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.
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The only nonchemical option offered up by the dermatologists I spoke with — short of a surgical hair transplant or platelet-rich plasma therapy, which is like Kim Kardashian’s vampire facial but for your scalp — was the laser comb. First cleared by the FDA in 2009, the HairMax LaserComb is a handheld laser device that is designed to promote hair growth. As the manufacturer explains in a letter to the FDA, “The device provides distributed laser light to the scalp while the comb teeth simultaneously part the user’s hair to ensure the laser light reaches the user’s scalp,” which, in turn, stimulates the hair follicles.

My story is little different it seems. My fiancé was dionosed with Rocky Mountain Spotted Fever from a tick bite. And after test after test almost losing her and so many blood drawings then blood transfusions along with dialysis. Fighting depression trying to stay possitive is getting harder everyday. We ask all her doctors about why her nails break so easy, skin changing and hair falling out handfulls at a time…..then being looked at like we’re crazy has took my faith out of their hands.
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.
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. 

Minoxidil should be applied twice daily, and one year of use is recommended before assessing its efficacy.6,7 Women also may benefit from adjunctive treatments such as estrogen (hormone replacement or oral contraceptives) or spironolactone (Aldactone). In men, minoxidil may work better in areas with higher concentrations of miniaturized hairs, and its efficacy may be increased by the synergistic use of once-daily tretinoin (Retin-A) applied at separate times during the day.6,8 Minoxidil does not work on completely bald areas and has relatively few side effects; a dosage of 2 mL per day of a 2-percent solution costs about $10.00 to $12.50 per month.


I know how upsetting it is to start to notice thinning hair. Mine has been thinning for the last two yrs. I am not longer able to style my hair at all because of lack of thickness. I know in my case its memopause, plus some meds I am on. I do take biotin, and would appriciate any advice on shampoos that might help make the hair look thicker. I No loner put bleach in my hair, but do you a color with no bleach. I have gotten my self a little hair peice that clips on, and going to have it colored, trimed for me, and use that when going out.. Some hair pices a are very, very, nice. I would suggest you look into them untill some cure comes about. My Partner in Life brought it for me because he knows how upset I have been about my Hair.. Nice guy for sure. Good luck to all.. This is a place that I hope every woman finds who is having this problem.
I’m 28 and suffer from patches of hair loss. recently it has become so bad that i can no longer leave my hair down. it is really distressing for me, especially as I have recently met a guy and I’m not sure whether I should tell him about it or not. Currently when I meet him, I back brush my hair and try my hardest to cover the gaps; this ultimately means i am making things worse for my hair! I dont know what to do

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.

The views expressed in this article intend to highlight alternative studies and induce conversation. They are the views of the author and do not necessarily represent the views of hims, and are for informational purposes only, even if and to the extent that this article features the advice of physicians and medical practitioners. This article is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment, and should never be relied upon for specific medical advice.


Sinclair Scale: The 5-point Sinclair Scale is a modified visual grading scale. Grade 1 is normal. This pattern is found in all girls prior to puberty, but in only half of women age 80 or over. Grade 2 shows a widening of the central part. Grade 3 shows a widening of the central part and thinning of the hair on either side of the central part. Grade 4 reveals the emergence of diffuse hair loss over the top of the scalp. Grade 5 indicates advanced hair loss. This grade is uncommon, occurring in less than 1% of women.
Trying to figure out exactly what is causing your hair loss is going to require a little detective work on the part of your physician. Several lab tests are going to need to be done. I’ll make sure to make another post this week about the standard lab tests that should be ordered to start the process. Hopefully you don’t have to bring the list to the doctors office, he/she should know already. I get concerned when women have to bring a list of tests that should be ordered to their doctor. My feeling is that if they don’t know what to order then how are they going to be able to accurately read the results. But… a good doctor is a good doctor, and if you have one that really cares and takes a strong interest in your hair loss with a willingness to work with you in finding the cause then great.
Sinclair Scale: The 5-point Sinclair Scale is a modified visual grading scale. Grade 1 is normal. This pattern is found in all girls prior to puberty, but in only half of women age 80 or over. Grade 2 shows a widening of the central part. Grade 3 shows a widening of the central part and thinning of the hair on either side of the central part. Grade 4 reveals the emergence of diffuse hair loss over the top of the scalp. Grade 5 indicates advanced hair loss. This grade is uncommon, occurring in less than 1% of women.
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 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.
Because of its psychologic nature, the mainstays of treatment are counseling, behavior modification techniques, and hypnosis. Selective serotonin reuptake inhibitors and other medications for depression or obsessive-compulsive disorder may be used in some cases, although no medications are FDA-approved for treatment of trichotillomania.17 If a more moth-eaten appearance of hair loss is present and no evidence of hair-pulling behavior can be elicited, syphilis should be suspected.
Hopeing somebody may be able to help or even point me in the right direction. I am 21 years old and have a medium length graduated bob,longest layer being shoulder length. Since march this year I noticed the right side of my head felt a lot thinner then the left. So due to this i started to sleep on my left side, havent dyed my hair since april,stopped straightening my hair everyday, let my hair dry naturall, you name it I tried it. However it has now got to the stage that the middle layer of my hair has completly broken off and is only about 4 inches long. I am absolutly heart broken about it, and also cannot understand . I do not want to have to cut all my hair off as it has taken me years to grow out an awful hair cut and do not suit short hair at all so all in all feel very upset and worried. If there is anybody that can help I would really appreaciate it.
Depressed Girl–I feel so sad for you because I feel the same anxiety as you do—just not knowing what’s up with your own body is scary, especially when your hair is at stake. I’ve mentioned it in other threads on this site, but I think you should look at stopthethyroidmadness.com for some info about hypothyroid and adrenal issues. There is sooooo much info on there, and you will learn a lot. Once you can advocate for yourself, a lot can be done in terms of doctors (once you do have insurance). In terms of no health insurance, the site I mentioned above will direct you to companies that sell saliva test kits to test your adrenal and thyroid hormones–you don’t need health coverage to order them, but they are a bit pricey, but worth every single penny if you start to get answers…
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.
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!
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.
Rogaine’s foam squirts out just like hair mousse and is applied with “cool, dry hands.” Applying means working the foam down to the scalp where you want to see thicker growth — for it to work, “it has to get into your scalp,” Dr. Wolfeld explains. “If it sits on your hair, it’s not really as effective.” Once massaged, it dissolves into a watery liquid that leaves a tingly sensation, “but no burning!” one of our balding testers was happy to discover.
CURRENT REGIMEN: 6 weeks ago I purchased Hair Essentials… and am seeing some fine hair growth. Weight loss & exercise can also heighten follicular dormancy. (Have lost 90 lbs. in the last year.) Important to maintain 50-60mg/daily protein levels, as well as routine multi-vitamin, higher levels of B-Complex, D and Calcium levels while dieting… heavily impacts hair, nails & skin. Am researching possible relationship between gastrointestinal health and hair loss.

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
Hopeing somebody may be able to help or even point me in the right direction. I am 21 years old and have a medium length graduated bob,longest layer being shoulder length. Since march this year I noticed the right side of my head felt a lot thinner then the left. So due to this i started to sleep on my left side, havent dyed my hair since april,stopped straightening my hair everyday, let my hair dry naturall, you name it I tried it. However it has now got to the stage that the middle layer of my hair has completly broken off and is only about 4 inches long. I am absolutly heart broken about it, and also cannot understand . I do not want to have to cut all my hair off as it has taken me years to grow out an awful hair cut and do not suit short hair at all  so all in all feel very upset and worried. If there is anybody that can help I would really appreaciate it. 

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.
"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."

When men have hereditary hair loss, they often get a receding hairline. Many men see bald patches, especially on the top of the head. Women, on the other hand, tend to keep their hairline. They see noticeably thinning hair. The first sign of hair loss for many women is a widening part. In rare cases, men see noticeably thinning hair. And in rare cases, women can see a receding hairline or bald patches. The reasons for this are unknown.
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.
when i was 24, went to so. america to visit family. they hadn’t seen me since my last visit, which was when i was 17. there was a guy who i had liked and hung out with when i spent my 17th summer there and was excited to see him once again, “as an adult”. i think it was the second day or so of hanging out with him when he says to me: “hey, i noticed you’re losing your hair”. i was beyond embarrassed at that moment and all i could muster out was, “yeah, i know”. thanks for pointing it out there buddy. next came anger mixed with that embarrassment. i felt, and still feel, that people stare at my head and notice my thinning hair when they are talking to me. when i came back to the states a few weeks later, the first thing i did was make an appt with my pcp. she referred me to an endocrinologist who found my testosterone level slightly elevated. it was in the 70 range. i didn’t have masculinization going on so she told me she didn’t want to put me on medication and to return if i noticed in increase or changes in symptoms.
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.)
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.
I’m 55.. gee, had to count with my fingers, lol~ but since I had started puberty I started losing my hair. I managed through the difficult years of Junior High and High school (2 college yrs) by having perms done. The many different ways of trying to cover it. At 14 being told its male hair baldness was pretty much saying nothing you can do. All my life I stayed away during the day time, or with hats, I even worked nights. Tried many items, then later in life diagnosed with PCOS, which makes sense, why would a young girl just starting puberty start going bald. My siblings had too much hair, my sister looked like Bernadette Peters, with twice the hair. About 4 yrs ago a life long friend, called me at 2 am, said turn on HSN, I did, and it was a color fill in~we both purchased it and I absolutely love it! I look normal enough to walk past you, just don’t stare too long, lol, its called Truhair by Ashley Scott. Cant be without it. I use the Rogaine womans 5%, this helps my hair from keep falling, use it every night before bed, I take 5000 vitamin d and 10,000 biotin~ I wish I had these items back when I was teenager, would have saved me decades of embarrassment and heartache. My bald spot/thinning spot looked like a monks cap. I feel the best I have in many, many years. My 23 yrs. daughter had 3.7 ovarian cancer, spread everywhere and she survived, but now..after her 5 yrs remission, she started losing her hair. I feel so horrible for her. I know its from chemo and she ended up having a full hysterectomy, and I’m trying to get her to see a Endorinologist, as I’m sure with hers its her hormones. I finally also gave this affliction to our Lord and the thinning has decreased significantly ! I’m going to keep praying! and also praying for a cure ! the torment of losing your hair is real and devastating.

I am scared to find out whether I have PCOS…I was hoping to find out about my insulin as I sensed a major blood sugar problem for years, but I took the news surprisingly poorly. I’m more stressed than before and am terribly depressed. The doctor, by the way, had zero to say about it all. Nothing. His words “Ask your gynocologist, I am just a lowly MD.” [gasp]


For my hair loss I’ve seen four dermatologists, two endocrinologists and have spoken about it with my gynecologist, and general practitioner as well as have also seen someone who “specialized” in thyroid problems. All that’s missing is a partridge in a pear tree These are the total numbers I can recall over the last 8 years. Since my hair loss is hormone related I think that the endocrinologists were probably the most knowledgeable and most helpful about my situation. That’s me though, everyone’s hair loss and causes are different.


I am scared to find out whether I have PCOS…I was hoping to find out about my insulin as I sensed a major blood sugar problem for years, but I took the news surprisingly poorly. I’m more stressed than before and am terribly depressed. The doctor, by the way, had zero to say about it all. Nothing. His words “Ask your gynocologist, I am just a lowly MD.” [gasp]
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.
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.
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.
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.
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: 

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.
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