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.


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.
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....
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.
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 directed history and physical examination usually uncover the etiology of hair loss. The history should focus on when the hair loss started; whether it was gradual or involved “handfuls” of hair; and if any physical, mental, or emotional stressors occurred within the previous three to six months3  (Table 1). Determining whether the patient is complaining of hair thinning (i.e., gradually more scalp appears) or hair shedding (i.e., large quantities of hair falling out) may clarify the etiology of the hair loss.4
Figure 2 is used with permission from Utah Valley Family Practice Residency Program.Figures 3 and 10 are used with permission from the Utah Valley Family Practice Residency Program. Figure 5 is used with permission from Mark Luba, M.D., Good Samaritan Family Practice Residency. Figure 6 is used with permission from Richard Usatine, M.D., UCLA. Figures 9 and 11 are reprinted with permission from the American Academy of Dermatology.

Okay, on the latter side if things, I would like all to know that with or without hair you are all beautiful. I don’t know you but I know what I have read about you and you all seem so courageous. I know how much it hurts to see so much of our hair falling out or gone but we have to be strong and realize that it is not the hair that is going to make us but our hearts. Diana, please stop stressing so much. Stress is the number one killer. My father always tells me that I worry so much but he constantly reminds me that if I was to leave this world who will be here to take care of my babies? Find happiness and comfort in God. Seek answers by praying. My prayers will and have been answered and they keep continuously getting answered…because without my prayers I would not have come across this website.
Hi Everyone I thought I was the only person with major hairloss because everywhere I look all I see is beautiful heads of hair. I am 34 years old and my hair started thinning 7 months ago at first I thought it was just my ponytail getting thinner but my hair became horrible with split ends and dryness too (I have always had extremely healthy hair and never had split ends) – I thought I had burnt my hair using a straightener and that’s why it was thinning. However it has gotten worse and worse and I finally visited a doctor. I have had full blood tests for thyroid issues, hormone levels, cholesterol etc etc all were perfectly normal, I had a thyroid antibody test which was at the high end of normal but still within normal range, I had a thyroid function test which was within normal limits however he thought I did have some slight inflammation ie thyroiditis. My doctor said this isn’t causing the hair loss either. I have loads of energy, don’t get tired, eat well am normal weight range the only other thing I have noticed is my eyelashes seem stunted in growth (not thinned out though) and my eyebrows have thinned on the outer edges. My last two nails on both hands have a dark (looks like they have lifted slight) strip just below the white nail part. I am booked to have a stress test, pelvic ultrasound and to see an endocrinologist also to rule out all other possible reasons for hairloss. I am now getting to the point of embarrassment to go out it is soooo thin on top particularly on one side of temple and majorly down the centre where I used to part my hair. HELPPPPPP!!!!!
Thank you Diana. If you find out any more information, I would appreciate it. I have a dermatologist across the street from the Skin and Cancer Institute. I’m still not sure who to start with, the dermatologist or an endocronologist. I left a message for my PCP today to see if she is comfortable working with female hair loss or if not if she could refer me to someone who specializes in it. I will let you know what I hear back. In the meantime, thanks for your support. Take care.

The course of typical alopecia areata is not predictable with a high likelihood of spontaneous remission. The longer the period of time of hair loss and the larger the area involved, the less likely the hair will regrow spontaneously. Therefore, there are a variety of treatments, but none of these can confidently be predicted to impact the course of this disease. Local steroid injections intracutaneously may be very helpful in restarting the hair growth cycle in treated areas. Steroid creams, lotions, and shampoos have been used for many years but are of limited benefit at best. Although oral systemic steroids are known to induce hair growth in affected patients, their long-term use is contraindicated because of the likelihood of undesirable side effects.

According to practitioners of traditional Chinese medicine, hair health is tied to two things: kidney energy and the blood, which nourish the hair. The solution: acupuncture and Chinese herbs. While there isn't a lot of hard science to back this up, Maureen Conant, a TCM practitioner at Full Bloom Acupuncture in Seattle, says that she's seen women's hair stop falling out and then gradually regenerate after a few months of weekly treatments.


Hello. Chris, I am so happy that you made an appt to see Dr. Redmond. How did it go? I really hope it helped. i have been on treatment now for almost 3 months. Dr. Redmond told me to be patient, that things could take a year to improve, but I do feel mostly that things have stabilized. In my work (i am a physician) I have seen alot of sad cases in the last few weeks. Young patients with major illnesses, some possibly incurable and fatal. It has made me really sad. It has also made me realize that regardless of what is happening to my hair, I have to try and be happy. I have to be thankful that I am healthy and have wonderful family and friends. Not that it is a consolation, but for us, our illness is on the surface and not life threatening…unless we make it by the psychological part. Thank you for everyone who has contributed to this website so that I can deal with the psychological part better. I am doing research into wigs now and will let all of you know when I have more info. Supposedly there is a soap opera star who was bald at 14 and has been wearing wigs for a long time. She has made a line of wig’s I think called Amy’s presence. It seems that she has led a happy life despite her hairloss. Once I found out more, I will let you know. I know its not a cure, but at least it is a remedy. One day at a time, I know we can all get through this. Be well.
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!
*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.
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.
How to use minoxidil: Be sure that your hair and scalp are dry. Using the dropper or spray pump that's provided with the over-the-counter solution, apply it twice daily to every area where your hair is thinning. Gently massage it into the scalp with your fingers so it can reach the hair follicles. Then air-dry your hair, wash your hands thoroughly, and wash off any solution that has dripped onto your forehead or face. Don't shampoo for at least four hours afterwards.
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.
Protein: When the body does not get enough protein, it rations the protein it does get. One way the body can ration protein is to shut down hair growth. About 2 to 3 months after a person does not eat enough protein, you can see the hair loss. Eating more protein will stop the hair loss. Meats, eggs, and fish are good sources of protein. Vegetarians can get more protein by adding nuts, seeds, and beans to their diet.
There are numerous nonsurgical treatments that when combined, can offer significant hair improvements. Dr. Yaker’s TCHR Volumizing Glycolic Acid Shampoo and Conditioner help restore vitality to the hair by deep cleaning the scalp and reestablishing lost moisture content and physiological pH to the scalp and hair. Dr. Yaker has also formulated his own oral supplement, which is a blend of Aminoplex hair repair vitamins. This is made up of amino acids (building blocks of protein) that produce keratin, which makes up close to 97% of our hair. In addition, Dr. Yaker’s specially compounded FDA approved topical medication, Minoxidil (brand name: Rogaine®), is clinically proven to help slow down, stop and even reverse hair loss in women. Other nonsurgical therapies offered are Low Level Laser Therapy (LLLT) using the advanced LaserCap®, and Platelet Rich Plasma (PRP) with placenta-derived extracellular matrix therapy to help restore thinning hair. Lastly, Dr. Yaker offers scalp and facial micropigmentation where permanent ink is applied to the skin, creating micro dots that replicate the natural appearance of hair. This is used for the scalp and eyebrows.

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

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 just came across this website and would welcome any recommendations on hair loss specialists in the suburbs of Philadelphia, PA. I have an appointment with my family doctor in a couple weeks, and I’m sure she’s going to run blood work. I’m a 55 yo female and have been experiencing large amounts of hair loss in the past few months. I am generally in good health with the exception of some “structural” issues (scoliosis, etc.). Thank you!
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.
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.
In-office laser light treatments or at-home handheld devices, such as the HairMax LaserComb, supposedly grow new hair by stimulating blood flow to the area (think: an amped-up version of a scalp-stimulating shampoo). Just don’t expect the device to make your noggin go from looking like George Costanza’s to Jerry Seinfeld’s. “These lasers won’t grow any new hair. If anything, they may just help you hang on to some of the hair that you already have a bit longer,” says Dr. Joyce.

Hi everyone, I am a 19 years old girl that is loosing my hair. I started to lose my hair since I was 14. once 18 I decided to go for a hair transplant surgery. I wanted to feel as any another girl and be confident. I went to bosley may 2007 and did the surgery. They told me it will take 6 to 8 months for my new hair to grow few inches. I went there after 6 and after 8 months but unfortunatly we havent seen any growing hair yet. The doctor told me that it depends from one person to another and it might take me from 12 to 15 months. I went to see him yesterday and by then it was almost 15 months… he walked in looked at my hair didnt say any word for a while and then told me: “I am going to give you your money back” I cried right away for a while I couldnt take it. I haddreams and hope. I imagined my life differently after the surgery. Anyways all that to tell you guys if you wanna go for a hair restoration AVOID BOSLEY. I live in boston nd went to the bosley place in the newbury street. I believed them because of all their advertising. Now i dont even know what to do. School is almost starting and i dont feel like going. I wanna look nice and feel relaxed. I feel the pain every morning before going to school. I cry every night when I get home. I need to find a solution. i thought about extensions but cant go for them cuz i am scared to lose more hair. My God help us!

i’ve come across this site before, but today has been an already 5 hour session reading everything that has been posted and researching things on the side. first and foremost, i want to thank you all for your words, rants, and honesty. i stayed home from work today after breaking down in the bathroom, already dressed for work, because of my hair. a few posts made me cry, a few made me smile and all remind me that i am not alone. i, like a few of you, hate that i focus on my hair, but even though i try my damndest to not do so, it really does depress me. i know i will bounce out of it, but it’s only a matter of time before it comes back. today is the first day that i have ever not gone in to work because of the hair situation. here’s my story:


The mission of the National Institute of Arthritis and Musculoskeletal and Skin Diseases is to support research into the causes, treatment, and prevention of arthritis and musculoskeletal and skin diseases; the training of basic and clinical scientists to carry out this research; and the dissemination of information on research progress in these diseases.
I am 43 and I have been thinning/losing my hair for the past four years. It is so upsetting. I know very few people who can relate…until I came across this site. Has anyone tried apple cider vinegar? I read that it can help with hair loss, but I am skeptical, as all of the remedies I’ve tried thus far have been disappointing. I try to put my hair loss situation in perspective, but I’m not always successful. Best wishes to all of the women on this site. I hope hair restoration is around the corner for all of us.
That meant new products like Hims and Keeps were out.Hims and Keeps are relatively new companies that allow you to set up a subscription for hair loss treatments. Both offer finasteride (after an online consultation with a doctor) or 5 percent minoxidil. However, their minoxidil solutions contain propylene glycol, so we cut them from consideration.
I am 43 and I have been thinning/losing my hair for the past four years. It is so upsetting. I know very few people who can relate…until I came across this site. Has anyone tried apple cider vinegar? I read that it can help with hair loss, but I am skeptical, as all of the remedies I’ve tried thus far have been disappointing. I try to put my hair loss situation in perspective, but I’m not always successful. Best wishes to all of the women on this site. I hope hair restoration is around the corner for all of us.
My hopes and prayers are for all of us… that somewhere a doctor, an organic chemist, SOMEONE… ANYONE… will care enough to actually research this. Thank you, all of you, for your tears, suggestions and sharing. I WILL NOT WEAR A WIG… WHAT LIES BEHIND US, WHAT LIES AHEAD OF US, PALES IN COMPARISON TO WHAT IS INSIDE OF US. WE ARE STRONG, VIBRANT… WE WILL PREVAIL.

One of the most significant concerns for patients following a diagnosis of cancer is the side effect of losing their hair. For many, especially for those who have experienced a full, thick head of hair throughout their lifetime, the thought of losing it can be devastating. Chemotherapy treatment owes its effectiveness to a variety of powerful medications which are designed to quickly attack the compromised, cancerous cells. Unfortunately, in addition to treating cancer, the medications also attack the roots of your hair. This can cause the hair to fall out very quickly, even in large clumps, or gradually over time. Some of the most common medications leading to hair loss include:
Okay, on the latter side if things, I would like all to know that with or without hair you are all beautiful. I don’t know you but I know what I have read about you and you all seem so courageous. I know how much it hurts to see so much of our hair falling out or gone but we have to be strong and realize that it is not the hair that is going to make us but our hearts. Diana, please stop stressing so much. Stress is the number one killer. My father always tells me that I worry so much but he constantly reminds me that if I was to leave this world who will be here to take care of my babies? Find happiness and comfort in God. Seek answers by praying. My prayers will and have been answered and they keep continuously getting answered…because without my prayers I would not have come across this website.
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