A biopsy is rarely needed to make the diagnosis or aid in the management of alopecia areata. Histologic findings include peribulbar lymphocytic infiltrate ("swarm of bees"). Occasionally, in inactive alopecia areata, no inflammatory infiltrates are found. Other helpful findings include pigment incontinence in the hair bulb and follicular stelae, and a shift in the anagen-to-telogen ratio towards telogen.[citation needed]

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 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.
*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.
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.
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. 

One of the first research studies linking alopecia with celiac disease was published in 1995. Italian doctors had noticed that several of their patients with alopecia also had celiac disease and that in one of these patients—a 14-year-old boy—the missing hair on his scalp and body completely regrew after he adopted a gluten-free diet. This boy's case and a few others prompted the doctors to screen a large group of alopecia patients for celiac disease.


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?
"The majority of men lose their hair not through stress, or bad diet, or lack of sleep, but through the genetic trait of male pattern baldness which is hard to treat through shampoos or supplements alone. Women lose their hair for very different reasons, but the argument still stands that a lot of the hair loss products on the market are just offering false hope. That said, there are a few that really work."
A little farther up the follicle is the mysterious feature called the bulge. That's where follicle stem cells live. When they get the right set of chemical signals, these self-renewing cells divide. They don't divide like normal cells, in which both halves become new cells that keep splitting and developing. Only one half of the follicle stem cell does that. The other half becomes a new stem cell, and stays put for future regeneration.
Alopecia areata: Researchers believe that this is an autoimmune disease. Autoimmune means the body attacks itself. In this case, the body attacks its own hair. This causes smooth, round patches of hair loss on the scalp and other areas of the body. People with alopecia areata are often in excellent health. Most people see their hair re-grow. Dermatologists treat people with this disorder to help the hair re-grow more quickly.

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!
Have you experienced anything dramatic? Car wreck? Tremendous unusual stress? Are you on Birth Control? Did you stop? Did you dye your hair? I believe the arrhythmia is due to anxiety but you may want to go to the doctor for that. All of these questions may answer the problem. There is a condition called telogen efflivium (it is a temporary condition) and will run it’s course for 3-9 months no one knows the exact length. All we do know is that there is nothing to stop it. You are wise to not start rogaine but you really need to look into these questions. And if your answers are all No. Go to another dermatologist and voice your concerns. Ask for all the blood tests related to hair loss do a scalp biopsy get to the bottom of it. Find out if it is temporary and if it is let it run it’s course and do whatever you can to not stress. Then if it is more than that get into action and start treatment because the sooner you treat it the better the results. Hair loss is not cookie cutter there is no one answer for all of us at this time. I wish you the absolute best.
Hair loss caused by folliculitis decalvans, an inflammatory disorder that leads to the destruction of hair follicles, is often accompanied by redness, swelling, and lesions on the scalp that may be itchy or contain pus, known as pustules. This type of hair loss is not reversible, but dermatologists can offer medication to control symptoms and, in some instances, stop the progression of hair loss.
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.  

About 2 years ago I lost approximately 50% of my hair and the quality went from thick, strong, straight, healthy hair to thin, weak, frizzy, kinky dry hair that not only sheds but breaks and flakes off pieces at my ends. My skin has become very dry and my nails have become weak also. I went to an endocronologist that put me on 125mg spironolactone which had been increased slowly over a period of a year. He also decided he wanted to give me a layered approach by adding on 2 other medications over a year, one was Glumetza ER 500mg twice a day and Actos 15mg once a day. He said my DHEA was a little high and that these drugs used for off label treatment would help grow my hair back. My hair stopped falling out and a little grew back but the quality of my hair was still very sickly almost like someone on a chemo drug. I was concerned about my liver and stopped taking the drugs, unfortunately my hair started shedding again. 

I need help. I have been taking Elavil for sleeping for years just reccently I have noticed alot of hair loss and I am so worried. I also take synthroid. and just got off of cytomel because that also causes hair loss.I found out by going on line that taking Elavil and synthroid together it can cause hair loss and heart rhythm disorders. I have been having lots of heart plapations too. Does anyone know if you stop taking Elavil will the hair come back or if you chance snythroid to another drug? let me know we need to stick together on this.
Once male-pattern baldness starts, it’s not going to stop until every last hair on your head has shrunk or shed, though the rate at which this happens differs from person to person and depends on genetics. And since the grind of hair loss is unending, it’s important to start treatment as soon as your hairline starts bothering you. If you’re looking for a more quantitative metric, Dr. Paul McAndrews, clinical professor of dermatology at the USC School of Medicine and member of the International Society of Hair Restoration Surgery, assures me that “you have to lose half your hair before the human eye can tell.” (Of course, if you don’t care about losing your hair and are fine with going full Prince William and shaving your head, go for it. We’ve got some recommendations for razors and hair trimmers to help you out on that front.)
Diffuse female hair thinning and hair loss during premenopausal age is usually not heredity. It is usually caused by hormonal imbalances seeing in PCOS or thyroid disorder, nutritional deficiency (low iron), and stress. Women with PCOS produce high levels of androgens such as testosterones and DHEAS. The ratio of LH and FSH is also more than 2. Make sure you get your sex hormones check if you notice your hair thinning.

So far, I’ve only been on the Propecia for about three weeks. I don’t notice any side-effects thus far. I am taking 2.5 mg of Proscar, to be exact. I feel good and have not noticed any difference in my hair. I continue to lose about 20 hairs when I shower and brush it each day. That may not sound like a lot but I have already lost so much of my hair, that I think that represents more hair loss than it sounds. At least it is stable for now…I thank GOD that it is not getting worse. I DO have re-growth but it is fine and “wispy” as you said. It is not the same as the rest of my “normal” hair but hey, at least some of it is growing back in. Slowly and finer. That seems to support the AGA diagnosis. The thing that really drives me crazy is that I still don’t know WHY the TE started in the first place. The TE unmasked the AGA, but why the damn TE and what from here? Anyway….I digress and obsses!


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. 

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.
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.
Men, oh yeah, different ball game. Just think how much money is spent on prostate research and medication versus female cancers!!!!! This IS a male society, but just smile, that makes you feel better. Do not let this get under your skin. KNOW who you are with or without hair, you are one fabulous person, loving and shining your light on this world. Step into that, claim it, own it. Whoever is unkind to you, just love them, bless them and wish them well. They have a bigger problem than you, trust me. And the WILL bump into it one day and not know what hit them.
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.
Sorry to hear about her incident. Unfortuantely, I had issues around her age. Doctors often will say that there are no issues or nothing can be done, but that’s not true. There’s a few things she can do and the sooner she does it, the better. Regrowth may not occur, but maintance may. She should go see a dermatologist that specializes in this area (or at least has some knowledge about it). One way to do this is to check out the American Academy of Dermatology website. If you check out their annual meeting, you can find out who is doing research in this area and/or giving talks. It would be really important to find out why she is losing her hair. It may be alopecia, but there might also be other reasons she’s losing her hair. Her PCP might be able to gear you in the right direction and/or do some blood work to eliminate the “usual” suspects as to why she may be losing her hair.
“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.
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