (she won’t name names to protect the privacy of her clients).
I too visited the infamous-overpriced Dr Redmond from NYC. I’m on spiro and all the meds for 7 months, going on 8. Forget regrowth, forget halting of shedding, the rate of hair shedding refuses to slow. (I’m also certain its PCOS and not lupus that causing my hairloss, thoroughly medically investigated my hairloss. ) At the start of my treatment, I cut my hair to bout 5 inch lenght, so I’d easily be able to tell thinning versus halt versus regrowth. And all I can say is, I have less hair than I started with. Unfortunately even a physicians intervention is incapable of helping me. To all those out there, atleast this approach before scratching it off your list, its the least you can do.

Baldness typically refers to excessive hair loss from your scalp. Hereditary hair loss with age is the most common cause of baldness. Some people prefer to let their hair loss run its course untreated and unhidden. Others may cover it up with hairstyles, makeup, hats or scarves. And still others choose one of the treatments available to prevent further hair loss and to restore growth.
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.
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I took spironolactone several years ago, and after 3 days got tinnitus (ringing in ears) permanently. Quit using it. Now, I take Fo-ti, Beta sitosterol, saw palmetto, and black cohosh. Also don’t use commercial hair dyes, as they made more hair fall out and if you have a yeast infection, take yeast defense as an itchy scalp from yeast (think too much sugar in diet) will make your hair fall out. Fructis has come out with a shampoo called Fall Fight that seems to help. My hair loss has stopped, although the volume has not come back. Look for solutions on your own, plenty of articles on the internet. Good luck!
I am 18 years old and about a month ago i noticed my hair falling out increasingly fast. It has scared me to death. I’ve gone to see my general practitioner and he said that hair goes through shedding stages and that it is normal. It is definitely not normal for me. I insisted that he check my thyroid and my results came back normal. My family just repeatedly tells me that I’m crazy and have no reason to worry. I have just purchased an apartment with my friends and will start college in the fall. I am terrified to begin my new life with a hair loss problem. My hair has always been my best feature. It has always been thick, healthy, beautifully wavy, and I have always received compliments on it. I am emotionally devastated to watch my hair fall out in large amounts just from taking a shower or brushing my hair. It is nice to know that I’m not crazy, or alone. Thank You All!
*All medications have both common (generic) and brand names. The brand name is what a specific manufacturer calls the product (e.g., Tylenol®). The common name is the medical name for the medication (e.g., acetaminophen). A medication may have many brand names, but only one common name. This article lists medications by their common names. For information on a given medication, check our Drug Information database. For more information on brand names, speak with your doctor or pharmacist.
“I think their effectiveness is not as significant as finasteride or minoxidil,” says Dr. Wolfeld, “however, it’s something that can be used quite easily by patients at home. If they use it two or three times a week, I tell them it can help to thicken their hair.” Results can take up to 18 months to show up, so Dr. Wolfeld stresses that patience is a virtue.
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.

KARYN SPRINGER, M.D., is a staff physician at Intermountain Health Care, Orem, Utah, and a part-time faculty member at the Utah Valley Family Practice Residency Program, Utah Valley Regional Medical Center, Provo, where she also completed a residency. Dr. Springer received her medical degree from the University of Utah Medical School, Salt Lake City....
Let me give a background of my health issues. I am 54 years old and I was diagnosed with Hashimoto’s (hypothyroid) disease AND going through menopause about 6 years ago. I have a great ob/gyn that will treat both using compounded bio-identical hormones. I have bloodwork at least twice a year, more if I’m not feeling 100%. My testosterone levels were usually on the low side, but still WNL.
Hi! Any recommendations for doctors that care about or specialize in hair loss in South Carolina (or NC or GA for that matter–I can travel.) I am very glad to have found this site. I am 3 months into using 5% Rogaine and taking 50 mg of Spiro. I have noticed a decrease in shedding but no regrowth.Very very very stressful problem to have. So nice to have ideas and support here.
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.
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]
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.
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. 

During a hair transplant procedure, a dermatologist or cosmetic surgeon removes tiny patches of skin, each containing one to several hairs, from the back or side of your scalp. Sometimes a larger strip of skin containing multiple hair groupings is taken. He or she then implants the hair follicle by follicle into the bald sections. Some doctors recommend using minoxidil after the transplant, to help minimize hair loss. And you may need more than one surgery to get the effect you want. Hereditary hair loss will eventually progress despite surgery.
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:
Spironolactone, an aldosterone antagonist with antiandrogenic effects, works well as a treatment for hirsutism and may slow hair loss in women with AGA, but it does not stimulate hair regrowth. Estrogen may help to maintain hair status in women with AGA, but it also does not help with regrowth. Few controlled studies have examined the many non–FDA-approved hair growth agents such as cyproterone acetate (not available in the United States), progesterone, cimetidine (Tagamet), and multiple non-prescription and herbal products. A full discussion of approved and unapproved treatments for AGA can be found elsewhere.6,7 In all forms of alopecia, hairpieces and surgical transplants can produce satisfactory results but are expensive.
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!
I’ve been to five doctors. Two of them made fun of me. Only one doctor was remotely interested in my hair loss. He prescribed propecia, mens Rogain, and told me to take 2600 ml of biotin a day. My hair is still falling out. I am almost bald. None would give me any tests to determine the cause (other than thyroid, which has been done twice). The doctors tell me it is hereditary. If they could see my family, they would know that is not true. No one that I know of in my blood line has lost their hair. I am beside myself. I barely leave the house anymore. I wish I could find some help somewhere.
Spironolactone, an aldosterone antagonist with antiandrogenic effects, works well as a treatment for hirsutism and may slow hair loss in women with AGA, but it does not stimulate hair regrowth. Estrogen may help to maintain hair status in women with AGA, but it also does not help with regrowth. Few controlled studies have examined the many non–FDA-approved hair growth agents such as cyproterone acetate (not available in the United States), progesterone, cimetidine (Tagamet), and multiple non-prescription and herbal products. A full discussion of approved and unapproved treatments for AGA can be found elsewhere.6,7 In all forms of alopecia, hairpieces and surgical transplants can produce satisfactory results but are expensive.
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.
My hair was healthy. No split ends and thick and tame – I could not break it. The healthy condition of my hair may be the reason that I didn’t loose all of it. My hair loss was due to a “HAIR DESTROYER” causing chemical damage, burning my scalp and my hair ( I think she used a product banned in Australia). I had bald spots on my crown the size of 50 cent pieces and the rest of my hair was singed. I lost my hair gloss, I was left with hair that was as thin a rice paper and breaking everywhere. I had severe itching on my scalp for two years. Not pleasant. I cursed her every day and still do. I bought myself a pair of hairdressing scissors and cut as much hair off as I could; and chipped into it everywhere. I do this every two weeks. Hence I will never go to a hair dresser again and have not colored my hair since December 2012 – I asked for Brown on Brown 10 vol – how could an idiot of a hair destroyer (dresser) get it so wrong.

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.


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.
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.
Also my energy levels are high. I remember that at the beginning i did heavy cardio and interval training which helped me lose weight fast but i did not realize how biotin played a part in my weight loss until AFTER i stopped working out. I continue to take biotin every day and now that I am no longer on my diet i eat whatever i want and i don't gain weight. It appears the biotin may be keeping my metabolism to the level it was at during my training. So i highly recommend it to you. For me the best is www.certifiedbiotin.com my friends also use this one. 

I too have problem with hair loss. I had seen a dermatologist that charged me $85 just to pull my hair and told me nothing wrong with me. I told her my hair normally fall off a lot when I wash me hair, but she insisted that my hair is healthy. She spent approximately 5 minutes with me. From that experience, I don’t go see anybody else about my hair, bad experience. That was 10 years ago. I am not 43 years old. I just don’t trust the doctors any more. I still have problem with my hair so if any of you know a recommend/good caring doctor(s) in Houston Texas, please let me know. Thank you.

A separate study, published in Skin Therapy Letter — a professional reference site for dermatologists — found that women also benefit from using the more potent 5 percent minoxidil treatment. “Patient-reported improvement in hair volume and coverage appears to be greater with 5 percent minoxidil foam,” reads the report. Plus, because the 5 percent treatment is stronger, women only have to apply it once a day to get the same results as they would with the 2 percent treatment applied twice daily.

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.
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.
Certain medical issues can also impair hair growth. An overactive or underactive thyroid gland can cause hair loss. So can iron deficiency. When women go through menopause and their estrogen levels fall, their hair often begins to thin. Many women also lose some hair a few months after giving birth because of the hormonal changes the body experiences.
I’m interested in what took place 4 months before the onset of your hair loss (and others with telogen effluvium). For me, it has always been either a baby born or a course of antibiotics. Oral birth control can also cause a sudden change in the gut flora–as can pretty much any medication. Staph infections are another connection I think should be pursued. Some women don’t know they’re colonized with Staph but they constantly have dry, cracked (mild or severe) sores in their noses.
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 am 18 years old and about a month ago i noticed my hair falling out increasingly fast. It has scared me to death. I’ve gone to see my general practitioner and he said that hair goes through shedding stages and that it is normal. It is definitely not normal for me. I insisted that he check my thyroid and my results came back normal. My family just repeatedly tells me that I’m crazy and have no reason to worry. I have just purchased an apartment with my friends and will start college in the fall. I am terrified to begin my new life with a hair loss problem. My hair has always been my best feature. It has always been thick, healthy, beautifully wavy, and I have always received compliments on it. I am emotionally devastated to watch my hair fall out in large amounts just from taking a shower or brushing my hair. It is nice to know that I’m not crazy, or alone. Thank You All!
Side effects and concerns: Minoxidil is safe, but it can have unpleasant side effects even apart from the alcohol-related skin irritation. Sometimes the new hair differs in color and texture from surrounding hair. Another risk is hypertrichosis — excessive hair growth in the wrong places, such as the cheeks or forehead. (This problem is more likely with the stronger 5% solution.)
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.

I too visited the infamous-overpriced Dr Redmond from NYC. I’m on spiro and all the meds for 7 months, going on 8. Forget regrowth, forget halting of shedding, the rate of hair shedding refuses to slow. (I’m also certain its PCOS and not lupus that causing my hairloss, thoroughly medically investigated my hairloss. ) At the start of my treatment, I cut my hair to bout 5 inch lenght, so I’d easily be able to tell thinning versus halt versus regrowth. And all I can say is, I have less hair than I started with. Unfortunately even a physicians intervention is incapable of helping me. To all those out there, atleast this approach before scratching it off your list, its the least you can do.


Eyebrows unfortunately is a different ball game, that is skin transplantation from skin at the back of your head where your hair grows. This means that you would have to trim your eyebrows for the rest of your life. The cost for this surgical treatment is $5000, and again covered by Care Credit. Not sure if I want to do this. I am very light blond. I may just consider permanent eye brow tatoe. I have seen beautiful work – cost around $500.
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.
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!
“If you don’t want a scar because you like to wear your hair short, you might opt for a “scarless” hair transplant,” says Dr. Joyce. Also known as follicular unit extraction (FUE), grafts are harvested one at a time with tiny punches that heal virtually undetected so you can still buzz your head. “If you’ve gone so bald that you don’t have a lot of donor hair on your head, we can do FUE extractions with body hair such as on your chest, stomach, back, and sometimes even the pubic area,” says Dr. Joyce.
What’s important to know: the cause of hair loss is specific to each individual, which is why it is so important to have a board-certified dermatologist examine, diagnose, and treat your condition. DR.DENNIS GROSS will review your symptoms, examine your scalp, perform a possible scalp biopsy, and/or order medical and blood tests if an underlying medical condition (like thyroid disease, diabetes, or autoimmune diseases like lupus) is suspected.

There can be several factors behind hair loss such as environmental effects, aging, too much stress, excessive smoking, nutritional deficiencies, hormonal imbalance, genetic factors, scalp infections, use of wrong or chemically enriched hair products, certain medicines and medical conditions like thyroid disorder, autoimmune diseases, polycystic ovary syndrome (PCOS), iron-deficiency anemia, and chronic illnesses.

How many of us are out there… feeling alone and pretending to not be ashamed. As a child, I had so much hair that my mother used a thinning shears on my locks. In high school I had a glorious mane, cut into a ‘Gypsy’… what great pictures. By my mid-20’s I had to cut my hair short because it was so thin that it wouldn’t hold a style. Was diagnosed with PCOS and told that this syndrome, combined with heredity, caused my hair loss.
Evaluating and treating hair loss (alopecia) is an important part of primary care, yet many physicians find it complex and confusing. Hair loss affects men and women of all ages and frequently has significant social and psychologic consequences. This article reviews the physiology of normal hair growth, common causes of hair loss, and treatments currently available for alopecia.
SOURCES: George Cotsarelis, MD, director, Hair and Scalp Clinic, University of Pennsylvania School of Medicine, Philadelphia. Andrew Kaufman, MD, assistant professor, department of dermatology, University of California, Los Angeles; medical director, Center for Dermatology Care, Thousand Oaks, Calif. Tom Barrows, PhD, director of product development, Aderans Research Institute Inc., Atlanta. Cotsarelis, G. and Millar, S.E. Trends in Molecular Medicine, July 2001; vol 7: pp 293-301. American Society for Dermatologic Surgery web site. American Academy of Facial and Reconstructive Plastic Surgery web site. American Hair Loss Council web site. Springer, K. American Family Physician, July 1, 2003; vol 68: pp 93-102. Hair Loss Help web site, "Interview with Dr. Ken Washenik from Bosley." Fuchs, E. Developmental Cell, July 2001: vol 1: pp 13-25.

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.
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

There’s also a women’s version (Women’s Rogaine Foam) — but a three-month supply costs $22 more online. The only difference between the two products are the instructions; women are instructed to apply once a day instead of twice. If you’re a woman who doesn’t feel like paying extra for marketing, the men’s product will suffice. A cheaper generic version is Kirkland Signature Minoxidil Foam, but with a longer history on the market and more customer testimonials, Rogaine is our first choice.
Ann, I’m so sorry to hear about your home. That breaks my heart for you. I wish you the best in recovery of your home and blessings on your finances. But I do have to say I think that only losing 20 sounds like a dream! I absolutely know that my TE was triggered by PPD in hair dye. I only wish that I would have figured it out sooner. I was forewarned with itching for a year, no dandruff flaking or anything just itching and that was my body trying to heal itself against the allergy and the all hell broke lose on my head! Please keep me posted propecia; I wouldn’t even look for any improvement for 6 months though. But please be here when you do see it! Have a blessed day!
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.
i am a mother of a 10 yr old beautiful daughter who at this moment has started to lose some hair on her eyebrows.. at first i thought it was just skin disorder because it started out as an round and whitish spot on her left eyebrow…and only applied ointment on it. but then i statrted to notice that her eyebrows are have seen to not look normal and both end of her eyebrows are gone … and so i immediately took her to a dermatologist and with just one look at her through a lighted mirror ( i think) she told me – its alopecia.. due to stress, – that really shocked me…she’s a happy ten year old girl.. attending grade school.. she’s my only child … day and night we are together..so i am very secured in knowing that if she has any problem in school or with her friends – she would tell me as she always does.. and then the doctor showed me pictures od bald older men and told me that sometimes _ alopecia showed itself in men’ s mustaches.. sideburns… etc. then she gave us a prescription for an ointment to use on her brows 2 x a day and get back at her after two weeks.
I am 46 and starting menopause, according to my bloodwork. I didn’t have any tradtional menopause symptoms. My only health issue was burning scalp and hairloss–a lot. (I do not use any chemicals on my hair and don’t even blow dry it.) After losing almost half of my hair in 3 months I went off the pill (mircette which is low estrogen) and withing 48 hours the burning decreased by about 50%. Then I started using progesterone cream. Within 3 days the hairloss slowed from losing 65+ hairs in the morning to just 15-20. By the 6th day the burning is 95% gone. I can wear my hair in a ponytail with a soft scrunchie today! Maybe I have estrogen dominence, which is talked about in Dr. Lee’s book “What Your Doctor May Not Tell You About Menopause: The Breakthrough Book on Natural Progesterone”. I hope that I continue to improve and I hope each one of you finds the solution to your hairloss. By the way, my doctor ( GP) told me to stay on the pill and that nothing could be done for my hairloss. It was the owner of a family-owned pharmacy that suggested the progesterone cream and to stop the pill.
KARYN SPRINGER, M.D., is a staff physician at Intermountain Health Care, Orem, Utah, and a part-time faculty member at the Utah Valley Family Practice Residency Program, Utah Valley Regional Medical Center, Provo, where she also completed a residency. Dr. Springer received her medical degree from the University of Utah Medical School, Salt Lake City....
Yes, absolutely. There are certain hair treatments, as well as styles, that can trigger hair loss: tight braids, pigtails, hair weaves, and cornrows can all trigger temporary hair loss called traction alopecia. Chemical relaxers; overuse of chemical colorants; hot-oil treatments; overuse of flat irons, curling irons, or even hot blow-dryers can all damage hair at the root, causing it to fall out. If you are experiencing hair loss, its best to schedule an appointment with our office so that we can help diagnose your issue and determine how best to your hair loss.
If you’re a gentleman who’s been noticing a receding hairline or is worried about balding, the first step is to schedule a visit with a doctor or dermatologist and make sure your hair loss isn’t a sign of a more serious health issue. “Not all hair loss is male-pattern hair loss,” explains Dr. Marc Glashofer, a board-certified dermatologist specializing in hair loss and practicing in northern New Jersey. A thyroid disorder, an autoimmune disease, or even a scalp issue could be making you look like Bruce Willis in Die Hard 2. But most hair loss is androgenetic alopecia, also known as male-pattern baldness, and fortunately (or not, depending on your perspective), it’s just a symptom of getting older.
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.
A separate study, published in Skin Therapy Letter — a professional reference site for dermatologists — found that women also benefit from using the more potent 5 percent minoxidil treatment. “Patient-reported improvement in hair volume and coverage appears to be greater with 5 percent minoxidil foam,” reads the report. Plus, because the 5 percent treatment is stronger, women only have to apply it once a day to get the same results as they would with the 2 percent treatment applied twice daily.
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. 
I’m 26 and started losing my hair (in the course of about a month) one year ago. I’ve seen three doctors about it. The General practitioner just pulled my hair and said it looks like my hairloss had already righted itself. Well, I didn’t believe her. So I went to a derm and he said he saw little regrowth hairs so it was just temporary hairloss and if, for some reason, I haven’t regrown my hair in to a noticable length in a year to come back to him for more bloodwork. (I had gotten my thyroid checked in my yearly physical and they said it was just slightly elevated . However, they told me this was not enough to put me on medication that they would check it again in one year) It has been one year and I think my hair is actually getting thinner. I’m just panicking. I’ve always had thick, straight as a board hair like another woman on this post had said, and now it is very thin, breaks easily and is ‘kinky’. I don’t understand why its kinky, why would my really long hairs that took years to grow now start to be damaged and kink when they fall out? I never got split ends, I never had short hairs fall out and when my hair did fall out in its normal pattern it would always fall out in one long, straight, thick strand. Does this mean I have a miniaturization of my follicles that has been going on for years? That maybe my hair strands are growing back thinner? I agree with another girl on this site that said she feels like there is no hope now. I was assured by my derm that my hair loss would not get worse. This helped me to cope a bit because instead of looking like someone with thick hair, I just had to look like someone with thin, wispy hair. I thought maybe I could deal with that, as long as I didn’t have to go bald. Well as much as this site has encouraged me in that ‘misery loves compay’ I now see that there are very few solutions and left untreated it can make us bald! I might also mention that I was never on birth control, and have no idea why I just suddenly started losing my hair. However, I have always had PMS and heavy periods. I guess I just want to know, is this for sure a problem with my hormones? Is it because my thyroid is slightly elevated? Should I even bother going to a doctor anymore? How can women as young as 18-30 be getting this problem? I guess I just am in that panic mode, where I really just want some reassurance that the odds of this getting better are good. I’ve past that one year mark of when I’m supposed to know if it was temporary or not and so now that sense of panic is renewed. Is this just going to keep getting worse? What do I do!? I hope some of you have some comments that could help me out. Thanks for listening to me rant.
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!
Your doctor might also suggest the prescription pill finasteride, sold under the brand name Propecia and also in generic versions. Although the drug is not federally approved for use in female patients, some doctors have observed good results in postmenopausal women. But women who are planning to have children should not take this drug because it can cause birth defects.

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.
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.
Alopecia areata is a disease that attacks your hair follicles (the part of your skin that makes hair). In most cases, hair falls out in small, round patches about the size of a quarter. This causes only a few bare patches. Some people may lose more hair. In only a few people, the disease causes total loss of hair on the head or loss of all body hair.
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]
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.
Finally people who understands what I am going through …I am in a desperate search for doctors in the Miami/Boca Raton, Florida area. Can anyone help? I dont know yet what has been causing my hair loss…I had been loosing some hair throighout the years, and sometimes it gets lees severe but lately has just gotten worse and there is no stopping it seems. I had mt Tyroid checked by PCP a coulpe months ago and my iron level also looked normal …getting desperate. Would appreciate some help.
Hi there.. I to am experiencing hair loss.. lots of it.. Doesn’t even feel like hair.. and my scalp hurts.. almost like a throbbing.. I have leukemia and have had since 2005 but doesn’t appear to present a problem. I’ve had trouble a couple of times in the past few years due to stress (lost a sister in a car wreck) but my hair got healthy again. This time around there has been no stress.. I was low in B12 (261), however, I’ve been getting shots and its up to 450. They’ve ruled out thyroid.. Any ideas what else it could be and how I should move forward in figuring it out? I’m very anxious.. I’ve always had long very thick coarse hair but always healthy.. now it looks limp and always feels dirty..
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]
Blow dryers, flat irons, and other devices: Frequent use of a blow dryer tends to damage hair. The high heat from a blow dryer can boil the water in the hair shaft leaving the hair brittle and prone to breakage. Dermatologists recommend that you allow your hair to air dry. Then style your hair when it is dry. Dermatologists also recommend limiting the use of flat irons (these straighten hair by using high heat) and curling irons.
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.
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 struggled with my hair for a long time now. I am quickly approaching my 40s and I have bad hair quality. Recently, I have also noticed that my hair has stopped growing as it used to. A few years ago I went to the salon on a monthly basis. Now, it takes me almost two months before I even need to cut my hair! I am desperate and I really need help right now. Hair is one of the most important parts of a woman and I don’t want to give up on this one. I went to the doctors but they didn’t found anything wrong with me. The exams I took showed that I am healthy and there’s no reason for this to even happen to me. Please, I really need hair advice urgently!!!!!!!!!!!!

If a pregnant woman comes in contact with crushed or broken Finasteride tablets, wash the contact area right away with soap and water. If a woman who is pregnant comes into contact with the active ingredient in Finasteride, a healthcare provider should be consulted. If a woman who is pregnant with a male baby swallows or comes in contact with the medicine in Finasteride, the male baby may be born with sex organs that are not normal.
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’m interested in what took place 4 months before the onset of your hair loss (and others with telogen effluvium). For me, it has always been either a baby born or a course of antibiotics. Oral birth control can also cause a sudden change in the gut flora–as can pretty much any medication. Staph infections are another connection I think should be pursued. Some women don’t know they’re colonized with Staph but they constantly have dry, cracked (mild or severe) sores in their noses.
Almost all hair loss in guys results from male-pattern baldness, a genetic trait that comes from your parents. Other causes include certain medications, too much vitamin A, or not enough protein. Illness or stress can lead to sudden, heavy shedding called telogen effluvium. Good news, though: Hair loss that isn’t from male-pattern baldness often reverses itself.
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).

“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.
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.
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Aside from the falling hair, I’m also experiencing bouts of arrhythmia. There are instances when my heart would beat slowly and it feels like it’s going to break my ribcage. It’s hard to breathe and I get dizzy. Do you think these are related? I don’t want to go to another doctor yet because I haven’t researched yet and because of my many disappointing experiences with them, I would never dare to consult with one without knowing anything.
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.
There can be several factors behind hair loss such as environmental effects, aging, too much stress, excessive smoking, nutritional deficiencies, hormonal imbalance, genetic factors, scalp infections, use of wrong or chemically enriched hair products, certain medicines and medical conditions like thyroid disorder, autoimmune diseases, polycystic ovary syndrome (PCOS), iron-deficiency anemia, and chronic illnesses.
again, she found my testosterone level a tad high, in the 50’s. she initially wanted me to start on both metformin and spironolactone. i am not a diabetic, but apparently the metformin stops testosterone production and the spironolactone inhibits testosterone from absorbing…or something to that nature. she didn’t come out and say that my elevated level was the cause of my hair loss, but she did say elevated levels “could” be the culprit, but that either way she wanted my levels to normalize. makes sense. she listened to me patiently and spent a good amount of time, medically, with me. she ordered labs: not anemic, good iron, good protein, no thyroid problems. the metformin made me sick. she told me to start slowly with each med and that she’d increase it with time, based on my body’s reaction. with spiro you need to have your potassium checked within two weeks of starting it. sadly, i didn’t follow through with the meds because they made me feel so sick and i couldn’t go back to her since i lost my insurance. but after reading all of these posts, i have scheduled another appt with her in a few weeks and will ask her to put me on spiro only and will see if this helps.
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.
Bald spots, thinning, and breakage can be symptoms of a serious underlying health condition such as alopecia, lupus, thyroid issues, and other common types of disease that cause hair loss. If you have noticed a dramatic increase in shedding or other change in the appearance of your hair, Drs. Robert J. Dorin and Robert H. True can help. During an evaluation at one of our offices in New York, New Jersey, or Boston, we can discuss your options and provide you with solutions to restore your appearance and confidence.
Your doctor might also suggest the prescription pill finasteride, sold under the brand name Propecia and also in generic versions. Although the drug is not federally approved for use in female patients, some doctors have observed good results in postmenopausal women. But women who are planning to have children should not take this drug because it can cause birth defects.
If you’re a gentleman who’s been noticing a receding hairline or is worried about balding, the first step is to schedule a visit with a doctor or dermatologist and make sure your hair loss isn’t a sign of a more serious health issue. “Not all hair loss is male-pattern hair loss,” explains Dr. Marc Glashofer, a board-certified dermatologist specializing in hair loss and practicing in northern New Jersey. A thyroid disorder, an autoimmune disease, or even a scalp issue could be making you look like Bruce Willis in Die Hard 2. But most hair loss is androgenetic alopecia, also known as male-pattern baldness, and fortunately (or not, depending on your perspective), it’s just a symptom of getting older.
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