There are numerous diseases that can affect the hair and scalp. Hair loss can be caused by a variety of conditions. Diseases such as alopecia areata, anemia, male/female pattern baldness, and infections of the scalp can all cause significant difficulty and loss of daily well-being. Stanford Dermatology has established a special clinic focusing on the diagnosis and treatment of these disorders of the hair.
“A scalp biopsy is the gold standard for diagnosing hair loss,” said Dr. Marc Avram, a dermatologist in private practice with offices in Manhattan and Brooklyn. “The test examines the follicles themselves and can help determine whether the hair loss is genetic, inflammatory, infectious or due to an unusual physical or emotional shock to the system.”
Alopecia areata: Researchers believe that this is an autoimmune disease. Autoimmune means the body attacks itself. In this case, the body attacks its own hair. This causes smooth, round patches of hair loss on the scalp and other areas of the body. People with alopecia areata are often in excellent health. Most people see their hair re-grow. Dermatologists treat people with this disorder to help the hair re-grow more quickly.
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.
However, ketoconazole is still not FDA approved for hair loss treatment, which means it cannot be endorsed or marketed as such. Put simply, ketoconazole likely curbs hair loss, but additional research is needed for the FDA to give it approval. While it is safe to use as a supplement to our top picks, we wanted to recommend products with as much scientific backing as possible. So, we stuck with FDA approved minoxidil or FDA cleared laser treatments. But we’ll keep a close eye on products like ketoconazole shampoos and update as new research appears.

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
How to use minoxidil: Be sure that your hair and scalp are dry. Using the dropper or spray pump that's provided with the over-the-counter solution, apply it twice daily to every area where your hair is thinning. Gently massage it into the scalp with your fingers so it can reach the hair follicles. Then air-dry your hair, wash your hands thoroughly, and wash off any solution that has dripped onto your forehead or face. Don't shampoo for at least four hours afterwards.
I haven’t seen any information about DHT blockers which I’ve read iis the leading cause of hair loss. It’s a “bad” hormone released that causes hair loss. Any comment or recommendations? One supplement to reverse DHT contains saw palmetto, which I’ve heard isn’t recommended for women. Totally stumped, depressed and irritated with so many suggestions that may or NOT work. Compassionately sending this message to all those suffering with hair loss….it’s totally devistating.
Testosterone replacement is becoming popular for men. Cotsarelis warns that this may accelerate hair loss. Propecia might help -- but because it prevents testosterone breakdown, it might affect the dose of male hormone replacement therapy. Cotsarelis warns men taking both Propecia and testosterone replacement to make sure their doctor carefully monitors their testosterone levels.

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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 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?
I don’t know in which proportion including diet, all of these things occurred but I believe A-Ret abuse was a large part of it as evidenced by blood tests taken by my PCP which I was never able to get re-evaluated due to doctor apathy. My sister is experiencing an unrelated bout of hair loss concentrated at her crown and feels hopeless. I’m sending her to this board and to all of your suggestions right away. My problem seems to have subsided but I’m remaining only optimistically cautious and still very vigilant about monitoring hair loss. Thank you everyone again for contributing to this board.
“While nutritious eating isn’t going to bring your hair back by any means, eating plenty of protein-rich foods and healthy fats can make the hair that you still have look thicker and shinier.” Skimping on the B vitamins in particular can interfere with the formation of hair cells and, therefore, hair growth. The best sources of Bs are protein-packed foods like chicken, fish, eggs, and pork, as well as leafy greens such as spinach. (These foods are also good for melting belly fat, so it’s a win win).
Laser light therapy is not a baldness solution, and the HairMax takes a time commitment: You have to use the product for 15 minutes a day, three days a week and you have to keep using it indefinitely to get results. Still, laser light therapy has no major side effects, and may be best for men who have noticed some increased shedding and want to maintain more of the hair they have on their head.
The most common pattern is one or more well-defined spots of hair loss on the scalp. If alopecia occurs in an ophiasis pattern (hair loss involving the temporal and posterior scalp) or if large areas of the scalp are involved for long periods of time, the prognosis is worse. A more generalized form of hair loss is referred to as diffuse alopecia areata where there is widespread dramatic thinning of the scalp hair. Occasionally, all of the scalp hair is entirely lost, a condition referred to as alopecia totalis. Less frequently, the loss of all of the hairs on the entire body, called alopecia universalis, occurs.
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.
How many of us are out there… feeling alone and pretending to not be ashamed. As a child, I had so much hair that my mother used a thinning shears on my locks. In high school I had a glorious mane, cut into a ‘Gypsy’… what great pictures. By my mid-20’s I had to cut my hair short because it was so thin that it wouldn’t hold a style. Was diagnosed with PCOS and told that this syndrome, combined with heredity, caused my hair loss.
And though this treatment appears to be safe and somewhat effective, it’s hard to tell who will react well to this low-level light therapy, which is why the doctors I spoke with were hesitant to fully endorse it. “We’re not sure what the optimal power is, what the optimal wavelength is, we don’t even really know the mechanism of action of how this is working,” says Rieder. Plus, it doesn’t work on everyone. “There are subpopulations of patients who do respond to low-level laser light, but this is not easily predictable,” explains McMichael, though she adds that the risk of using the LaserComb is low.

I am so so grateful and want to thank everyone who has contributed to this forum. I am 52 years old, and in June of this year my Obgyn said it was time for me to get off Birth control pills , as I was getting too old and the estrogen levels would be dangerous at this time. I had been on BCP since the age of 18 with a break from the age of 35-38, and always been under the impression that BC pills might cause hair loss, but was totally unaware that when you came off them that the real deal happened. He just casually said, don’t take them and we will see if you are in menopause. Well I did and 2 months later (mid Aug..) I went straight into menopause, hot flashes all day, night sweats, etc., Then came the shedding, TE, as I am to understand. By mid-September the texture of my hair felt strange and the hair on the right side/back of my hair thinned out considerably, and I was developing a bald patch. Having always had very thin hair that I was always self conscious about (I had to wear a wig as a child, as I had monilethrix an inherited hair disease, which went into remission, but the hair loss caused terrible self esteem issues throughout my teenage years.), I cried my eyes out, then went on a quest to find out who to see. Derm, another ObGyn or endocrinologist? From everything that I had read, everyone went to countless doctors to find a cure. Having dealt with my HMO over the years to get a quality specialist in different areas, I knew I would be bald by the time I found the right doctor. Then I came across this forum, like Hope in Aug, I have spent countless hours on the internet in search of a solution. Thanks to her post and Toni on 7/14/08 and Shelleo, I found my answer. I called Dr. Redmond, in New York, and prayed that I could get an appointment right away. My prayers were answered, and I have an appointment this coming Monday 10/28!! I will be getting his book I the next day or so, as recommended, and truly feel, from what I have read, if anyone can help me, he is the one. Thank you for sharing your stories. I will make sure to check back, so I can, too, possibly help someone else.
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
Hi everyone, I am a 19 years old girl that is loosing my hair. I started to lose my hair since I was 14. once 18 I decided to go for a hair transplant surgery. I wanted to feel as any another girl and be confident. I went to bosley may 2007 and did the surgery. They told me it will take 6 to 8 months for my new hair to grow few inches. I went there after 6 and after 8 months but unfortunatly we havent seen any growing hair yet. The doctor told me that it depends from one person to another and it might take me from 12 to 15 months. I went to see him yesterday and by then it was almost 15 months… he walked in looked at my hair didnt say any word for a while and then told me: “I am going to give you your money back” I cried right away for a while I couldnt take it. I haddreams and hope. I imagined my life differently after the surgery. Anyways all that to tell you guys if you wanna go for a hair restoration AVOID BOSLEY. I live in boston nd went to the bosley place in the newbury street. I believed them because of all their advertising. Now i dont even know what to do. School is almost starting and i dont feel like going. I wanna look nice and feel relaxed. I feel the pain every morning before going to school. I cry every night when I get home. I need to find a solution. i thought about extensions but cant go for them cuz i am scared to lose more hair. My God help us!
The best fix by far for replacing lost hair is a transplant. Back in the day, docs used plugs that resembled cornrows (definitely not natural looking). Today, guys have more options. You can go for “the strip method” where a doctor surgically removes a strip of hair from the back of your head, dissects every hair graft under a microscope, and then plants the individual grafts onto hair-thin areas of your scalp with tiny incisions.
Androgenic alopecia, also known as "male pattern baldness" and “female pattern baldness,” can strike younger as well as older people. It's genetic, so having a family history can predict if you might inherit it. In both men and women, it's linked to having an excess of male hormones (androgens) around the hair follicles, which can block hair growth. Women are more likely to develop androgenic alopecia after menopause, when they have fewer female hormones.
Many factors can contribute to hair disorders. Alopecia, or hair loss, may be caused by medical conditions such as lupus, thyroid disorder, protein or iron deficiencies, or hormonal imbalances.  Hirsutism -- abnormal hair growth in women (such as a beard or chest hair) -- may be caused by ovarian, adrenal, thyroid or pituitary conditions. Identifying the cause, and treating the condition are our goal. 
My name is Leslie and IO was recently diagnosed with pcos. My hair has been falling out for about two years! I am African American and I have always had thick healthy hair now you can see my scalp. I started using a product called regrow and my bald spots are filling in but my hair is still thinning! I was fortunate enought to have a child in 2003 I have been trying to have another child for 3 years with no luck can somebody help me with my thinnig hair and infertility……..I don’t even feel like a woman anymore.
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However, ketoconazole is still not FDA approved for hair loss treatment, which means it cannot be endorsed or marketed as such. Put simply, ketoconazole likely curbs hair loss, but additional research is needed for the FDA to give it approval. While it is safe to use as a supplement to our top picks, we wanted to recommend products with as much scientific backing as possible. So, we stuck with FDA approved minoxidil or FDA cleared laser treatments. But we’ll keep a close eye on products like ketoconazole shampoos and update as new research appears.
Central centrifugal cicatricial (scarring) alopecia: This type of hair loss occurs most often in women of African descent. It begins in the center of the scalp. As it progresses, the hair loss radiates out from the center of the scalp. The affected scalp becomes smooth and shiny. The hair loss can be very slow or rapid. When hair loss occurs quickly, the person may have tingling, burning, pain, or itching on the scalp. Treatment may help the hair re-grow if scarring has not occurred.
The general medical consensus around laser treatments — caps and combs alike — is that low-level laser light therapy stimulates the cells within the hair follicle. These devices may also increase cell metabolism to promote thicker and more durable hair shafts, something that neither minoxidil or finasteride can do. To use the HairMax Ultima, all you have to do is glide the device over your scalp slowly. Treatments should take about eight minutes, and you should do it three days per week for the best results.
The mission of the National Institute of Arthritis and Musculoskeletal and Skin Diseases is to support research into the causes, treatment, and prevention of arthritis and musculoskeletal and skin diseases; the training of basic and clinical scientists to carry out this research; and the dissemination of information on research progress in these diseases.
have something to say that sounds alarming: I came to the Texas to live 10 weeks ago from the UK. Within only 2 weeks of being here my hair started falling out dramatically, I would lose around 500 to 700 hairs every time I washed my hair, this would also include hair lost through blow drying as I got to the point I would sweep it up off the floor too. Before I left the UK my hair was beautifully silky and shiny and looked so healthy. Over the following 8 weeks the hair loss worsened to the extent I started getting so dramatically thin all over the top of my head that I got myself into a panic every time I would do out as I didn’t want anyone to see me this way as I am quite an attracted woman 38 years of age. My periods are normal and my health appears good, just now I am suffering from depression because of this. The point I am making here is, I never had this in my life before, sure I have had bouts of hair fall from stress but never has it ever got to the point I can no-longer go out ever. I see so many things about this on the TV here in Dallas always advertising women’s hair loss? I also see too much of this on the net also from the US that now I am really getting worried about ever coming here and if this continues I’m going to leave the US and never come back. The people here are so lovely so please don’t get me wrong just that my health and my hair come first. I have visited the US many times and been to many States over the recent years from California to FL to Chicago and each time I come over I start to lose my hair. Bit this time is the worst ever! When I Skype my family back home they are shocked of course and we are all wondering if it is the food chain, the water, the air, pollution, I mean it’s got to be something right? I also spent years over in Brasil and also Lima Peru but never had anything like this, in fact my hair got even better over there than from when I was in the UK last. I’ve got a strong suspicion the doctor’s over here know more than they are letting on and have done for a long time but just making money out of peoples misery. I saw a doctor here who did some blood works and charged me $800 and he didn’t even do a hormone profile or (Ferritin) as checking iron is a total waste of time, Ferritin is the end response of iron absorption. Checking iron in the blood is what is floating around and not what has been absorbed. He wanted to then send me onto an Endo who wanted to charge me another $400. for a consult plus she said anything from $600. for additional blood works. I Lima Peru I can get 10 x more blood works done for no more than $120. Be cheaper for me to get a return flight and have all the tests done over there. Sorry to say this but, the US is a total rip-off when it comes to this sort of thing. Everyone back home thinks the whole thing stinks and sounds very suspect. If my hair gets any worse I’m defo going leave and most likely head on to Lima for a while and then go set my roots in Brasil. I really wanted to be here in the US as I have so many lovely friends over here and could really see a future for me here. I am gutted. Anyways I’m going to do some research to see if I can find a good Endo myself as well as a dermatologist. Maybe it is all to I do with all the nuclear testing they did years ago? they say radiation remains for a 100 years and what with weather conditions, wind, rain, crops, livestock, water supply? Now we have phytoestrogens and now we have this other thing to worry about frankenfoods. Us women have a more complex hormone system than males and this has got to wreak havoc on our endocrine system our glands and of course our hormones. I believe whatever is causing this must be doing something to us internally that is the cause. So lotions and potions working from the outside is not the answer or a permanent solution. I think something is disrupting us from the inside and screwing with our hormones be it thyroid, sex hormones or whatever. So stop sugar drinks, artificial foods and water from plastic bottles, microwave foods and start to clean up your health from the inside and perhaps try find organic meat, vegetable, fruit, fish suppliers. Maybe little more costly, but far cheaper than giving the money to a bunch of quacks? I guess thank goodness for European rules and regulations on food compared to here. Like to hear peoples thoughts.
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.
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.
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. 

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 want to say that all of you are very courageous and sharing. I appreciate everything I have read here. Thankfully, I am starting out in a slightly better position – I still have a fair amount of hair left. I started with a HUGE amount of hair. For the last 6 – 12 months, I have been losing handfulls of hair in the shower every morning, then some more when I comb it out, then a bit more when I put styling product in it, then just a bit more during the day. The shower is the huge hit, though. I’m 37 and on a ton of medication – synthroid, neurontin (an amitryptiline derivative), anti-depressants, and a host of pain medications for a degenerative back problem. I brought my hair loss up to a doc around the time it started, since I was already on synthroid, he re-tested my levels, and said everything was fine. My hair structure has always been on the thin side, but there was just so damn much it didn’t matter – now there is a lot less. What used to take upwards of 20 minutes to dry with a dryer, now takes 5. I’ve been worried about it for quite a while, and didn’t know what to do. I started my on-line research today with hair extensions and stumbled on this site. I am encouraged that I’m starting my search for an answer relatively early in my hair loss journey. I have some great advice and questions to go in to see my doc about. If anyone has any recommendations for the Boise, ID area for a dermatologist and endocrinologist, I would really appreciate it.
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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