Telogen effluvium occurs when the normal balance of hairs in growth and rest phases is disrupted, and the telogen phase predominates. The disproportionate shedding leads to a decrease in the total number of hairs. Axillary and pubic areas often are involved, as well as the scalp.2 The hair-pluck test usually shows that up to 50 percent of hairs are in the telogen phase (in contrast to the normal 10 to 15 percent), although these results can vary in persons with advanced disease.4  The patient often is found to have had inciting events in the three to four months before the hair loss (Table 4).1,4 If 70 to 80 percent of hairs are in the telogen phase, the physician should look for causes of severe metabolic derangements, toxic exposures, or chemotherapy.1,4 No specific treatment for hair loss is required because normal hair regrowth usually occurs with time and resolution of underlying causes. Lack of significant historical events and a delay in regrowth should raise suspicion for syphilitic alopecia.1
It is expensive ($700) to see him. He does give you a bill which you can submit to your insurance company (max reimbursement $150-$200). He will send you a lab slip once you sign up for the appt so you don’t have to go through any other doctor to get the labs done. I have regular insurance through work and didn’t get charged at the lab. If you do go to see him, I highly recommend reading his book first so you know what to expect. He spends alot of time with you (initial consultation is 1 hour and 30 minutes) but you don’t want to waste any of that time on questions that he answered in his book). In my opinion, he is a very learned and specialized physician. he has had excellent training and has taken a personal self interest in this. He is the only physician I have seen. I have not yet tried a dermatologist.
I live in Orlando. I understand your panic. How old are you? Are you in menopause or peri or is it purely hair loss not horome related? I have been to a dermatologist I traveled 2 hours to another city. I’m like you, desperate and going from doctor to doctor. It’s a nightmare and I’m losing more hair all the time. Where are you losing your hair? on top? Is it diffuse? I feel like I’ve wasted so much time. I felt in November it was menopause related. I went in Menopause early 40s. wasted months on HRT since January and hair worse on top. I felt like I was in a nightmare and nobody understands. You truly don’t want to leave the house. I went to derm specializing in hair loss. He did biopsies. Female pattern hair loss on top. Folicullitis in back. I had even had hair fall out around nape of neck. But he just basically said nothing. I was waiting for biopsy to come back and more blood work and I said can’t I take something. He said you’re not going to lose any in two weeks. I’m like are you kidding me? every week is another nightmare. Anyway he says take spiro 50 mgs, use Rogaine. Even I know from these blogs you need to take 100 to 200 for female hair loss. Basically I go back and he says hair transplant. Did I mention he does hair transplants. So he does nothing beyond diagnosis except offer hair transplant. I’m like My hair is falling out all over. I need to get it stabilized first. sorry I’m rambling. I’m using rogaine foam. It makes me feel good to use it as if I’m doing something. Been on a month almost. Now just went on finasteride, but jury is out if that will help. But even that I asked for from him and his dose was lower than on these sites. So I asked for higher. I wish I could take spiro, but it upsets my stomach horribly. So I’m going to Redmond. I should have gone in January. I can’t believe this is happening to me. I’m sorry I’m rambling.

First Dr.I saw was my regular dermatologist. He basically said I should “try not to stress so much” and it would grow back. My neurologist wasnt happy with that answer either so he sent me to another derm., she checked my iron and put me on Chromagen?. 6 months later, no new growth Then she said male pattern baldness, use men’s rogaine and that was it.
Hair changes about as fast as grass grows, which is to say it’s extraordinarily slow and not visible to anyone checking impatiently in the mirror every day. But during regular follow-up appointments, Harklinikken uses high-tech equipment to photograph and magnify the scalp and count new hairs and active follicles, which motivates users to adhere to the regimen. Too many people give up on treatments like Rogaine and low-level-light devices before they’ve had a chance to work, Dr. Senna said.
Iron supplements. Iron deficiency could be a cause of hair loss in some women . Your doctor may test your blood iron level, particularly if you're a vegetarian, have a history of anemia, or have heavy menstrual bleeding. If you do have iron deficiency, you will need to take a supplement and it may stop your hair loss. However, if your iron level is normal, taking extra iron will only cause side effects, such as stomach upset and constipation. 

If a pregnant woman comes in contact with crushed or broken Finasteride tablets, wash the contact area right away with soap and water. If a woman who is pregnant comes into contact with the active ingredient in Finasteride, a healthcare provider should be consulted. If a woman who is pregnant with a male baby swallows or comes in contact with the medicine in Finasteride, the male baby may be born with sex organs that are not normal.
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.
*Photograph used with permission of the Journal of the American Academy of Dermatology. This photograph was published in the Journal of the American Academy of Dermatology, Vol. # 60, Gathers RC, Jankowski M, Eide M, et al. “Hair grooming practices and central centrifugal cicatricial alopecia,” 660-8. Copyright Elsevier (2009). Journal of the American Academy of Dermatology.   
Anti-androgens. Androgens include testosterone and other "male" hormones, which can accelerate hair loss in women. Some women who don't respond to minoxidil may benefit from the addition of the anti-androgen drug spironolactone (Aldactone) for treatment of androgenic alopecia. This is especially true for women with polycystic ovary syndrome (PCOS) because they tend to make excess androgens. Doctors will usually prescribe spironolactone together with an oral contraceptive for women of reproductive age. (A woman taking one of these drugs should not become pregnant because they can cause genital abnormalities in a male fetus.) Possible side effects include weight gain, loss of libido, depression, and fatigue.
I’m typing on my iPad so forgive the many mistakes I will make. Thank you so much fornrplying I’ve been wondering where u and Pilar are. And good for u for not visiting. Ive had my moments where I can stay away and eve feel good. I had all of my extensions removed and I think it has affected the way I feel. But bit feels so good for them to be gone! And in all honesty my hair is in even better shape than it was before I got them. My ends are not as wispy as they were. I wore them for two months and they really made me feel better but I could never wash my hair like I wanted and every time my husband touched my head he said when are u going to get these out! Anyway I’ve felt not as good since I had them removed. I like to hibernate but my husband is a social butterfly; I use to be……but we All know how this changes you! Please please let me know how the propecia works. If there are any side affects, etc….like weight gain, moodiness, gloating etc…..there is a lady bin our office on spire and I have been reading the horrific side affects it has and I’m wondering about propecia. I hope u r doing really good. U sounded really strong in ur post and I’m glad. And yes I am deeply depresses over this. I would so get a hair system but my husband is soooooo anti fake anything. Which drives me crazy. I just want to feel better. Have a blessed nite and thank u. Please keep in touch and thank u for replying I felt I would hear from u. Have u spoken to the doc since u ve been on pro?
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. ????????
With those pinned down, it wasn’t hard to determine which don’t actually work. Pretty much all the “active” ingredients listed in ineffective treatments — from biotin and zinc to emu oil and saw palmetto — have never been proven, and are instead marketed based on logical-seeming correlations. It would make sense that biotin, a B vitamin readily found in hair, skin, and nails, could help hair grow more quickly. And caffeine is a stimulant that works in coffee, so rubbing some on your scalp might wake some of those sleepy follicles… right?
I do not believe birth control pills nor rogaine to be an appropriate long lasting answer for hair loss. I do not want to be on drugs for a length of time. Luckily, I have researched how the answer possibly lies within your lifestyle. What you eat, How much you exercise, how much sleep you get and stress you have. As for hormone-caused hair loss, the adrenal gland produces a 1/4 tsp of hormones per year. If you go slightly under or over that amount, a hormone imbalance is the result. If you use table salt, or are on a low-salt diet…you may be negatively affecting your hormones.
In contrast to trichotillomania, traction alopecia involves unintentional hair loss secondary to grooming styles. It often occurs in persons who wear tight braids (especially “cornrows”) that lead to high tension and breakage in the outermost hairs (Figure 10). Traction alopecia also occurs commonly in female athletes who pull their hair tightly in ponytails. The hair loss usually occurs in the frontal and temporal areas but depends on the hairstyle used. Treatment involves a change in styling techniques. Other hair-growth promoters may be needed in end-stage disease, in which the hair loss can be permanent even if further trauma is avoided.1

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 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.
i also have learned that most people are low in their vitamin d levels, which may also contribute to hair loss. i actually had labs done to check for my vitamin d level, by a cardiologist. my heart is fine, thankfully, but she did tell me to take 2000i.u. daily of vitamin d3, specifically. when i researched about it, i found the possible hair connection. so i do take that daily. i will also be buying vitamin b6 and 12 and biotin. and i will research the gut connection because biologically speaking, it makes sense. i will return with another post in a few months and update.
Hello all. First, I would like to say that this site is absolutely amazing. I have never felt so touched in my life. I too suffer from hair loss. I cannot really say what the cause is because I have never been properly diagnosed–still searching for answers. I have been to many doctors and have had many blood tests only to get back normal results (which I guess is good) but how can this be? What really amazes me is when I discuss may hair loss with my doctor, whom ever it may be that day –Endo., Derm., GP., they never seem to really want to help or maybe they just don’t know. I have spent so much money on so many different doctors and it is as if they all go by the same book. Where does one go to seek answers? It really is a sad situation. I believe that all the doctors that I go to must be going through the same type of training and education. Maybe I need to go to a doctor that just got out of med school and hope and pray that he/she learned something new instead of the norm–Purchase Men’s Rogaine….Jeez.

While you won’t find a miracle shampoo on the market, nioxin and some other products can help keep your scalp in tip-top shape to improve the look of any hairs you do have left on your head. In fact, feeding your hair with the proper nutrients both inside and out can make it appear healthier, so you might consider using products with natural herbs, such as rosemary and mint.

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.
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.”
Low-level laser light brushes, combs and other devices which are FDA-cleared for both men and women are available without a prescription. Although it’s not clear how the devices work, it’s thought to “stimulate the hair follicles’ energy cells to be more active,” Francis said. They’re also foolproof, telling you when and how far to move the device and they even automatically shut off.
Ironically, taking the hormone levothyroxine to treat an underactive thyroid can contribute to some hair loss, among other side effects, but this seems to be more common within the first month of treatment and more often in children than adults. This hair loss is only temporary and will go away as treatment is continued and thyroid hormone levels stabilize.
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