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.

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).


Interesting. After reading these posts, I called a dermatologist in the Houston, TX area asking for an appt. and whether he prescribes medication for hair loss in women. I mentioned Spironolactone. He told the nurse that he does not, and that it can actually cause hair loss. This is exactly the frustration we all experience. You hear a different opinion from each Dr. and don’t know what the right answer is. If anyone knows of a good endocrinologist in Houston, please let me know. I’ve been losing hair for about 5 yrs (now 39 yrs) and have to use hair-loc extensions just to feel confidence when in public. I did not see much about Propecia in these posts. Have any women taken it w/ much success?
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.

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.”
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.
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.
I look forward to seeing you both there. There are quite a few ladies that have experiences with different wigs and head coverings, including a really wonderful stylist that works with women who are losing their hair. She can also be of great help for those looking into different wig or hair system options. Her name is Mystique and here is her page:
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.
Lisa, don’t know if you are out there and reading this but I called my dermatology office today. I have worked with them since about 2003/2004 when I had severe cystic acne (it is about as bad as hair loss in dealing with it) and together the nurse and I were successful. I have hope, I got in to see her tomorrow and I’m taking all the meds/vitamins I am taking. Call Arizona Skin & Cancer Institute, they are in Chandler AZ right by Chandler Regional. I’ve been in tears all day because a clump came out. I thank God for my beautiful children who were there for me through the acne and my mom. You just listen to me talk about what I am going through. Getting through work was hard today. Anyway, Lisa call them and try to get in. I don’t know if I will have success but I’ve done a lot a research and I know what to ask. I did look up symptoms of protein deficiency – strange I had great hair in October 07 and my nails were really hard and now they are brittle and breaking and my hair is falling, I also went through a couple of weeks of this werid swelling of my arms, legs, feet, hands in April. And have been constipated, and my running isn’t giving me the usual firm legs, all signs of not enough protein. Maybe I’m grasping at straws but anyway…hope you are doing ok.

The scalp pain has not gone away. I have tried 100 things prescribed by 100 doctors. Dermatologists have told me to add zinc supplements to my diet, use a cream with “clobetasol propionate” on my scalp, improve the quality of my scalp by getting rid of any flakiness – hundreds of options. Trichodynia – pain of the scalp – is a poorly understood subject. I don’t know if it is hormonally related, and exacerbated by the stress (of losing so much hair) – I cannot answer you.
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.
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I have had hair loss for the past several years. I have seen both endocrinologists and dermatologists. I had one derm who was good, but I unfortunately moved. She put me on minoxidil 5% and spironolactone. I am now seeing and endo but he has me on Synthroid and I was very interested to read on this site that it can actually be a cause of hair loss! If anyone can recommend a doctor in Chicago i would appreciate it. I see there are 2 other people asking for recommendations but I haven’t seen responses to them. Thanks!
The other main hair-loss treatment that was recommended by all four dermatologists I interviewed is finasteride, often called by its brand name Propecia. This FDA-approved medication is only available with a prescription, but these days, it’s found as a generic and ordered online after a virtual consultation, through start-ups like Hims, Keeps, and Lemonaid.

Before men or women invest in hair restoration, consultation and workup by a board-certified dermatologist experienced should be performed first to rule out other medical conditions that may trigger hair thinning and second to maximize medical therapy. Full medical therapy as prescribed and outlined by a board-certified dermatologist must continue in order to protect one's investment in hair transplant such as NeoGraft hair restoration.

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.
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.
I am 46 and starting menopause, according to my bloodwork. I didn’t have any tradtional menopause symptoms. My only health issue was burning scalp and hairloss–a lot. (I do not use any chemicals on my hair and don’t even blow dry it.) After losing almost half of my hair in 3 months I went off the pill (mircette which is low estrogen) and withing 48 hours the burning decreased by about 50%. Then I started using progesterone cream. Within 3 days the hairloss slowed from losing 65+ hairs in the morning to just 15-20. By the 6th day the burning is 95% gone. I can wear my hair in a ponytail with a soft scrunchie today! Maybe I have estrogen dominence, which is talked about in Dr. Lee’s book “What Your Doctor May Not Tell You About Menopause: The Breakthrough Book on Natural Progesterone”. I hope that I continue to improve and I hope each one of you finds the solution to your hairloss. By the way, my doctor ( GP) told me to stay on the pill and that nothing could be done for my hairloss. It was the owner of a family-owned pharmacy that suggested the progesterone cream and to stop the pill.

Alopecia areata is a disease that attacks your hair follicles (the part of your skin that makes hair). In most cases, hair falls out in small, round patches about the size of a quarter. This causes only a few bare patches. Some people may lose more hair. In only a few people, the disease causes total loss of hair on the head or loss of all body hair.
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.
Hair doesn’t make the man. Remind yourself of everything else you have to offer. Or take care of things you can control, like staying in shape. It’s OK to look to others for support. And if you need a little inspiration, think of bald men or guys with shaved heads who ooze confidence, like The Rock, Vin Diesel, and Pitbull. Consider yourself in good company.
Moreover, there are so many subtleties in hair restoration surgery that it's important to choose a physician who specializes in the field, not one who has added "hair restoration" to their menu of services along with other cosmetic surgical procedures, and performs a limited number of the procedures per week.  Experience counts, just like anything in life, and there are many of us in the USA who specialize exclusively in hair restoration, and treat only patients with thinning hair.  It's important to meet personally with your surgeon, and have an in-person evaluation, and a micro-analysis of your scalp to receive the highest level of care possible.  
Family history will often tell the doctor what type of alopecia a person has. Occasionally, a punch biopsy may be necessary to determine the type of hair loss. Looking at plucked hairs under a microscope can help to tell the difference between alopecia areata and androgenic alopecia. Other tests might be done to check for autoimmune diseases like lupus that can accompany alopecia.
in between all these years, i also tried some homeopathic methods. i read dr. andrew weil’s book on health and used to take 2000mg of alpha-linolenic acid either by evening primrose oil, grapeseed oil or borage oil. it didn’t regrow my hair but i do feel that it helped stall it. only problem is that after a year or so it stopped working for me, but it may help some of you out. there’s a connection, according to dr. weil, between alpha-linolenic acid and hair. i’ve also used homemade rosemary water and washed my hair with it, but it only helps with making me smell like the bush it comes from.

Try and find a doctor that seems to care about women’s hair loss, and understands the emotional devastation it causes. I don’t want my doctor to dismiss my hair loss, and I don’t want him/her to tell me it’s no big deal. It is a big deal and if your doctor makes you feel uncomfortable in any way, they he/she is not for you. If possible try and speak with the doctor by phone (believe it or not some doctors will talk to you on the phone first) and if the rules of the office don’t permit this then try and ask as many questions to the receptionist, such as, does Dr. X see a lot of women for hair loss? Does he order blood work? What does he usually prescribe for treatment? The reality of that last question is that their is no “usual treatment” every woman is different and hopefully the receptionist tells you something to that effect. I don’t want to see a doctor that prescribes Rogaine as his/her first line of defense even before making a proper diagnosis with blood work or any other necessary tests. I firmly believe you should not be walking out with a bottle of Rogaine the first day of your appointment. Sure the doctor can probably be able to tell if your hair is experiencing miniaturization, but what about the blood work to determine the causes? Rogaine may be the right treatment for you, but I’d like to know why.


Alopecia areata is not contagious.[9] It occurs more frequently in people who have affected family members, suggesting heredity may be a factor.[9] Strong evidence of genetic association with increased risk for alopecia areata was found by studying families with two or more affected members. This study identified at least four regions in the genome that are likely to contain these genes.[14] In addition, alopecia areata shares genetic risk factors with other autoimmune diseases, including rheumatoid arthritis, type 1 diabetes, and celiac disease.[3] It may be the only manifestation of celiac disease.[15][16]
Alopecia areata is not contagious.[9] It occurs more frequently in people who have affected family members, suggesting heredity may be a factor.[9] Strong evidence of genetic association with increased risk for alopecia areata was found by studying families with two or more affected members. This study identified at least four regions in the genome that are likely to contain these genes.[14] In addition, alopecia areata shares genetic risk factors with other autoimmune diseases, including rheumatoid arthritis, type 1 diabetes, and celiac disease.[3] It may be the only manifestation of celiac disease.[15][16] 

According to practitioners of traditional Chinese medicine, hair health is tied to two things: kidney energy and the blood, which nourish the hair. The solution: acupuncture and Chinese herbs. While there isn't a lot of hard science to back this up, Maureen Conant, a TCM practitioner at Full Bloom Acupuncture in Seattle, says that she's seen women's hair stop falling out and then gradually regenerate after a few months of weekly treatments.
My hair started thining out this past year. I notice my hair falling out when i got pregnant with my son. I got diabetes with my pregnancy. my scalp itches and it hurts. It feels like i had my hair tied up so tight and let it go. it hurts to move my hair. i saw a dermatologist and said it was due to the stress of child birth. it has been over a year and is still falling out. has anyone heard of this and what i can do. My Pcp check my hormone levels and said everything is fine. I need help.
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.
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.
I had embolization and an angiogram for an AVM on my jaw. I was told there would be some hair loss because of the radiation (The size of a quarter). Well I have lost all but 1/3 of my hair left …not the area of a quarter! Has anyone ever had this happen? My doctor says the hair should grow back, but it has been three months and it is still coming out and no new growth. I don’t know what to do! Any suggestion? As with many women my hair was a part of my identity. I am not bragging but people remember me as the girl with all the hair. I realize we are more than our hair, but it makes me so sad!
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. 
Sea salt has the ability to stabilize hormones, alkalize the body (which is SUPER important), and do a plethora of other beneficial things. Due to very weak experimentation by doctors, most people believe the stigma that salt causes high blood pressure and we should avoid salt. It’s true, TABLE (or refined) salt causes blood pressure to rise. Table salt is sucked dry of 80 minerals in order to make it look pure/white. Unrefined light grey salt (aka sea salt) contains 80 minerals our bodies need. It has the ability to LOWER blood pressure, stabilize hormones, correct pH levels, prevent acid reflux, detox, decrease hypertension, strengthen the immune system, helps with chronic fatique, etc, etc…
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