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.
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. ????????
Hi Everyone I thought I was the only person with major hairloss because everywhere I look all I see is beautiful heads of hair. I am 34 years old and my hair started thinning 7 months ago at first I thought it was just my ponytail getting thinner but my hair became horrible with split ends and dryness too (I have always had extremely healthy hair and never had split ends) – I thought I had burnt my hair using a straightener and that’s why it was thinning. However it has gotten worse and worse and I finally visited a doctor. I have had full blood tests for thyroid issues, hormone levels, cholesterol etc etc all were perfectly normal, I had a thyroid antibody test which was at the high end of normal but still within normal range, I had a thyroid function test which was within normal limits however he thought I did have some slight inflammation ie thyroiditis. My doctor said this isn’t causing the hair loss either. I have loads of energy, don’t get tired, eat well am normal weight range the only other thing I have noticed is my eyelashes seem stunted in growth (not thinned out though) and my eyebrows have thinned on the outer edges. My last two nails on both hands have a dark (looks like they have lifted slight) strip just below the white nail part. I am booked to have a stress test, pelvic ultrasound and to see an endocrinologist also to rule out all other possible reasons for hairloss. I am now getting to the point of embarrassment to go out it is soooo thin on top particularly on one side of temple and majorly down the centre where I used to part my hair. HELPPPPPP!!!!!
My scalp is pain-free but has on occasion flared again but 1/100 of the original pain. My scalp still needs frequent shampooing (I could go weeks without it before) to keep the dermatitis at bay. My hair and scalp are still fairly dry and brittle despite aloe for moisture, avocado oil to moisturize and seal in moisture and Behentrimonium Methosulfate to close cuticles, provide slip and halt hair snapping, BUT the breakage is 90% better. I’m still too afraid to go back to humectants though I know they’re amazing as moisture-retainers for dehydrated hair. I have spots of completely missing hair towards my hairline that hasn’t and will probably never regrow but I’m focusing on nursing everything else back to health.
Trichotillomania is a psychiatric impulse-control disorder.17 The mean age of onset is eight years in boys and 12 years in girls, and it is the most common cause of childhood alopecia.1,15 Although any part of the body can be involved, the scalp is the most common. Patients also may eat the plucked hairs (trichophagy), causing internal complications such as bowel obstruction.18 The hair loss often follows a bizarre pattern with incomplete areas of clearing (Figure 9). The scalp may appear normal or have areas of erythema and pustule formation. A scalp biopsy may be necessary to rule out other etiologies, because patients may not acknowledge the habit.

That meant new products like Hims and Keeps were out.Hims and Keeps are relatively new companies that allow you to set up a subscription for hair loss treatments. Both offer finasteride (after an online consultation with a doctor) or 5 percent minoxidil. However, their minoxidil solutions contain propylene glycol, so we cut them from consideration.


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. 
Eyebrows unfortunately is a different ball game, that is skin transplantation from skin at the back of your head where your hair grows. This means that you would have to trim your eyebrows for the rest of your life. The cost for this surgical treatment is $5000, and again covered by Care Credit. Not sure if I want to do this. I am very light blond. I may just consider permanent eye brow tatoe. I have seen beautiful work – cost around $500.
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]
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.

I’m 42 and I noticed my front top and sides thinning about a year ago – a lot coming out when brushing after washing. I went to the doctor who happened to be African-American (I’m caucasion) and she actually asked me if I wore “corn rows” a lot! Needless to say, she was worthless and just prescribed me something for dandruff, which I do not have! I went to an endocrinologist to see if my thyroid or menopause was the problem – tests turned out honky dorie! Now I can see through the top of my head when the sun shines on it (scar-y) and I’m having to cover over the temple areas with sweeps of hair from the other side (interesting, the right side is much thinner). I will say that I’ve gone through hell and back with a mentally ill young adult but if it was stress, wouldn’t it have come out quicker than just in the last year (I’ve been dealing with his illness for 7 years now)?? I’ve heard that sometimes it takes 2 or 3 blood tests and doctors to finally see that one has thyroid problems. Is this the experience of others, and would I be throwing my money away by seeing my general practitioner?
You lose up to 100 hairs from your scalp every day. This is normal, and in most people, those hairs grow back. But many men – and some women – lose hair as they grow older. You can also lose your hair if you have certain diseases, such as thyroid problems, diabetes or lupus. If you take certain medicines or have chemotherapy for cancer, you may also lose your hair. Other causes are stress, a low protein diet, a family history or poor nutrition.

I am so sorry you’ve been so down. I’ve had some other troubles lately that have been bringing me down so the hair loss almost seems so much less important right now. I may lose my home to foreclosure in the next month so I’m focused right now on getting that resolved and trying to stay out of foreclosure. Then I can go back to focusing on my hair again! ha!
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)
Wow, I just started doing some research on this because I have been having problems with my hair thinning on the top of my head for several years, along with some sensitivity. I went to my internal medicine Doctor and he didn’t say much, which struck me as odd… he referred me to my women’s doctor who was slightly more sypathetic but offered no suggestions other than to see a dermatologist. I have been putting it off because I feel like I am getting the run-around. I see that I am not alone! 

Finally people who understands what I am going through …I am in a desperate search for doctors in the Miami/Boca Raton, Florida area. Can anyone help? I dont know yet what has been causing my hair loss…I had been loosing some hair throighout the years, and sometimes it gets lees severe but lately has just gotten worse and there is no stopping it seems. I had mt Tyroid checked by PCP a coulpe months ago and my iron level also looked normal …getting desperate. Would appreciate some help.
Finally people who understands what I am going through …I am in a desperate search for doctors in the Miami/Boca Raton, Florida area. Can anyone help? I dont know yet what has been causing my hair loss…I had been loosing some hair throighout the years, and sometimes it gets lees severe but lately has just gotten worse and there is no stopping it seems. I had mt Tyroid checked by PCP a coulpe months ago and my iron level also looked normal …getting desperate. Would appreciate some help.
Onion - A study published in the Journal of Dermatology examined the results when onion juice was used in people with alopecia areata. Twenty-three people applied onion juice directly to the scalp twice daily for two months. Participants began to experience hair growth after just two weeks of treatment. At four weeks, hair regrowth was seen in 17 people and at six weeks, hair growth was apparent in 20 people.

Trying to figure out exactly what is causing your hair loss is going to require a little detective work on the part of your physician. Several lab tests are going to need to be done. I’ll make sure to make another post this week about the standard lab tests that should be ordered to start the process. Hopefully you don’t have to bring the list to the doctors office, he/she should know already. I get concerned when women have to bring a list of tests that should be ordered to their doctor. My feeling is that if they don’t know what to order then how are they going to be able to accurately read the results. But… a good doctor is a good doctor, and if you have one that really cares and takes a strong interest in your hair loss with a willingness to work with you in finding the cause then great.
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.
I”m sitting here reading all your letters hoping that you’ve helped someone and hoping that you can help me, too. I’m 48 and all my life I’ve been told how beautiful my hair was. I now live in S Florida and within the last couple of years I stopped styling my hair because of the heat and the humidity. I usually wear it in a ponytail (never tight – I’m sure that’s not the problem). About a year ago I noticed athat a lot of hair was on the back of my car seat.I mean A LOT.When I went home to NY I tried to style my hair like I used to and it didn’t work. It just layed there.The more I looked I noticed how thin it was. I came back to Fl and went to a dermatologist who barely looked at me and told me to try rogaine.
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