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.

KARYN SPRINGER, M.D., is a staff physician at Intermountain Health Care, Orem, Utah, and a part-time faculty member at the Utah Valley Family Practice Residency Program, Utah Valley Regional Medical Center, Provo, where she also completed a residency. Dr. Springer received her medical degree from the University of Utah Medical School, Salt Lake City....

Topical immunotherapy (i.e., contact sensitizers) is the most effective treatment option for chronic severe alopecia areata (Table 5).6 Response ranges from 40 to 60 percent for severe alopecia areata, and reaches approximately 25 percent for alopecia totalis and alopecia universalis.6 Because of potentially severe side effects, only clinicians who have experience with these agents should prescribe them.


"The majority of men lose their hair not through stress, or bad diet, or lack of sleep, but through the genetic trait of male pattern baldness which is hard to treat through shampoos or supplements alone. Women lose their hair for very different reasons, but the argument still stands that a lot of the hair loss products on the market are just offering false hope. That said, there are a few that really work."
Eva if you can look at some of Pilar’s post she mentions in one of them a dr she sees in NYC. She loves her and the dr has done a lot for her. I would say there is no doubt it is the Retin A that has caused your loss, but it is probably Telogen Efflivium which is temporary and the recovery is nothing like they say it is. Especially if your scalp is miserable because there is a lot of inflammation that will need to calm down before everything can reset itself. Please try to find her post where she list the derm she sees. She loves her.
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
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?

Hello everyone. I am a 14 yr old girl that is loosing my hair. I know that may seem young, but I knew it was coming. My father and I have the same hair and it runs in his family to have hair loss at an early age. I have been loosing my hair since I was ten. It hasn’t been chunks, but if you add the hair together, that is alot of hair loss. So I was wondering if anyone had any information they could help me out with, other than seeing a doctor. My mom is taking me, even though we don’t know what to expect. I mean, this is genetic so I’m praying there is a cure somehow to either stop my hair from falling or adding hair on my head. Please help! If anyone has any advice please let me know immediately. I thank you for your time.
Physical stress can also be a cause for hair loss. Any kind of physical trauma surgery, a severe illness, an accident, even the flu can lead to temporary hair loss. This can trigger a type of hair loss known as Telogen effluvium. Hair loss usually gets noticeable 3-6 months after the trauma but once your body recovers, your hair would start growing back again.
Ms. Imhof, who lives in Land O’Lakes, Fla., was skeptical. The company’s before and after photos seemed too good to be true. But she went for a consultation and made the cut. (Harklinikken’s products are not available to anyone with autoimmune illnesses like alopecia or baldness from scarring, or anyone who is unlikely to see at least a 30 percent increase in growth.)
I have had alopecia universalis for 12 years now. It was very difficult in the beginning when my hair began to fall out. I was in college and devastated because I thought my life was over. I have now grown to accept myself and the way I look now. I know I would not be who I am today without this having happened, and I really like me! It does get better, but it is a process. A good support system and love from family and friends gets you through. Good luck to you all on your journey.
Clearly, minoxidil is not a miracle drug. While it can produce some new growth of fine hair in some — not all — women, it can't restore the full density of the lost hair. It's not a quick fix, either for hair loss in women . You won't see results until you use the drug for at least two months. The effect often peaks at around four months, but it could take longer, so plan on a trial of six to 12 months. If minoxidil works for you, you'll need to keep using it to maintain those results. If you stop, you'll start to lose hair again. 

“I think their effectiveness is not as significant as finasteride or minoxidil,” says Dr. Wolfeld, “however, it’s something that can be used quite easily by patients at home. If they use it two or three times a week, I tell them it can help to thicken their hair.” Results can take up to 18 months to show up, so Dr. Wolfeld stresses that patience is a virtue.
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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 HairMax Ultima 12 LaserComb ($395) makes for a great addition to any hair loss regimen — provided you can afford it. Dr. Wolfeld notes that it’s a popular option in his practice. “Some people like the action of combing something through their hair,” he says. “They find that to be a little bit easier to do as part of their routine in the morning.” Dr. Khadavi also recommends using a laser treatment of some kind in conjunction with other treatments. “Lasers do help in stimulating the hair into the growth phase. We don’t know the exact mechanism of how it works, but it definitely helps.”
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.
Medications are available that encourage regrowth of hair. These medications, such as topical minoxidil* and oral finasteride, are not appropriate for everyone with hair loss. Hair growth medications work to varying degrees in different people, and only trigger complete regrowth in a minority of individuals. They work best for people who have smaller amounts of hair loss. Hair loss returns if you stop taking the medication. Finasteride is not appropriate for women who may become pregnant, as it can cause severe birth defects. Spironolactone, although not approved by Health Canada for this purpose, is a medication that may help women who are losing hair due to excess testosterone. Biotin is a vitamin that makes hair and nails stronger and is often used as an adjuvant therapy.
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.
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.
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.
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