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.
Alopecia areata is an autoimmune disease, where a person's immune system attacks the body, in this case, the hair follicles. When this happens, the person's hair begins to fall out, often in clumps the size and shape of a quarter. The extent of the hair loss varies; in some cases, it is only in a few spots. In others, the hair loss can be greater. On rare occasions, the person loses all of the hair on his or her head (alopecia areata totalis) or entire body (alopecia areata universalis).

Also, re: the Proscar, I think that it may already be helping some as I think my shedding may be tapering off a bit more. I am losing a few less hairs Per day now. Maybe? I don’t know, but I am trying to stay positive!! I have no real regrowth. Just wisps, extremely fine hair, almost hard to see. Kind of transparent. I am not expecting miracles, but trust me…. THe moment I feel I have any true results to share with you girls, I will definitely be posting them! There aren’t many success stories out here. We need more. I guess people don’t come out here as much if they are experiencing good things w their hair?


I’m a dermatologist and am more interested in telogen effluvium these days because I have it bad–and this time it’s not because I just had a baby. I’m learning more about the gut-skin-hair connection and am suspicious that it has to do with the bacterial flora in your gut. You can learn more about changing your gut flora at BodyEcology.com. Her book is intense but I’ve decided to give it a try after recommending it and seeing it work so well with acne patients.
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.
Hi I need help I am not sure what doctor I need to see, one day I started to have lots of back pain and my lower left side real bad I went to bed and when i shower lots of my hari started to fall off, I mean I loose my hair but not as much and I just wanted to cry when I saw lots and lots coming out. My hair is so thin now and you can see the bald spots im ony 35 and Im not sure if its my hormones or not. Can someone help me and let me know which doctor is best to see for hair loss

The only nonchemical option offered up by the dermatologists I spoke with — short of a surgical hair transplant or platelet-rich plasma therapy, which is like Kim Kardashian’s vampire facial but for your scalp — was the laser comb. First cleared by the FDA in 2009, the HairMax LaserComb is a handheld laser device that is designed to promote hair growth. As the manufacturer explains in a letter to the FDA, “The device provides distributed laser light to the scalp while the comb teeth simultaneously part the user’s hair to ensure the laser light reaches the user’s scalp,” which, in turn, stimulates the hair follicles.


"Firstly, even the very good ones won’t get to the root of the issue - pardon the pun - and prevent or treat male or female pattern baldness which is caused by genetics, nor deal with hormonal issues at the heart of female hair loss. But they can help make the hair you do have stronger and healthier. And they can be useful in putting a hair loss regime in place, along with medication like Minoxidil or Finasteride and/ or a hair transplant.
While diet alone won’t save your hair, there may be some truth to the old adage that you are what you eat. “You’re not going to have the healthiest hair if you’re living off doughnuts, because being nutrient-deficient weakens strands and makes them more prone to breakage,” says Denise Kernan, owner of DK Hair Techs, Inc., a member of the International Society for Hair Restoration Surgery, and a hair transplant technician who has worked on everyone from senators to sports stars to actors to mafia guys (she won’t name names to protect the privacy of her clients).

I am 20 and have been losing hair since I was 17. It is such a confidence killer. I really do miss my beautiful thick and black hair. Now my hair is thin and a bit gray as well. I only think of it sometimes…but I used to be so depressed i can barely get out of bed. Whenever I am talking to someone, I always wonder if they are looking at my hair. I am currently using Rogaine for Women…it worked one summer when I was following the regimen religiously. However, I am so bad with routines, so now I try to remember to put it on my scalp morning and night. I recently also started to take Shen Min Hir Nutrients…not sure if it works yet. Does anyone have any advice? I really want to get a hair biopsy but I don’t know how. The places I called offered scalp analysis to prepare for hair transplants…which is not something that I am considering. I also saw 2 derms, one didn’t know what was wrong and only offered Rogaine as a solution, and the other said it is androgenic alopecia. I think I might have hormonal problems, but really not that sure. My scalp is always oily and so is my skin. Before my hairloss, I had really itchy scalp. Now it’s still oily but I wash it every other day. I also dye my hair to hide the gray. Sometimes I just feel so ugly and depressed in thinking about my hair. Beautiful hair is the only thing that I want back.


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.
Thank you Diana. If you find out any more information, I would appreciate it. I have a dermatologist across the street from the Skin and Cancer Institute. I’m still not sure who to start with, the dermatologist or an endocronologist. I left a message for my PCP today to see if she is comfortable working with female hair loss or if not if she could refer me to someone who specializes in it. I will let you know what I hear back. In the meantime, thanks for your support. Take care.
A little farther up the follicle is the mysterious feature called the bulge. That's where follicle stem cells live. When they get the right set of chemical signals, these self-renewing cells divide. They don't divide like normal cells, in which both halves become new cells that keep splitting and developing. Only one half of the follicle stem cell does that. The other half becomes a new stem cell, and stays put for future regeneration.

Alopecia areata, also known as spot baldness, is a condition in which hair is lost from some or all areas of the body.[1] Often it results in a few bald spots on the scalp, each about the size of a coin.[2] Psychological stress may result.[2] People are generally otherwise healthy.[2] In a few, all the hair on the scalp or all body hair is lost and loss can be permanent.[1][2]
There can be several factors behind hair loss such as environmental effects, aging, too much stress, excessive smoking, nutritional deficiencies, hormonal imbalance, genetic factors, scalp infections, use of wrong or chemically enriched hair products, certain medicines and medical conditions like thyroid disorder, autoimmune diseases, polycystic ovary syndrome (PCOS), iron-deficiency anemia, and chronic illnesses.
To us, that meant any product with zero proven ingredients, case studies, or FDA clearance — which shrunk our list by a whopping 180 contenders. That’s right, there are only three treatments that have actually been cleared by the FDA and supported with clinical studies: finasteride (commonly marketed as Propecia), minoxidil, and laser treatments. And, since finasteride is prescription-only, it left us with two.
I’m interested in what took place 4 months before the onset of your hair loss (and others with telogen effluvium). For me, it has always been either a baby born or a course of antibiotics. Oral birth control can also cause a sudden change in the gut flora–as can pretty much any medication. Staph infections are another connection I think should be pursued. Some women don’t know they’re colonized with Staph but they constantly have dry, cracked (mild or severe) sores in their noses.
There’s also a women’s version (Women’s Rogaine Foam) — but a three-month supply costs $22 more online. The only difference between the two products are the instructions; women are instructed to apply once a day instead of twice. If you’re a woman who doesn’t feel like paying extra for marketing, the men’s product will suffice. A cheaper generic version is Kirkland Signature Minoxidil Foam, but with a longer history on the market and more customer testimonials, Rogaine is our first choice. 

“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.

Dr. Curtis says genes and hormones are the leading causes of hair loss.  And it's not just something we face as we age.  She says, "I've seen patients as young as 14-15 years old start having hair loss. It's all dependent on your genetics. Unfortunately the earlier it starts, the more likely it's going to be more severe in nature and the faster it can progress."
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.
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.”
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.
Its been 1.5 years since my problem started. I noticed first the texture became course or wiry. Then I wore a hair net and hard hat for 8 years I don’t know if that helped with my condition or not. Then I went to got my hair highlighted within 1 week my hair broke off to 1/2″ just in front the rest was full. Since then I have tried all kinds of hair therapy. The texture changed to being normal but I have Nice shiny almost bald spot on my head. Nothing I tried helped in regrowth. Went over all my mess with my doctor she said no should damage my hair. Also it grows but as soon as it starts looking decent I have breakage. What to do what to do.
Mistakenly thought of as a male disease, around 40% percent of women will suffer from some form of hair loss by the age of 50. A woman’s hair is an important part of her aesthetic make-up. It represents her style and taste, and frames her face while accentuating her best features. Unfortunately, most physicians don’t have answers or solutions for women who begin to lose their hair.  Plano, TX hair restoration surgeon, Dr. Joseph Yaker, understands that this can be extremely catastrophic to a woman’s self-confidence, body image and quality of life. Clinical studies have shown that psychiatric disorders such as depression and anxiety are more common in people with hair loss, especially women. 
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