Current evidence suggests that alopecia areata is caused by an abnormality in the immune system that damages hair follicles. This particular abnormality leads to autoimmunity, a misguided immune system that tends to attack its own body. As a result, the immune system attacks particular tissues of the body. In alopecia areata, for unknown reasons, the body's own immune system attacks the hair follicles and disrupts normal hair formation. Biopsies of affected skin show immune lymphocytes penetrating into the hair bulb of the hair follicles. Alopecia areata is occasionally associated with other autoimmune conditions such as thyroid disease, vitiligo, lupus, rheumatoid arthritis, and ulcerative colitis. The diagnosis or treatment of these diseases is unlikely to affect the course of alopecia areata. Sometimes, alopecia areata occurs within family members, suggesting a role of genes.
If you do decide to start treatment to save your hair, a good place to start is with minoxidil, more commonly known as Rogaine. Don’t expect this hair-loss treatment to create luscious locks; minoxidil is better at slowing down or preventing more loss rather than promoting hair growth. But, according to Dr. Amy McMichael, professor and chair of Wake Forest Baptist Medical Center’s Department of Dermatology, it is effective “if used as recommended, with evidence of improvement seen around six to nine months.” Simply massage the foam or solution into your scalp once or twice daily, and for best results, use a formula with 5 percent concentration.
My current solution is this : I have bought clip in hair extensions from Sally’s Beauty Supply store (about 100$) I actually just trim them myself and dye the hair left on my head and the extensions using an ammonia free hair dye (L’oreal or Garnier) in order for them to blend. I use a lot of root lifter and fill in the balding spots with Toppik (dark brown) and top it off with a shine spray. I’m telling you, most people have NO clue of my problem. I feel this is the best way to feel like a woman as I continue on this quest to solve my hair loss problem. I’d be happy to tell more of you about the regimine … high maintenance yes, but you know what, we all have to do what we need to do.
Not surprisingly, treatments with 5 percent minoxidil work better than treatments with 2 percent minoxidil. A randomized clinical trial published in the American Journal of Clinical Dermatology in 2002 found that, in men with androgenetic alopecia, “5 percent topical minoxidil was clearly superior to 2 percent topical minoxidil and placebo in increasing hair growth.” The difference was actually pretty astounding — after 48 weeks, the men who used 5 percent minoxidil experienced 45 percent more hair growth than the men who used the 2 percent treatment.
Results from several small studies suggest that biotin supplements may improve thinning hair and brittle nails. Less commonly known as vitamin H, biotin is part of the B complex vitamins, which help your body metabolize fats and protein. Some experts even recommend a daily supplement for everyone since it’s generally safe and pretty hard to get too much of it.

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 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.
There are many potential causes of hair loss in women , including medical conditions, medications, and physical or emotional stress. If you notice unusual hair loss of any kind, it's important to see your primary care provider or a dermatologist, to determine the cause and appropriate treatment. You may also want to ask your clinician for a referral to a therapist or support group to address emotional difficulties. Hair loss in women can be frustrating, but recent years have seen an increase in resources for coping with the problem.
Triamcinolone acetonide (Kenalog), 0.1 mL diluted in sterile saline to 10 mg per mL, is injected intradermally at multiple sites within the area to a maximum dosage of 2 mL per visit.6 The main side effect, atrophy, can be minimized by not injecting too superficially and by limiting the volume per site and the frequency of injection (no more often than every four to six weeks).6 Because spontaneous resolution often occurs in patients with alopecia areata, assessing treatment response can be difficult. Intralesional steroids should be discontinued after six months if no improvement has been noted.
Iron supplements. Iron deficiency could be a cause of hair loss in some women . Your doctor may test your blood iron level, particularly if you're a vegetarian, have a history of anemia, or have heavy menstrual bleeding. If you do have iron deficiency, you will need to take a supplement and it may stop your hair loss. However, if your iron level is normal, taking extra iron will only cause side effects, such as stomach upset and constipation.
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 have not heard anyone talk about the “HairClub” use to be a center called the “Hair Club for Men” but now seems to also be catering to women. I had a consultation last week and the consultant looked at my scalp with an instrument that showed my scalp on a screen, she performed a microscopic hair and scalp analysis. Of course I really needed to see my scalp magnified a trillion times and seeing both thick and thin hair and of course all the empty spots where hairs use to be. She was very informative and showed me the cycle of healthy hair and also the ones that are not and how they thin and eventually fall out and the hair follicle closing. Their pamphlet show women with different stages of hair lost, from patches to almost bald. She explained that there was hope and that with a yearlong regiment of going once a month and having my scalp treated with their products and some sort of scalp stimulation I can get my hair back. Of course this comes at a price, almost 3k for the year. She did say that the monthly regiment will include hair styling as well. woohooo. Anyways I want to know if anyone has been to one of these Hair club facilities and if they have had any success with the personalized program without having to resort to surgery. My prayers go out to all of you.
Many medications are being studied, including abatacept, MEXIS/M6S, triamcinolone, secukinumab, tralonkinumab, apremilast, botulinum toxin, INCB018424, bimatoprost, clobetasol, AS101, autologous platelet-rich plasma, topical minoxidil, and nitric oxide gel.[27] Some of these medications are approved for other diseases, others are not available outside of studies.
Hair is made up of the hair follicle (a pocket in the skin that anchors each hair) and the shaft (the visible fiber above the scalp). In the hair bulb, located at the base of the follicle, cells divide and grow to produce the hair shaft, which is made from a protein called keratin. Papilla that surround the bulb contain tiny blood vessels that nourish the hair follicles and deliver hormones to regulate the growth and structure of the hair.
I wanted to say I have been to both a GYN here and a hair loss dermatogist here in Lake Mary FL, with no results, so I am still looking for another derm that knows something about hair dye allergys. I have had my hormones tested, the dr said that my estro was high, but she expected that since their is no period. I am only 45 , I used to have very thick coarse hair. Had a bad eposide of itching, then hair lost last year. I told the derm that I suspected the hair color. They did not seem intested, said that hair loss comes with age. I have now had another spell, of bad rashing. It is the hair dye. From my reseach it can have PPD, in it almost all do. Check the web for PPD allergy. As you color you can become more and more subseptable to it. My hair stylist always commented on the hair loss. I think that hormones changing can effect it also. You can become allergic to this chemical at any time. It is hard to connect the dots. Dr.’s don’t seem interested. Natualist, I tried accupunture and non homotherphy, no noticable difference.. I have tried Jason hair shampoo, not much luck with that either. BUT look for PPD/free hair colors…and test before using, that will save some hair from falling. So far I have found a Wella, Yo Colors, Reflex, Nauture Pat It usually happens a week later, not right after coloring FYI…What does work is Botin…..
I live in Orlando. I understand your panic. How old are you? Are you in menopause or peri or is it purely hair loss not horome related? I have been to a dermatologist I traveled 2 hours to another city. I’m like you, desperate and going from doctor to doctor. It’s a nightmare and I’m losing more hair all the time. Where are you losing your hair? on top? Is it diffuse? I feel like I’ve wasted so much time. I felt in November it was menopause related. I went in Menopause early 40s. wasted months on HRT since January and hair worse on top. I felt like I was in a nightmare and nobody understands. You truly don’t want to leave the house. I went to derm specializing in hair loss. He did biopsies. Female pattern hair loss on top. Folicullitis in back. I had even had hair fall out around nape of neck. But he just basically said nothing. I was waiting for biopsy to come back and more blood work and I said can’t I take something. He said you’re not going to lose any in two weeks. I’m like are you kidding me? every week is another nightmare. Anyway he says take spiro 50 mgs, use Rogaine. Even I know from these blogs you need to take 100 to 200 for female hair loss. Basically I go back and he says hair transplant. Did I mention he does hair transplants. So he does nothing beyond diagnosis except offer hair transplant. I’m like My hair is falling out all over. I need to get it stabilized first. sorry I’m rambling. I’m using rogaine foam. It makes me feel good to use it as if I’m doing something. Been on a month almost. Now just went on finasteride, but jury is out if that will help. But even that I asked for from him and his dose was lower than on these sites. So I asked for higher. I wish I could take spiro, but it upsets my stomach horribly. So I’m going to Redmond. I should have gone in January. I can’t believe this is happening to me. I’m sorry I’m rambling.

Most people naturally shed about 50 to 100 hairs a day, but sometimes men and women can shed much more, leading to thinning hair, hair loss, and over time, baldness. The causes of this hair loss can be a result of hormones, underlying medical conditions, and even certain medications like antidepressants, high-blood pressure medications, and NSAIDS (non-steroidal anti-inflammatory medications). Sometimes, hair loss is purely genetic and can run in families.
Physical stress can also be a cause for hair loss. Any kind of physical trauma surgery, a severe illness, an accident, even the flu can lead to temporary hair loss. This can trigger a type of hair loss known as Telogen effluvium. Hair loss usually gets noticeable 3-6 months after the trauma but once your body recovers, your hair would start growing back again.

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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.
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.
During this procedure, surgeons remove a narrow strip of scalp and divide it into hundreds of tiny grafts, each containing just a few hairs. Each graft is planted in a slit in the scalp created by a blade or needle in the area of missing hair. Hair grows naturally this way, in small clusters of one to four follicles, called follicular units. As a result, the graft looks better than the larger "plugs" associated with hair transplants of yesteryear.
I recently noticed I was loosing hair on the front of my head, I started using the rogain Foam and after a month my hair started falling out even more. It’s gotten really bad, I can see my entire scalp now and my hair is falling out in chunks. Rogain advised you loose hair making room for new ones to grow, has anyone had any experience using rogain? Is This normal?
As the name suggests, androgenetic alopecia involves the action of the hormones called androgens, which are essential for normal male sexual development and have other important functions in both sexes, including sex drive and regulation of hair growth. The condition may be inherited and involve several different genes. It can also result from an underlying endocrine condition, such as overproduction of androgen or an androgen-secreting tumor on the ovary, pituitary, or adrenal gland. In either case, the alopecia is likely related to increased androgen activity. But unlike androgenetic alopecia in men, in women the precise role of androgens is harder to determine. On the chance that an androgen-secreting tumor is involved, it's important to measure androgen levels in women with clear female pattern hair loss.
Central centrifugal cicatricial (scarring) alopecia: This type of hair loss occurs most often in women of African descent. It begins in the center of the scalp. As it progresses, the hair loss radiates out from the center of the scalp. The affected scalp becomes smooth and shiny. The hair loss can be very slow or rapid. When hair loss occurs quickly, the person may have tingling, burning, pain, or itching on the scalp. Treatment may help the hair re-grow if scarring has not occurred.
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.
Some of the skin disorders like lupus and sarcoidosis can cause hair loss. In case of lupus, the hair tends to get brittle and may fall out in patches. Lupus hairs or short, broken hairs usually appear above the forehead. Hair loss is not permanent in general here. Some individuals with lupus also develop a form of lupus known as discoid or cutaneous lupus that affects the skin. Scars that sometimes develop on the skin of the scalp may lead to hair loss. 

"Dr. Yaker is ABSOLUTELY AMAZING! He is innovative, highly professional, incredibly skilled and extremely passionate about hair restoration. His bedside manner is one of complete dedication and compassion with genuine care for his patients and their needs. He strives for excellence in everything he does, and it's evidenced by his loyal client following and their satisfaction with their incredible outcomes. I'd recommend him to anyone & everyone interested in hair restoration or transplantation."


You are what you eat – and that’s true for your hair as well. A diet containing mostly whole foods, especially the skin of plants such as cucumbers, potatoes, peppers, and even bean sprouts are rich in the mineral silica and contribute to hair strength. Foods like lean meats are high in iron and are essential to the protein-based, building blocks of hair growth.


Hi Lisa, hope you were able to speak with your doctor. I also talked at length with my mom and sister and feel a little better. My mom has hair but it is very thin but I forget she has had surgeries and takes a lot of meds for various conditions and she knows this has caused her hair loss. My sister has PCOS and that has made her hair thin out. I had a good appt with my dermatology nurse. She sat and talked with me and listened and was very interested and caring. I cried for about half the visit. She examined my head and does see the thinning but it isn’t consistent for androgentic alopecia and there aren’t any just out of nowhere hairloss in the family (she seemed more concerned with females than male relatives). What I haven’t stated is that I don’t handle stress well, the last time I underwent major stress was with the acne and she thinks it has taken on another form. To be as brief as I can besides taking two night classes, working full time, single mom no help from their dad ( a teen daughter and preteen son!), major stress at work, separated/divorced, financial stress, found out my dad’s prostate cancer came back, aging parents (they can’t take care of things like they used to and I’m living with them and it’s on me now), and just found my ex husband (not my kids’ dad) has lung/brain cancer and we aren’t on speaking terms and we work for the same company, oh yeah and I have new boyfriend. The last of this list happened all this month. I know I haven’t been eating well, and with the constipation if I’m severely stressed it runs right through me, then I know its bad. So she and I decided to go with biotin & a multivitamin, see my PCP she really wants me back on anti anxiety pills, I will still see him but I want to talk to him more at length because it can cause hairloss, we are continuing my 200 mg of aladactone, my orthotricyclen, eat better, I do have regrowth in my bangs. She is very concerned about my mental health (my BFF says to me “how is my ball of nerves today?” that’s how bad I am!). I know I just need to manage it better and talking to her was the first step because she too went through a stress shedding period (I do remember it, it was a year ago) and her hair is coming back in. She said it will come back for me. But for my own psychological health she said for me to get the rogaine foam for men and use it, just so I can see regrowth faster. She said they say not to use if for women because of the pregnancy issue and that isn’t a factor for me. I also had burning and itching but with the use of Nioxin it is better. She also said only wash my hair once a day (I usually do twice), and use low heat for my hair. She is going to see me in three weeks.
Each follicle produces hair for 2 to 6 years and then takes a break for several months. While the hair follicle is in its rest phase, the hair falls out. There are around 100,000 follicles on the scalp, but because each follicle rests at a different time and others produce hairs, hair loss is usually unnoticeable. More noticeable hair loss occurs when there is a disruption to the growth and shedding cycle, or if the hair follicle is obliterated and replaced with scar tissue.

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.
Please help. My hair has always been my pride and joy. I figured since it is pretty damn healthy, it could deal with some bleach damage. And I figured the master stylist who did all the color-corrections would know how much would be too much. I was wrong, and now I want to burst into tears every time I look at my hair or touch it. I just don't know what to do. my hair has also NEVER been shorter than this and it breaks and falls out. What should i do to regrow hair?
I had an amazing dermatologist who cured me of my acne b/c she sent me to an endocrynologitst who did agree w/ her that I had PCOS, but when the Aldactone didn’t work, the dermatologist told me “well tha’s that, you have male pattern balding.” She said it like you have two arms and two legs – just a matter of fact, no big deal, but it landed like she sent a single young woman a death sentence. I never went back to her and have not seen a dermatologist since then b/c right after her I went to Dr. Strick at UCLA same kind of stuff (mentioned it in other comment) and am now working w/ my endocrinologist and internal medicine doctors. I agree, you must go to more than one b/c doctors do not know everything and some don’t even know what they are supposed to know for their own field and specialty – they are human too and are good at some things and lacking in othters. Just keep looking until you get someone who cares that this is an upsetting matter for you and will help you find solutions that actually work for you individually instead of a bottle of Rogaine like it’s an apple or 2 aspirins and then call them in the morning.
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!
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