Alopecia areata is believed to be an autoimmune disease resulting from a breach in the immune privilege of the hair follicles.[4] Risk factors include a family history of the condition.[2] Among identical twins if one is affected the other has about a 50% chance of also being affected.[2] The underlying mechanism involves failure by the body to recognize its own cells with subsequent immune mediated destruction of the hair follicle.[2]
I too have suffered from hair loss, more noticebly over the past 2 year, although it first started 10 years ago. I am 39 female and always had a full head of hair. Now, my hair has gone dry, dull and and has lost it volume. I have been to my Dr and have had test done, however everything has come back ok. i.e. my hair los was not found to be down to any internal deficiencies hormones, nutrient levels, diseases etc , so now my Dr is referring me to a dermatoligst to see if the problem is due to the skin on my scalp. However it maybe advisable if you havent already, to visit a licesend Trichologist, this is someone who specifically deals with the scientific study of the health of hair and scalp, and would have a more thorough knowledge about your hair than any GP and by conducting a hair analysis, can identify your hair loss problem. I intially visited, and it was he who suggested I go along to my GP and ask for specific types of tests. However, he also informed me for some cases there are conditions that can be cured, but with other, it could simply be that hair loss pattern is heriditary which can occur in both male and female ( this does not necessarily need to come from your parents or grandparent, it could come from family gene from generations back, that so happened to show up in you generations later!). In this case, the frank truth is little can be done. However there are different topical treatments, and people do not have to go to the extreme of hair surgery or even having to wear undignified wigs. Below is a link to a product called Toppik which I have used. Basically it small fibre which are made from the same fibres as natrual hair, which use sprink onto your hair to cover bald and thinning areas. It adds body, volume, and makes your hair ‘magically’ appear full regardless of the lenghth of your hair. Its not expensive, and also come with conditoner and shampoo to give your hair that added volume, even to the most thinnest of hair. I hope this will provide some solution and even comfort to those experiencing hair loss. The link is below – Good luck
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.
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.
Lichen planopilaris, a type of alopecia, occurs when a common skin condition, called lichen planus, affects the scalp. Lichen planopilaris may cause a dry, flaky rash to appear on the skin that causes hair on the scalp to fall out in clumps. The scalp may also become red, irritated, and covered in small white or red itchy, painful, or burning bumps.

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.


I’m interested in what took place 4 months before the onset of your hair loss (and others with telogen effluvium). For me, it has always been either a baby born or a course of antibiotics. Oral birth control can also cause a sudden change in the gut flora–as can pretty much any medication. Staph infections are another connection I think should be pursued. Some women don’t know they’re colonized with Staph but they constantly have dry, cracked (mild or severe) sores in their noses.
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.
^ Martinez-Mir A, Zlotogorski A, Gordon D, Petukhova L, Mo J, Gilliam TC, Londono D, Haynes C, Ott J, Hordinsky M, Nanova K, Norris D, Price V, Duvic M, Christiano AM (February 2007). "Genomewide scan for linkage reveals evidence of several susceptibility loci for alopecia areata". American Journal of Human Genetics. 80 (2): 316–28. doi:10.1086/511442. PMC 1785354. PMID 17236136.
Hey, lady. I am glad for you that you got the extensions removed if it makes you feel better, but if it doesn’t then you should get them put back in. I understand wanting your husband to feel you are attractive, etc. but if he did not like them but you did…maybe you should talk to him and tell him how much better they made you feel about your appearance? A thought anyway. I am totally single so don’t have anyone to please but myself but I think in our hair loss, we have to make ourselves feel better first. That produces an effect that trickles down to everyone important to us in our lives. I’m sure your husband thinks you look gorgeous either way but you have to do what makes YOU feel gorgeous!
Minoxidil (Rogaine). This is an over-the-counter (nonprescription) medication approved for men and women. It comes as a liquid or foam that you rub into your scalp daily. Wash your hands after application. At first it may cause you to shed hair as hair follicles. New hair may be shorter and thinner than previous hair. At least six months of treatment is required to prevent further hair loss and to start hair regrowth. You need to keep applying the medication to retain benefits.
Alopecia areata affects people of all ages including young children. It produces circular patches of hair loss that appear overnight. More patches appear over time and eventually about 5% of people affected lose every hair on their body. This includes eyebrows, eyelashes and even nose hairs. In some people, hair grows back, either in the same place or on a previously unaffected part of the scalp or body.
Aside from the falling hair, I’m also experiencing bouts of arrhythmia. There are instances when my heart would beat slowly and it feels like it’s going to break my ribcage. It’s hard to breathe and I get dizzy. Do you think these are related? I don’t want to go to another doctor yet because I haven’t researched yet and because of my many disappointing experiences with them, I would never dare to consult with one without knowing anything.
This blog is great in all the support and understanding it provides, but I had a pretty hard time finding any suggestions for treatments that have actually helped anyone. I’m 22 and my hair has been rapidly shedding over the past 5 months. It’s also gotten thin and brittle. After 2 blood screenings, a dermatologist visit, and a visit to my general practitioner, nothing has improved. The doctor’s told me to wait it out, and that sometimes this “just happens”. They tested my hairs and saw that most of them were in the “resting” telogen phase, and decided I had Telogen Effluvium (TE) for undetermined causes.
Also, re: the Proscar, I think that it may already be helping some as I think my shedding may be tapering off a bit more. I am losing a few less hairs Per day now. Maybe? I don’t know, but I am trying to stay positive!! I have no real regrowth. Just wisps, extremely fine hair, almost hard to see. Kind of transparent. I am not expecting miracles, but trust me…. THe moment I feel I have any true results to share with you girls, I will definitely be posting them! There aren’t many success stories out here. We need more. I guess people don’t come out here as much if they are experiencing good things w their hair?
I have Alopecia Areata, Hoshimoto Thyroiditus, both are autoimmune diseases. I also now am losing hair all over my head. I have itching, redness, pustules and think it may be Cicatricial Alopecia (Scaring Alopecia). I have tried Biotin 10,000mcg per day for 3 yrs didn’t work, also Nioxin didn’t work. Minoxidil 5% worked the first time I lost some hair but not anymore. I have been given oils, creams, and still no luck.I went to a Derm and he didn’t seem to care. I am embarrassed to go out becauseyoou can really see my scalp through my very thin hair. I use to have very thick hair but that is gone. I can’t afford a wig and don’t know where to turn now. I have to support where I live (Rialto, Calif.). Any Ideas?
Hello ladies, I’m 32 yrs old and suffering from hair thinning. My hair just seems to have stopped growing. It’s now half of what it used to be 2 years ago! GP did some extensive tests, nothing came out. Might be birth control (on Quasense for 2 years – hair thinning started after that) but can’t stop it (it’s the only BC that’s worked for my very horrible cramps). Anyway, any suggestions for doctors (dermatologists/endo/any other) in San Francisco Bay Area or somewhere in California?
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]

I recently noticed I was loosing hair on the front of my head, I started using the rogain Foam and after a month my hair started falling out even more. It’s gotten really bad, I can see my entire scalp now and my hair is falling out in chunks. Rogain advised you loose hair making room for new ones to grow, has anyone had any experience using rogain? Is This normal?
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What a helpful website, thank you ladies for sharing. I am 55 and am loosing hair by handfuls when I shampoo. I have been using Minoxodil extra strength for about 5 years and it was helping but not anymore. I also have been taking Nioxin hair vitamins and they helped for the first 3 years but not now. I am going to check out Dr Redmond like several of you recommended and head to Sallys for hair extensions also. Does anyone know of a good Dermotologist or Endo Dr. in Humble or Kingwood Tx area? Karen
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!

When healthy hair is pulled out, at most a few should come out, and ripped hair should not be distributed evenly across the tugged portion of the scalp. In cases of alopecia areata, hair will tend to pull out more easily along the edge of the patch where the follicles are already being attacked by the body's immune system than away from the patch where they are still healthy.[11]
In answer to which doctor should I see for my hair loss, my opinion is that you should probably see both. Most doctors don’t know enough about hair loss as it is, so seeing doctors in different specialties may actually help you get a better, more accurate diagnosis. I am sure there are various conditions of hair loss that might be better served by seeing one more than the other. Perhaps a dermatologist would be better suited in determining if the cause was an infectious skin condition such as ringworm or scaring alopecia, and an endocrinologist may be better at diagnosing hormone related hair loss. The truth is, any doctor whether it is an endocrinologist, dermatologist, or general practitioner with a strong interest and knowledge in hair loss can make a proper diagnosis and work with you on the the treatment they think will produce the best results. The operative words here are “interest and knowledge.”
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.
Furthermore, Penn dermatopathologists developed an even more advanced method called the HoVert technique for diagnosing hair loss and other disorders from a scalp biopsy. The technique uses a unique horizontal and vertical testing approach that provides a greater amount of information to the referring dermatologist than standard industry longitudinal scalp biopsies.

The topical sensitizers, diphencyprone or squaric acid dibutylester, have been used in those suffering from recalcitrant alopecia areata or those with more than 50% hair loss. The goal of treatment is to create an allergic contact dermatitis of the scalp. This alteration in the immune response occasionally is accompanied by hair regrowth. The efficacy of the topical sensitizers has been demonstrated in both young children and adults, but it probably works less than half the time. Recent success using oral janus kinase inhibitors, including tofacitinib, ruxolitinib, and baricitinib, have been shown to be efficacious in severe, extensive alopecia areata in adults, but long-term therapy has potential side effects. The durability of response to these medications is variable, and most patients experience recurrence of hair loss after discontinuation. Perhaps topical therapy with these types of drugs may be available in the near future.
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.

I had embolization and an angiogram for an AVM on my jaw. I was told there would be some hair loss because of the radiation (The size of a quarter). Well I have lost all but 1/3 of my hair left …not the area of a quarter! Has anyone ever had this happen? My doctor says the hair should grow back, but it has been three months and it is still coming out and no new growth. I don’t know what to do! Any suggestion? As with many women my hair was a part of my identity. I am not bragging but people remember me as the girl with all the hair. I realize we are more than our hair, but it makes me so sad!
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 want to first write that I am not a fan of hair transplants for women, I personally think that most women with androgenetic alopecia are NOT candidates for this procedure. Having said that, I get emailed all the time from women looking for a good hair transplant surgeon. If you are deadset on having a consultation, please visit the International Alliance of Hair Restoration Surgeons. The IAHRS (http://www.iahrs.org) is an organization that selectively screens skilled and ethical hair transplant surgeons. Read my thoughts about hair transplants here.
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.
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.
I too visited the infamous-overpriced Dr Redmond from NYC. I’m on spiro and all the meds for 7 months, going on 8. Forget regrowth, forget halting of shedding, the rate of hair shedding refuses to slow. (I’m also certain its PCOS and not lupus that causing my hairloss, thoroughly medically investigated my hairloss. ) At the start of my treatment, I cut my hair to bout 5 inch lenght, so I’d easily be able to tell thinning versus halt versus regrowth. And all I can say is, I have less hair than I started with. Unfortunately even a physicians intervention is incapable of helping me. To all those out there, atleast this approach before scratching it off your list, its the least you can do.
What a helpful website, thank you ladies for sharing. I am 55 and am loosing hair by handfuls when I shampoo. I have been using Minoxodil extra strength for about 5 years and it was helping but not anymore. I also have been taking Nioxin hair vitamins and they helped for the first 3 years but not now. I am going to check out Dr Redmond like several of you recommended and head to Sallys for hair extensions also. Does anyone know of a good Dermotologist or Endo Dr. in Humble or Kingwood Tx area? Karen
What a helpful website, thank you ladies for sharing. I am 55 and am loosing hair by handfuls when I shampoo. I have been using Minoxodil extra strength for about 5 years and it was helping but not anymore. I also have been taking Nioxin hair vitamins and they helped for the first 3 years but not now. I am going to check out Dr Redmond like several of you recommended and head to Sallys for hair extensions also. Does anyone know of a good Dermotologist or Endo Dr. in Humble or Kingwood Tx area? Karen
Women also may experience AGA, often with thinning in the central and frontal scalp area but usually without frontal–temporal recession (Figure 3). A history and physical examination aimed at detecting conditions of hyperandrogenism, such as hirsutism, ovarian abnormalities, menstrual irregularities, acne, and infertility are indicated. Laboratory tests are of little value in women with AGA who do not have characteristics of hyperandrogenism.5
About one-third of women experience hair loss (alopecia) at some time in their lives; among postmenopausal women, as many as two-thirds suffer hair thinning or bald spots. Hair loss in women often has a greater impact than hair loss does on men w, because it's less socially acceptable for them. Alopecia can severely affect a woman's emotional well-being and quality of life.

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.
From doing this I have noticed less hair loss, some re-growth and some thickness, more coverage on the crown area, you cannot see the baldspots any more but just a long faint scalp line. But I will not go to a hairdresser or put colour in my hair. I believe this is why my hair is improving. I didn’t spend money on doctors or dermatologists and certainly will never give money to a hairdresser again. I use products with no parabens and sulfates. I hope my post helps; please try not to give up.
I just came across this website, I thought by chance but I think not! I have been having scalp pain, like my skull wanted to crack open. Then the tendersness of my hair folicals when the wind would blow. I started to loose lots of hair so went to my family doctor. All the test were done for Thyroid problems…all turned out what they call “normal”. Have you seen the wide range which is considered normal? How can this be when everyone is so different? I am loosing hair as I sit and write this message. The hair just gently falling onto my shoulder. I need to color my hair as it is time from the length of my silver roots but the last time I had my hair touched up, I thought I was going to die from the pain when the stylist tried to just shampoo the color off. Oh my God! Painful, painful. I used to be a stylist so you can imagine my shock when I was told it wasn’t my Tyroid!
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. 
You can also get a hair-loss kit from Hims, which comes with both minoxidil and finasteride. Keeps has one, as well. And though it might seem like overkill to take two different hair-loss treatments at once, this is one of those rare instances where more is actually better. McAndrews calls the combination of orally administered finasteride and topically applied minoxidil a “full-court press” against hair loss. “That’s doing the most you can for preventative medicine.” Rieder notes that taking both drugs together is more effective than taking either one alone.
The condition affects 0.1%–0.2% of the population,[26] and occurs equally in both males and females. Alopecia areata occurs in people who are otherwise healthy and have no other skin disorders.[7] Initial presentation most commonly occurs in the late teenage years, early childhood, or young adulthood, but can happen at any ages.[9] Patients also tend to have a slightly higher incidence of conditions related to the immune system, such as asthma, allergies, atopic dermatitis, and hypothyroidism.
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.
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