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.
Cicatricial alopecias tend to cause permanent hair loss. These disorders destroy hair follicles without regrowth and follow an irreversible course.21 It is likely that they involve stem-cell failure at the base of the follicles, which inhibits follicular recovery from the telogen phase.21 Inflammatory processes, including repetitive trauma as in trichotillomania, also may lead to stem-cell failure. Other processes may be caused by autoimmune, neoplastic, developmental, and hereditary disorders. Among these are discoid lupus, pseudopelade in whites, and follicular degeneration syndrome in blacks. Dissecting cellulitis, lichen planopilaris, and folliculitis decalvans also may cause scarring alopecia. Some disorders respond to treatment with intralesional steroids or antimalarial agents.21 Patients with these conditions should be referred to a physician who specializes in hair loss disorders.
Endocrinologist: The clinical specialty of endocrinology focuses primarily on the endocrine organs, meaning the organs whose primary function is hormone secretion. These organs include pituitary, thyroid, adrenals, ovaries, testes and pancreas. An endocrinologist is a doctor who specializes in treating disorders of the endocrine system and who is trained to diagnose and treat hormone problems by helping to restore the normal balance of hormones to your system. Endocrinologists treat many conditions, including:

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.


Treatment options for AGA (Table 3)6 focus on decreasing androgen activity. Minoxidil (Rogaine) and finasteride (Propecia) are the only medications approved by the U.S. Food and Drug Administration (FDA) for the treatment of AGA (Figure 4).6 Minoxidil is available without a prescription as a 2-percent topical solution that can be used by both men and women and as a 5-percent solution (Rogaine Extra Strength) that should be used by men only. The mechanism of action by which minoxidil promotes hair growth is unknown, but it appears to act at the level of the hair follicle. Minoxidil is an effective treatment for male and female AGA and is recommended as first-line treatment by the American Academy of Dermatology guidelines.5
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]
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.
Dr. Williams is also the primary investigator in a National Institute of Health (NIH) approved IRB study in regenerative medical treatment procedures with stem cell/stromal therapy for hair loss in androgenetic alopecia. A new study treating scaring and autoimmune (Alopecia Areata) alopecia is expected in 2017. Dr. Williams believes the foundations of health and hair restoration are founded on prevention and wellness. His primary practice is hair restoration surgery in Orange County, and he is involved in teaching medical students and residents from various medical training programs in northern and southern California. He is on the clinical teaching faculty of Western University of Health Science in Pomona, California; and Touro University College of Osteopathic Medicine in San Francisco, California, and Chapman University new Health Science teaching facilities.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

“While nutritious eating isn’t going to bring your hair back by any means, eating plenty of protein-rich foods and healthy fats can make the hair that you still have look thicker and shinier.” Skimping on the B vitamins in particular can interfere with the formation of hair cells and, therefore, hair growth. The best sources of Bs are protein-packed foods like chicken, fish, eggs, and pork, as well as leafy greens such as spinach. (These foods are also good for melting belly fat, so it’s a win win).
The main symptom of alopecia areata is hair loss. Hair usually falls out in small patches on the scalp. These patches are often several centimeters or less. Hair loss might also occur on other parts of the face, like the eyebrows, eyelashes, and beard, as well as other parts of the body. Some people lose hair in a few places. Others lose it in a lot of spots.
A bathroom covered with loose strands or an ever-scrawnier ponytail can be startling but doesn't necessarily mean anything's wrong. By age 50, half of women will complain of hair loss. "As we age, overall hair density changes and individual strands become finer," says dermatologist Doris J. Day, MD. But just because thinning is natural doesn't mean you have to accept it. Here are 13 solutions to help you keep the hair out of your brush and on your head.
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.
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!
Corticosteroids: This medicine suppresses the immune system. It can be given as shots, with the dermatologist injecting the medicine into the places with hair loss. Sometimes a patient gets a topical (applied to the skin) form of this medicine. It may be a cream, lotion, or ointment. The patient applies the medicine to the bare spots. Less often, patients take corticosteroid pills.
According to the International Society of Hair Restoration Surgery, since 2004, the number of female surgical hair restoration patients worldwide increased 24 percent. Modern surgical hair restoration procedures such as Follicular Unit Transplantation (FUT) and Follicular Unit Extraction (FUE) allow surgeons to take hair from the back of the head (genetically permanent hair zone) and transplant it to the areas where balding has occurred. The reason why the hair does not fall out once transplanted in its new location is because those hair follicles take on the same characteristics as the hair in the area where it originated, the genetically permanent zone. Both approaches result in lasting outcomes. In order to know if you are a candidate, Dr. Yaker will go over your medical history and examine your hair and scalp. He will determine if you have ample, good quality hair in the permanent hair zone in order to be able to relocate those hair follicles to the areas of hair loss.
If you have hair loss, you have options, like topical treatments, oral medications, red light procedures, to prevent more hair loss.   But, Curtis says,  "The only way to guarantee hair is the transplant."    She says once you find out what's causing hair loss, you and your doctor can decide how aggressively you want to approach the problem.   She says, "I say to patients, 'Here's what we can do to prevent further loss...'  If you say, 'Dr. Curtis, I want hair." Here's what we have to do, we're going to move it from the back to the front, nobody will know, it will look fantastic."
“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.

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.)
I am 31; as a child I had beautiful brown smooth hair with a hint of a wave. As soon as I hit puberty at 13 (1st period on my 13th b-day), my hair turned wavier. Same year, I remember looking down on my legs horrified at the hair I had developed. Only 1 thought came to me: “NOT NORMAL!” Body hair on women is a tricky subject, though, with media heavily influencing what’s considered ‘normal’. My mom, similarly hairy, just told me it’s genetic and normal.
Thank you all for sharing, For the pass years I have been having hair loss on and off. I have tried several natural treatment, example : hot oil , moist heat, acupuncture. Have seen several doctors and specialists which cost me thousands of dollars. I have insurance, but they will not accept, because they will not get pay, it is experimental my insurance paid for my lab tests. at this time my diagnosis is hypothyroidism. I am using organic foods, juicing; sunflowers seeds , pumpkin seed to make smoothie and oils from doTerra to massage my scalp. trying vitamins etc. etc. I cannot pinpoint what makes the improvement because I have used

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
I am 20 and have been losing hair since I was 17. It is such a confidence killer. I really do miss my beautiful thick and black hair. Now my hair is thin and a bit gray as well. I only think of it sometimes…but I used to be so depressed i can barely get out of bed. Whenever I am talking to someone, I always wonder if they are looking at my hair. I am currently using Rogaine for Women…it worked one summer when I was following the regimen religiously. However, I am so bad with routines, so now I try to remember to put it on my scalp morning and night. I recently also started to take Shen Min Hir Nutrients…not sure if it works yet. Does anyone have any advice? I really want to get a hair biopsy but I don’t know how. The places I called offered scalp analysis to prepare for hair transplants…which is not something that I am considering. I also saw 2 derms, one didn’t know what was wrong and only offered Rogaine as a solution, and the other said it is androgenic alopecia. I think I might have hormonal problems, but really not that sure. My scalp is always oily and so is my skin. Before my hairloss, I had really itchy scalp. Now it’s still oily but I wash it every other day. I also dye my hair to hide the gray. Sometimes I just feel so ugly and depressed in thinking about my hair. Beautiful hair is the only thing that I want back.
Hello Ladies. I love this site. I will be brief. I have only been to 1 Endo and they told me my glucose was pre diabetic but that my TESTOSTERONE was too high. Not over the line but right there. He put me on the cure all of metformin but I haven’t taken it yet. I am trying to lower my testosterone by diet and exercise and also watching everything I eat. Its not doing much but I have been doing this for about a month now. The holidays kill me with wine, coffee, and sweets. I have read the reviews and will probably pick up that book but also hit another endo and a dermo. You guys keep the faith. PS In Houston. Any suggestions on a dermo or endo you like, shoot them my way.

Thank you all for sharing, For the pass years I have been having hair loss on and off. I have tried several natural treatment, example : hot oil , moist heat, acupuncture. Have seen several doctors and specialists which cost me thousands of dollars. I have insurance, but they will not accept, because they will not get pay, it is experimental my insurance paid for my lab tests. at this time my diagnosis is hypothyroidism. I am using organic foods, juicing; sunflowers seeds , pumpkin seed to make smoothie and oils from doTerra to massage my scalp. trying vitamins etc. etc. I cannot pinpoint what makes the improvement because I have used
my daughter is 19 and has been diagnosed with androgenetic alopecia. She has been to several dermatologists. They don’t understand the problem. I am planning to bring her to Dr. Geoffrey Redmond. I read his website. He surely knows how to treat this kind of hair loss. I spoke to his receptionist… they are very accomodating and profesional. So, as much as I would like to believe, that Dr. Redmond will be able to fix this altogether, I do understand he is not a miracle worker. But, I do believe, if anyone can understand this
Some other autoimmune diseases can also lead to hair loss. Lupus, which affects many different systems of the body, is one of them. Symptoms include fatigue, headache, painful joints, anemia, abnormal blood clotting, and hair loss, according to the website LiveStrong. The disease is usually triggered by environmental factors like exposure to the sun. Hashimoto’s disease, which occurs when the immune system attacks the thyroid gland causing an underactive thyroid, can also result in hair loss.
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:
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.
Hair transplants will likely lead to better results in the long run (you are introducing new hairs to the balding areas), but you’ll still need to use minoxidil or finasteride after surgery to maintain the results. Like all hair loss treatments, hair transplants are best when combined with other methods, and you’ll want to speak with your doctor to see what combination is best for you.
The trick about all of these hair-loss products and treatments is that they’ll stop working as soon as you stop using them. “They have to be ready for a lifetime commitment,” says Rieder. But, just like brushing your teeth, as long you keep on keeping on with the scientifically proven preventative treatments, those hairs on your head should be just fine.
Typical first symptoms of alopecia areata are small bald patches. The underlying skin is unscarred and looks superficially normal. Although these patches can take many shapes, they are usually round or oval.[6] Alopecia areata most often affects the scalp and beard, but may occur on any part of the body with hair.[7] Different areas of the skin may exhibit hair loss and regrowth at the same time. The disease may also go into remission for a time, or may be permanent. It is common in children.
I also have been experiencing hair loss for the last 6 years and it is truly devastating. It is so hard to get up in the morning and go to work I feel so embarrassed, insecure and feel like every one around me is just staring at my head. I also just came across this website and I feel every one’s pain. For a woman, it is such a terrible thing to deal with. I will pray that we can all find the solution to this terrible situation. I live in Houston, TX and will be making an appointment with an endocrinologist soon.
I know that Planned Parenthood offers thyroid screening, should I try there to get mine checked to see if this is why my hair is thinning? I have no health insurance, I’m unemployed, and between feeling depressed and just incredibly tired, I don’t know how I can get a job and wait until benefits kick in to actually see a doctor. It’s so depressing. I always had fine hair, but a lot of it. It was shiny, mostly straight with a little wave, but now it’s just, what I consider to be, disgusting. I hate how my hair looks and it’s gotten to the point that I’m so stressed out I don’t even want to eat anymore. Which sounds awful, but I eat and I feel entirely not hungry and almost nauseated. I think it’s the tremendous stress. I’m afraid to call Planned Parenthood because part of me doesn’t want to know if there’s nothing that can be done, but do you think they can test for PCOS as well? My periods were always normal. I got it when I was 12, about 3 months before I turned 13, and they were like clockwork. Then when I was about 15/16, my grandparents died and that was a major shock and I got a few grey/white hairs, still not thinning/balding. Then when I was 17, I dyed my hair almost black because I was depressed, but hated it, tried to remove the color with over the counter stuff, and my hair turned into straw and was brassy orange. I ended up perming it at 18 because it was so frizzy and a friend convinced me that it’d be easier to just wear it curly than to keep blow drying it straight only to have it fuzz up/frizz up. This is probably tmi, and I’m sorry, but I need to vent. I was raped at 18 (a virgin) by 3 boys. I started eating a bunch of junk and withdrawing. I was always what I consider a chunky girl, but my weight has ballooned up since then. I have so much stress and the stress of this is exascerbating my hair loss I think, but I also fear I might have either hypothyroidism or PCOS, or potentially both. I’m even fearful I could have Cushings. The problem is that I don’t have health insurance anymore and any job I get will take about 3 months to kick in as far as benefits go. I just feel like it’s so unfair. Of course life isn’t fair, but still, it’s like this never ending circle for me. I can’t get to the doctor and get help without a job, but I don’t feel I can actually function without going to the doctor because I feel lousy. Oh, and my periods are all out of whack. I bleed monthly, but it’s like ceaseless. It’s so depressing knowing something is wrong, and having no hope to fix it. Thanks for listening.

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..
The dermatologist also will carefully look at your scalp and hair. During an exam, the dermatologist may pull on your hair. Sometimes a dermatologist needs to pull out a hair to get the necessary evidence. And sometimes a dermatologist needs to look at the hair on the rest of your body to see whether there is too little or too much hair in other areas.
Honestly, for female pattern baldness (what I have) I don’t think there really is any effective treatment — the only hope is learning to cope psychologically. (Just my humble opinion) So I don’t totally “hate” him for not being able to help me medically regarding the hair — but he was such a let down. I really expected more. (he’s an excellent dermatologist, for skin things at least)
Endocrinologist: The clinical specialty of endocrinology focuses primarily on the endocrine organs, meaning the organs whose primary function is hormone secretion. These organs include pituitary, thyroid, adrenals, ovaries, testes and pancreas. An endocrinologist is a doctor who specializes in treating disorders of the endocrine system and who is trained to diagnose and treat hormone problems by helping to restore the normal balance of hormones to your system. Endocrinologists treat many conditions, including:
@Amanda P. I regrew my hair and you can too. -I've been bleaching my hair on and off since forever. My hair wouldn't grow any longer it would just snap off. I've dreamed about having thick, long hair. And when I say dreamed, I mean it quite literally. So i decided to do something about it. My friend suggested Biotin when we were talking about my hair loss.
I just began reading this post this evening. My hair loss began when I was 18, currently 29. No bald spots, but it just keeps getting thinner and thinner and thinner. I have been to many doctors as well. Every PCP and family doctor have been of no help. After four dermatologists I have given up on that as well. I went to Hans Wiemann (in the St. Louis area) that offers laser treatments and hair transplants. The whole appointment was such a sales pitch that I was so aggravated and felt worse by the time I left. I have also tried an herbalist, chinese medicine, and a nutritionist/chiropractor. I try not to think about it, I really do, but let’s face it, that’s about impossible. I know my problem is NOT genetic, everyone in my family has a full head of hair. I’m healthy in terms of exercise and diet, I don’t take any medications, smoke, or drink. None of the doctors have ever found anything with blood work or urine samples. If anyone can suggest a doctor, specialist, anyone that can help in the St. Louis or Chicago area, PLEASE do let me know.
Each day the scalp hair grows approximately 0.35 mm (6 inches per year), while the scalp sheds approximately 100 hairs per day, and more with shampooing.1 Because each follicle passes independently through the three stages of growth, the normal process of hair loss usually is unnoticeable. At any one time, approximately 85 to 90 percent of scalp follicles are in the anagen phase of hair growth. Follicles remain in this phase for an average of three years (range, two to six years).1 The transitional, or catagen, phase of follicular regression follows, usually affecting 2 to 3 percent of hair follicles. Finally, the telogen phase occurs, during which 10 to 15 percent of hair follicles undergo a rest period for about three months. At the conclusion of this phase, the inactive or dead hair is ejected from the skin, leaving a solid, hard, white nodule at its proximal shaft.2 The cycle is then repeated.
Even though modern folklore, and even some limited scientific studies, have suggested that the mother's side of the family is largely responsible for a genetic predisposition toward baldness, the truth is balding is not all our mothers' fault. In fact, doctors now say baldness patterns are inherited from a combination of many genes on both sides of the family. There are some environmental factors that come into play, too.
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]
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