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.
Many medications are being studied, including abatacept, MEXIS/M6S, triamcinolone, secukinumab, tralonkinumab, apremilast, botulinum toxin, INCB018424, bimatoprost, clobetasol, AS101, autologous platelet-rich plasma, topical minoxidil, and nitric oxide gel.[27] Some of these medications are approved for other diseases, others are not available outside of studies.
I’m so glad you saw my post, and wrote back. Thank you again for writing about your experience. At the time I read it, I knew that was the path I had to go. I have a treatment plan, and intend on it being a successful one (I’m so trying to go from being a negative person to being positive, it really makes a difference). I have joined the network, and hope you do as well,. Angela, is right, there is so much caring, understanding and sharing of knowledge here, that so help with the emotional part of this thing called hairloss.
Just found this site today and want to thank everyone who is sharing. I don’t have the words for how devastated I feel about losing my beautiful, beautiful hair. Thank you for the information and fellowship here. I have a wonderful internist, but she hasn’t been able to help, (been dealing with PCOS for 12 years now and severe hair loss since Feb 2008). Will be looking for an endocrinologist and a dermatologist now too. Hope I can give back some day with good news.
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!
The loss of hair can be sudden, developing in just a few days or over a period of a few weeks. There may be itching or burning in the area before hair loss. The hair follicles are not destroyed and so hair can re-grow if the inflammation of the follicles subsides. People who experience just a few patches of hair loss often have a spontaneous, full recovery without any form of treatment.

Honestly, for female pattern baldness (what I have) I don’t think there really is any effective treatment — the only hope is learning to cope psychologically. (Just my humble opinion) So I don’t totally “hate” him for not being able to help me medically regarding the hair — but he was such a let down. I really expected more. (he’s an excellent dermatologist, for skin things at least)


“The most common cause of hair loss in both men and women is androgenetic alopecia, which is genetic pattern hair loss,” explains Dr. Michael B. Wolfeld, a board-certified plastic surgeon and an assistant clinical professor of plastic surgery at the Icahn School of Medicine at Mount Sinai Hospital in New York. The root cause of this type of hair loss is dihydrotestosterone (DHT), a byproduct of testosterone that shrinks certain hair follicles until they eventually stop producing hair.
The dermatologist also will carefully look at your scalp and hair. During an exam, the dermatologist may pull on your hair. Sometimes a dermatologist needs to pull out a hair to get the necessary evidence. And sometimes a dermatologist needs to look at the hair on the rest of your body to see whether there is too little or too much hair in other areas.
Hi,this is really tough for me and I don’t know what to say. I have always lost a lot of hair but I had a ton of hair. However,my mom commented that she noticed that it has thinned out more than usual and it has. And today, I just took picture of the top of my head and see a spot. Like you Lisa, I am completely freaked out, I am two weeks away from my 34th birthday. Sorry, Lisa I don’t know of any doctors except for my dermatologist that I am calling tomorrow and I found an endocrinologist through United Healthcare that I will call. I’m so upset that the crying just won’t stop. What worries me is that I’ve been on aladactone for about a year for acne (but was only at 50 mg) BUT she did up the dosage about 5 months ago (but only consistently take at the 200 mg for 3 months). But my fear is that the aladactone didn’t help prevent it for me. But the thinning out has been noticeable since about May/June of this year so maybe there is hope. Now, I have to put in there I went through a very stressful period from March until now. And had a rapid weight loss of 35 pounds (went from 168 to 133) and I’ve been doing a lot of running. But my concern is my sister has female pattern balding and so does my mom so I am very worried. My sister said the doctor said to up her protein and get super b-12 complex which I started two weeks ago, my sister said she has seen some regrowth. Today, I went and got biotin, magnesium and iron. And bought Nioxin shampoo as i heard it help give the appearance of more hair. I am calling the doctors tomorrow in hopes that it really was just my rapid weight loss, I have to admit I was under a lot of stress and barely eating, I’m eating better now though but again it runs in my family and I am completely freaked out. Lisa if I have any success I will let you know who my doctors were. Know that I too, live in Phoenix and am going through the same thing. It is hard, now I am afraid my boyfriend will leave me. Keep faith.
A hair growth cycle consists of three phases. During the anagen phase, hair grows actively. This phase may last for years. During the catagen phase, hair stops growing and separates from its follicle, which is the structure beneath the skin that holds the hair in place. The catagen phase lasts about 10 days. During the telogen phase, the follicle rests for two or three months, and then the hair falls out. The next anagen phase begins as a new hair grows in the same follicle. Most people lose 50 to 100 hairs per day as part of this natural cycle.

Spironolactone, an aldosterone antagonist with antiandrogenic effects, works well as a treatment for hirsutism and may slow hair loss in women with AGA, but it does not stimulate hair regrowth. Estrogen may help to maintain hair status in women with AGA, but it also does not help with regrowth. Few controlled studies have examined the many non–FDA-approved hair growth agents such as cyproterone acetate (not available in the United States), progesterone, cimetidine (Tagamet), and multiple non-prescription and herbal products. A full discussion of approved and unapproved treatments for AGA can be found elsewhere.6,7 In all forms of alopecia, hairpieces and surgical transplants can produce satisfactory results but are expensive.
so here i am. i’m ready to try the spiro, alone, especially after reading your posts. i’ve thought of shaving my head, and i may be closer to doing that. i keep my hair in a short bob since it helps not having it knot up when it’s longer, due to its fineness. i try to let it air dry, but blow drying it, upside down, adds volume. plus my curls do not really form anymore because of the texture. i have never counted my lost hairs individually, but i don’t need to have an exact number since just eyeballing what comes out every time i wash, comb, or just touch my hair is stressful enough. it’s hard to be in the sun. we hung out at a garden for Easter yesterday and the sun was burning my scalp. i have tried expensive shampoos, but nothing. i may look in to the toppik. i used to use this bumble and bumble brown hair powder, but since it didn’t quite match my color (it’s only available in three shades) it didn’t look so convincing. the toppik makes more sense since it’s a fibrous material.
Cicatricial alopecias tend to cause permanent hair loss. These disorders destroy hair follicles without regrowth and follow an irreversible course.21 It is likely that they involve stem-cell failure at the base of the follicles, which inhibits follicular recovery from the telogen phase.21 Inflammatory processes, including repetitive trauma as in trichotillomania, also may lead to stem-cell failure. Other processes may be caused by autoimmune, neoplastic, developmental, and hereditary disorders. Among these are discoid lupus, pseudopelade in whites, and follicular degeneration syndrome in blacks. Dissecting cellulitis, lichen planopilaris, and folliculitis decalvans also may cause scarring alopecia. Some disorders respond to treatment with intralesional steroids or antimalarial agents.21 Patients with these conditions should be referred to a physician who specializes in hair loss disorders.

^ 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.
A directed history and physical examination usually uncover the etiology of hair loss. The history should focus on when the hair loss started; whether it was gradual or involved “handfuls” of hair; and if any physical, mental, or emotional stressors occurred within the previous three to six months3  (Table 1). Determining whether the patient is complaining of hair thinning (i.e., gradually more scalp appears) or hair shedding (i.e., large quantities of hair falling out) may clarify the etiology of the hair loss.4
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. 

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.
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

My dermatologist recently prescribed 100 mg spironolactone for a month and told me to increase the dose to 200 mg after that. He also told me to use Rogaine for men. The Rogaine instructs that it not be used in the front of the scalp (where a lot of my hair loss is) but to only use it on the crown of the head. Can I safetly use it in front? Also, how do you deal w/ putting foam on your head 2 xs a day? My hair is thin with no body. If I add foam I’ll need to restyle it. Am I missing something? I don’t mind taking a pill but the Rogaine has me freaked so I haven’t started it. Any suggestions? I’m having a hard time thinking of using Rogaine the rest of my life.
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.
The pattern of hair loss, especially whether it is focal or diffuse, also may be helpful (Figure 1). The hair-pull test gives a rough estimate of how much hair is being lost.2,4  It is done by grasping a small portion of hair and gently applying traction while sliding the fingers along the hair shafts. Usually one to two hairs are removed with this technique. The hairs are then examined under a microscope (Table 2).
“The most common cause of hair loss in both men and women is androgenetic alopecia, which is genetic pattern hair loss,” explains Dr. Michael B. Wolfeld, a board-certified plastic surgeon and an assistant clinical professor of plastic surgery at the Icahn School of Medicine at Mount Sinai Hospital in New York. The root cause of this type of hair loss is dihydrotestosterone (DHT), a byproduct of testosterone that shrinks certain hair follicles until they eventually stop producing hair.
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