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.
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.
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.
Many other agents have been used to treat alopecia areata, including minoxidil, psoralen plus ultraviolet A (PUVA), and anthralin (Anthra-Derm), but success rates vary. Anthralin, an anti-psoriatic, in combination with topical corticosteroids and/or minoxidil, is a good choice for use in children and those with extensive disease because it is relatively easy to use and clinical irritation may not be required for efficacy.6 Hairpieces and transplants may be the only options available for persons with severe disease that remains unresponsive to available medical treatments. Patients with recalcitrant, recurrent, or severe disease should be referred to a subspecialist.
Other medical conditions — most commonly telogen effluvium and seborrheic dermatitis — can also cause hair loss, but most people can trace their follicular woes back to androgenetic alopecia, so we focused our search there. We started with more than 200 products, including all-natural solutions and high-tech gadgets, while skipping treatments that focus only on volumizing or thickening hair. We also limited our scope to the scalp, and left out specialty products designed only for eyebrows or beards.
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.

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.
I am 31 years old and I been loosing my hair (in the front) for 3 years now. I have seen different 4 different gynecologists and the one I have now she took blood work and other tests and the when all the tests came back everything was fine. I am trying to find a dermologist in my area that accepts my insurance. I just want to know what caused the hair loss and what can be done. It is embarrassing to even go out, when I do go out I make sure that I have a hat on. ????????

Sorry to hear about her incident. Unfortuantely, I had issues around her age. Doctors often will say that there are no issues or nothing can be done, but that’s not true. There’s a few things she can do and the sooner she does it, the better. Regrowth may not occur, but maintance may. She should go see a dermatologist that specializes in this area (or at least has some knowledge about it). One way to do this is to check out the American Academy of Dermatology website. If you check out their annual meeting, you can find out who is doing research in this area and/or giving talks. It would be really important to find out why she is losing her hair. It may be alopecia, but there might also be other reasons she’s losing her hair. Her PCP might be able to gear you in the right direction and/or do some blood work to eliminate the “usual” suspects as to why she may be losing her hair.
Alopecia areata occurs when your immune system attacks your hair follicles, causing varying degrees of hair loss. Alopecia areata usually starts with one or more small, round, smooth bald patches on your head, and can eventually cause complete hair loss on your scalp or even on your entire body. Full body hair loss is known as alopecia universalis.

Interesting reading all the stories, I had great hair until 15 years ago,and then the texture of my hair drastically changed. It be became “dead hair” wirery. I call it it my chicken feathers just taking its time to fall out which it has done over a long period of time, but I now have bald spots on the sides and thinning in my bangs. I started buying wigs years ago knowing that this was something that was inevitable. I’ve had all the tests and tried all the products, nothing..just curious if anyone else has had the “dead hair” issue
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.
A medical event or condition, such as a thyroid imbalance, childbirth, surgery, or a fever, typically triggers this type of hair loss. Telogen effluvium may also occur as a result of a vitamin or mineral deficiency—iron deficiency is a common cause of hair loss in women—or the use of certain medications, such as isotretinoin, prescribed for acne, or warfarin, a blood thinner. Starting or stopping oral contraceptives (birth control pills) may also cause this type of hair loss.
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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.
I got really sick at the age 40, 2 years after my second child was born,I started losing weight,I went from 54kg down to 47kg,my skin was splitting on the backs of my legs,both my hands,I had blisters up my arms ,on the tops of my feet,migraines that would have me vomiting none stop for ten hours,then only to sleep for 2 days to recover,no doctors were interested,I saw 8 and they all wanted me on anxiety medication because I was going through a break up that was there answer to the way I was feeling.No one wanted to listen to me.Almost feeling like
Thank you for all your post. My daughter had extremely thick hair about eight years ago. It was so thick you could barely put it in a scrunchie. Her hair has been continuously thinning to the point that you can see through it. All the women in my family on both sides have extremely thick hair. We live in the north east and have seen several GP and a Dermatologist who act like there is nothing wrong. I work in the medical field and when I hear this I get so mad because I feel like they want to just brush of like no big deal. It is a big deal to all women no matter what ages. I have written done some of the post advise and will continue to look for an endocrinologist for her. Please keep me postes on any new developements.

Hair: It’s a natural part of being a human. But when the temperature climbs, and skin is exposed, it’s one of those things that a good many of us want to control. This week, we’re tackling hairlessness, not just the process of hair removal (electric shavers and ingrown-hair treatments and aesthetician-approved tweezers) but also what to buy when you’re losing your hair, and even how to take care of a Sphynx cat. Here, we’re talking to dermatologists and hair-loss doctors about hair-loss treatments that actually work.
One of the first research studies linking alopecia with celiac disease was published in 1995. Italian doctors had noticed that several of their patients with alopecia also had celiac disease and that in one of these patients—a 14-year-old boy—the missing hair on his scalp and body completely regrew after he adopted a gluten-free diet. This boy's case and a few others prompted the doctors to screen a large group of alopecia patients for celiac disease. 

Several types of hair shaft abnormalities can lead to hair loss. These conditions cause strands of hair to thin and weaken, making them vulnerable to breaking. The hair loss doesn’t occur in the follicle but as a result of a break somewhere along the hair shaft, which is the visible part of a hair strand. This can result in overall thinning, as well as in many small, brittle hairs.


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.
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 also suspect, as you suggest, that the trichodynia is a result of rapid hair loss. I share your frustrations with how very little we dermatologists know on the subject. The only observational study on Trichodynia and chronic telogen effluvium involved only 8 patients. Only one of those eight went on to have androgenetic, permanent hair loss. The numbers followed is pathetic!

About 2 years ago my hair started thinning. I thought it was because I was in college and stressed. At that point I started going what is known as “CG” in the curly hair world. I no longer color, flat iron, use sulfates and I rarely blow-dry and use silicones. I use shampoos and conditioners with beneficial ingredients, not fillers. After 1.5 years on this Curly Girl routine, I experienced some relief and noticed my hair getting thicker. That lasted a couple months and now I’m back to losing a ton of hair. One day I counted 160 hairs…that was on a decent day. I’m sure I’ve lost 2x that amount before. My hair is noticeably thinner, drier, and it knots. It NEVER use to knot. I think my hair has become finer too, but I’m not positive. It just feels more fragile.


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.
Each hair develops from a follicle — a narrow pocket in the skin — and goes through three phases of growth. Anagen (A), the active growth phase, lasts two to seven years. Catagen (), the transition phase, lasts about two weeks. During this phase, the hair shaft moves upward toward the skin's surface, and the dermal papilla (the structure that nourishes cells that give rise to hair) begins to separate from the follicle. Telogen (C), the resting phase, lasts around three months and culminates in the shedding of the hair shaft.

I am so glad this site exsists. Thank you ladies for sharing your experiences and making this whole hair loss crisis feel less lonely. I’ve been having soo much hair loss over the past 8 months that now there’s a visibly bald spot at the top of my head and I have to wear a headband to hide it! Most days I contemplate shaving my head and walking around with a bandana so I don’t have to deal with the daily shedding (which literally causes me neck tension!). I’ve gone to my primary doctor twice and both times she’s drawn blood to test my thyroid levels. The first time the results showed my levels were normal but she still put me on levothyroxin to see if it would make a difference with the breakage. It didn’t. I just went back a second time and she took blood again to do a second test on my thyroid levels and also to see if I have lupus. I’m waiting for those results. I just want to know why this is happening now. I’m only in my early 30’s. I am so grateful that there are others of you out there dealing with this too, atleast we’re not by ourselves in this process.

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.


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]

It is perfectly normal for people to shed 50 to 100 hairs per day. This generally doesn't cause noticeable thinning of scalp hair because new hair is growing in at the same time that hair is shedding. However, hair loss occurs when this hair growth cycle and shedding is disrupted or when the hair follicle becomes destroyed and replaced with scar tissue. Female pattern hair loss (androgenetic alopecia) is the most common form of hair loss in women. This occurs gradually and is caused by genetics (from either side of the family), age, and the action of a specific male hormone, dihydrotestosterone (DHT). This hormone is found in lesser amounts in women and it preys on the hair follicles, preventing them from receiving vital nutrients for proper hair follicle growth, leading to the hairs shrinking, and resulting in a shorter lifespan. Interestingly, DHT does not need to be elevated to generate hair loss. Estrogen, when lowered as commonly seen in menopause, creates a change in the ratio of male to female hormones, giving an edge to these male hormones. Compounded with the sensitivity of DHT to the hair follicles, heredity can affect the age at which a woman begins to lose her hair, as well as the rate of hair loss and the extent of baldness. 


I’m 26 and started losing my hair (in the course of about a month) one year ago. I’ve seen three doctors about it. The General practitioner just pulled my hair and said it looks like my hairloss had already righted itself. Well, I didn’t believe her. So I went to a derm and he said he saw little regrowth hairs so it was just temporary hairloss and if, for some reason, I haven’t regrown my hair in to a noticable length in a year to come back to him for more bloodwork. (I had gotten my thyroid checked in my yearly physical and they said it was just slightly elevated . However, they told me this was not enough to put me on medication that they would check it again in one year) It has been one year and I think my hair is actually getting thinner. I’m just panicking. I’ve always had thick, straight as a board hair like another woman on this post had said, and now it is very thin, breaks easily and is ‘kinky’. I don’t understand why its kinky, why would my really long hairs that took years to grow now start to be damaged and kink when they fall out? I never got split ends, I never had short hairs fall out and when my hair did fall out in its normal pattern it would always fall out in one long, straight, thick strand. Does this mean I have a miniaturization of my follicles that has been going on for years? That maybe my hair strands are growing back thinner? I agree with another girl on this site that said she feels like there is no hope now. I was assured by my derm that my hair loss would not get worse. This helped me to cope a bit because instead of looking like someone with thick hair, I just had to look like someone with thin, wispy hair. I thought maybe I could deal with that, as long as I didn’t have to go bald. Well as much as this site has encouraged me in that ‘misery loves compay’ I now see that there are very few solutions and left untreated it can make us bald! I might also mention that I was never on birth control, and have no idea why I just suddenly started losing my hair. However, I have always had PMS and heavy periods. I guess I just want to know, is this for sure a problem with my hormones? Is it because my thyroid is slightly elevated? Should I even bother going to a doctor anymore? How can women as young as 18-30 be getting this problem? I guess I just am in that panic mode, where I really just want some reassurance that the odds of this getting better are good. I’ve past that one year mark of when I’m supposed to know if it was temporary or not and so now that sense of panic is renewed. Is this just going to keep getting worse? What do I do!? I hope some of you have some comments that could help me out. Thanks for listening to me rant.
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Hi: I am 61 yrs old. ( Although my hair has been thinning gradually I am all of a sudden shocked about how much of it is gone. I don’t loose a lot–between 10-15 a day probably but I see small areas without any hair grow where I usede have hair sa. I am sure that I am not growing any hair anymore. I have not seen any doctors about it yet but from reading about it I know my hair loss/thinning is due to many medications I have been using that I need to use; antidepressant/tyroid/cholesterol but most mportantly glaucoma medication which my doctor has increased the dosage due to the aggresive nature of it. Of course I am gong to talk to him as well as my family physician. But readign what ting has been very helpful. I will post my findings when I know more. Thanks everyone
In 2010, a genome-wide association study was completed that identified 129 single nucleotide polymorphisms that were associated with alopecia areata. The genes that were identified include those involved in controlling the activation and proliferation of regulatory T cells, cytotoxic T lymphocyte-associated antigen 4, interleukin-2, interleukin-2 receptor A, and Eos (also known as Ikaros family zinc finger 4), as well as the human leukocyte antigen. The study also identified two genes, PRDX5 and STX17, that are expressed in the hair follicle.[18]
Let me give a background of my health issues. I am 54 years old and I was diagnosed with Hashimoto’s (hypothyroid) disease AND going through menopause about 6 years ago. I have a great ob/gyn that will treat both using compounded bio-identical hormones. I have bloodwork at least twice a year, more if I’m not feeling 100%. My testosterone levels were usually on the low side, but still WNL.
The characteristic finding of alopecia areata is one or more well-circumscribed areas of otherwise normal, hairless skin in hair-bearing areas. Occasionally, it may be necessary to biopsy the scalp to confirm the diagnosis. Other findings that may be helpful are the appearance of short hairs that presumably represent fractured hairs, short thin hairs, and gray hair growing in a bald area. Other causes of hair loss are generally excluded from the consideration by history and clinical evaluation. 

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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